tbuckley/cabot-search huggingface dataset:
Microalbuminuria: Implications for micro- and macrovascular disease
Authors: Torsten Deckert, Allan Kofoed-Enevoldsen, Kirsten Nørgaard, Knut Borch-Johnsen, Bo Feldt-Rasmussen, Tonny Jensen
Journal: Diabetes Care (1992)

Microalbuminuria is diagnosed when the UAER is greater than 20 but less than 200 micrograms/min. The prevalence of microalbuminuria among diabetic patients is 15-20%. Persistent microalbuminuria in diabetic patients is a risk marker not only of renal disease, but also of proliferative retinopathy and cardiovascular morbidity and mortality. Even among nondiabetic individuals, those with microalbuminuria tend to have an increased cardiovascular morbidity. The established cardiovascular risk factors, such as smoking, elevated plasma cholesterol, fibrinogen, and hypertension, are seen more frequently in diabetic patients with persistent microalbuminuria than in normoalbuminuric diabetic patients of similar age, sex, and diabetes duration. However, these risk factors cannot by themselves explain the cardiovascular overmortality in these patients. In addition, insulin resistance or genetic disposition to hypertension or cardiovascular disease fails to be the missing link. Accumulating evidence suggests a common pathogenetic mechanism for microalbuminuria and premature atherosclerosis (i.e., qualitative alterations of the extracellular matrix, including decreased density and sulfation of HS-PG). Decreased density of HS in the glomeruli may lead to albuminuria and mesangial proliferation. In the intima of large vessel walls, decreased density and/or sulfation of HS may enhance several of the processes involved in premature atherosclerosis. Diabetes affects the composition and structure of the extracellular matrix in many ways and leads to decreased density and sulfation of HS-PG by several mechanisms. Genetic differences in the sulfation of HS and/or genetic defects in the coordinated biosynthesis of HS-PG might contribute to decreased concentration and sulfation of HS-PG in susceptible individuals. It is hoped that susceptibility genes can be identified soon, thereby making prevention of severe late diabetic complications more successful.
Noninvasive Assessment of Myocardial Viability
Authors: George A. Beller
Journal: New England Journal of Medicine (2000)

Despite advances in medical therapy and improvements in techniques for myocardial revascularization, the prognosis remains poor for patients with ischemic cardiomyopathy, which is characterized by extensive coronary artery disease and diminished global left ventricular function. Five-year rates of survival range from 50 to 60 percent. Survival is worse as the left ventricular ejection fraction decreases, the extent of coronary artery disease increases, and the age of the patient increases.1 Chronic left ventricular dysfunction in patients with ischemic cardiomyopathy most often results from either scarring, as a consequence of myocardial necrosis, or myocardial hibernation. The presence of myocardial hibernation suggests that . . .
THROMBOASPIRATION BEFORE PRIMARY PCI IN STEMI PATIENTS REDUCES INFARCT SIZE, BUT NOT MICROVASCULAR OBSTRUCTION: A MAGNETIC RESONANCE IMAGING STUDY
Authors: Nicolas F. Meneveau, Vincent Descotes-Genon, Romain Chopard, Joanna Dutheil, Marie-France Seronde, Florent Briand, Francois Schiele
Journal: Journal of the American College of Cardiology (2010)
Abstract P3-09-03: Final result of randomised controlled phase II study of the efficiency of palonosetron, aprepitant, and dexamethasone for day1 with or without dexamethasone on days2 and 3
Authors: Y Kosaka, N Sengoku, N Minatani, M Kikuchi, H Nishimiya, M Waraya, T Enomoto, M Kuranami, H Tanino, M Watanabe
Journal: Cancer Research (2013)

Abstract Background: Emesis is one of the major non-hematologic toxicity caused by chemotherapy. The control of Chemotherapy Induced Nausea and Vomiting (CINV) is conducted to a life lengthening. Recently, CINV is controlled by the second generation 5-HT3 receptor blocker (Palonosetron; PALO) and a NK-1 receptor antagonist (Aprepitant; APR). It has been shown that dexamethasone (DEX) with 5-HT3 receptor blocker improves acute / delayed CINV. However, it has not been determined the medication schedule for DEX with PALO and APR. The purpose of this study is evaluated the efficiency of palonosetron, aprepitant and dexamethasone for day1 with or without dexamethasone on days2 and 3. This is final result of current study. Methods: Breast cancer patients who administered anthracyclin drug regimen have been eligible from April, 2011 to June, 2013. The patients were randomised to group A (PALO/APR/DEX one day) and group B (PALO/APR/DEX three days). Trial designAprepitant125mg80mg80mg Palonosetron0.75mg dexamethasone9.9mg6.6 mg or placebo6.6 mg or placebo Chemotherapydo days12345 Eighty patients were estimate as study samples. The primary endpoint was a complete response (CR) rate of vomiting, the secondary endpoint was a complete control (CC) rate of vomiting. Results: Eighty two patients were enrolled in this study. There was not inferiority about CR rate of five days after chemotherapy (81.1% of group A, 82.1% of group B). CC rate of group A (62.2%) was better than that of group B (46.2%). However, CC rate was no significant difference between group A and B. There was no significant difference about any level of nausea between group A and B. Conclusions: One day of dexamethasone with Palonosetron and Aprepitant treatment is enough to control the emesis of high emetogenic chemotherapeutic agents. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-09-03.
Practice Guidelines and Prediction Rules Should Be Subject to Careful Clinical Testing
Authors: Scott Weingarten
Journal: JAMA (1997)

Practice guidelines, prediction rules, and protocols are now everywhere. During the past decade, a number of guidelines and prediction rules have become available to assist clinicians and patients in the diagnosis and treatment of many different conditions. Whether clinical recommendations are expressed as clinical practice guidelines, prediction rules, or protocols the intent is clear: to inform medical decisions and to decrease variations in care by systematically influencing clinical decisions. Specifically, the goal is to change the way we care for patients. In the past, there have been few intrusions in the privacy of the physician-patient relationship, and some clinicians are bcoming concerned that prediction rules and guidelines will devalue the "art of medicine" and threaten clinical autonomy. See also p 1935. Other clinicians may dismiss guidelines and prediction rules as another fad in health care management that will be replaced by the next up-and-coming fad. In support of their argument
Authors' reply to Moore and Smith and colleagues
Authors: L. Doyal, T. Muinzer
Journal: BMJ (2012)

We are glad that Moore, Hunter’s contemporary biographer, agrees with our argument.1 2 

Smith and colleagues accept that Byrne wanted to be buried intact. Hunter knew his wishes yet boiled him down to create a skeleton.3 Many people at the time were morally outraged (and still are) by body snatching. The authors claim that modern medical ethics exist to …
The Meaning of Jacksonian Epilepsy
Authors: Max Levin
Journal: JAMA (1965)

<h3>To the Editor:—</h3> The editorial on John Hughlings Jackson (<i>JAMA</i><b>189</b>:692 [Aug 31] 1964) calls for two comments. The editorial says that Jacksonian epilepsy "is characterized by progression of local spasm, usually unilateral, with retention of consciousness." I believe the intended meaning is correct, but the reader may find the statement ambiguous. The Jacksonian seizure<i>always</i>starts with unilateral spasm. The spasm<i>may</i>progress to become bilateral. Consciousness<i>may</i>be lost, but, if so, it is late in the seizure, never at the start. The editorial says that "Jackson preferred the term 'cortical epilepsy'...." for what we today speak of as Jacksonian epilepsy. The truth is quite to the contrary: Jackson objected to this term. Thus he wrote (<i>Selected Writings of John Hughlings Jackson</i>, vol 1, 415): "I do not use the term 'cortical epilepsy,' because both epileptic and epileptiform seizures are, to my thinking, cortical fits."
Catabolism of heme in vivo: comparison of the simultaneous production of bilirubin and carbon monoxide
Authors: Stephen A. Landaw, Edward W. Callahan, Rudi Schmid
Journal: Journal of Clinical Investigation (1970)

The quantitative relationship between the catabolism of heme and the formation of bilirubin and carbon monoxide (CO) was studied in untreated rats and in animals treated with phenobarbital or the porphyrogenic drug, allylisopropylacetamide (AIA). A novel metabolic chamber permitting continuous collection of the bile and breath was utilized for quantitation of bilirubin-14C and 14CO after the administration of hematin-14C or glycine-14C.
Methanethiol poisoning. Irreversible coma and hemolytic anemia following inhalation
Authors: W. T. Shults
Journal: JAMA (1970)

A 53-year-old man was hospitalized because of coma appearing shortly after exposure to methanethiol. Acute, severe hemolytic anemia and methemoglobinemia developed: both were brief in duration. The likely mechanism of the hemolysis was an oxidant effect of methanethiol in a person deficient in erythrocytic glucose-6-phosphate dehydrogenase (G-6-PD). Deep coma persisted until death 28 days after exposure to the chemical agent.
Immunisation and brain damage.
Authors: W Ehrengut
Journal: BMJ (1977)

with permanent injury.These injuries had usually been caused by collision with other swimmers or the side or bottom of the pool rather than by the catapult effect described.The cases described by Dr J6nasson emphasise the seriousness of injuries which may be associated with the use of this popular type of goggle which incorporates a strong elastic band.In the light of these reports the society is continuing to discourage their use during teaching sessions and proposes to seek the opinion of other organisations responsible for other aquatic activities.
Treatment of Cutaneous Sclerosis and Aplastic Anemia with Antithymocyte Globulin
Authors: Edward P. Balaban, Richard G. Sheehan, Peter E. Lipsky, Eugene P. Frenkel
Journal: Annals of Internal Medicine (1987)

We administered antithymocyte globulin to a 52-year-old man with cutaneous sclerosis (scleroderma) and severe aplastic anemia for treatment of the aplastic lesion. The use of this therapy resulted not only in marrow recovery but also in resolution of the sclerosis. This observation indicates that T lymphocytes, their products, or both, are important factors in the pathogenesis of cutaneous sclerosis. Furthermore, the success of this treatment could play a role in future investigations involving the treatment of scleroderma and scleroderma-like conditions.
802 TAIWAN AFP-CHILD-TUMOR (TCAT) SCORE FOR HAPATOCELLULAR CARCINOMA: A NEW PROGNOSTIC SCORING SYSTEM WITH ADEQUATE GROUPING AND REASONABLE WEIGHT OF PREDICTORS
Authors: S.-N. Lu, J.-H. Wang, C.-Y. Lin, Y.-H. Yen, K. Kee, C.-S. Changchien, T.-H. Hu, C.-M. Lee
Journal: Journal of Hepatology (2009)
Evaluation of the Clinical Management of Cancer Patients
Authors: Raymond E. Lenhard, T. Phillip Waalkes, David Herring
Journal: JAMA (1983)

The Johns Hopkins Oncology Center, Baltimore, has carried out a pilot study of a method of data collection and analysis to be used for planning and evaluation of continuing education programs conducted in the Maryland region. This study includes definition of techniques used to prepare a test instrument that will accurately reflect actual medical practice within a hospital. The system has been field tested in three diseases, cancer of the lung, breast, and uterine cervix, in two Maryland hospitals. The system appears to be an efficient and inexpensive method for definition of decision making in specific clinical settings and for measurement of change if serial reassessment is instituted.
Autonomic Mechanisms in Hemodynamic Responses to Isometric Exercise
Authors: C. Edwin Martin, James A. Shaver, Donald F. Leon, Mark E. Thompson, Pesara S. Reddy, James J. Leonard
Journal: Journal of Clinical Investigation (1974)

Selective autonomic blockade with intravenous propranolol, practolol, atropine, and combined atropine-propranolol was utilized to elucidate the role of the autonomic nervous system in the hemodynamic responses in young adult male volunteers to handgrip sustained at 30% of maximal voluntary contraction for 3 min. The initial 30 s of the tachycardia response was found to be mediated by withdrawal of vagal dominance, as evidenced by blockade of this response by prior atropinization. The mid and late portion of the heart rate response curve was demonstrated to be sympathetic in origin, since it was unaffected by atropine, but was suppressed by combined atropine-propranolol blockade. Sympathetic stimulation appears to be a secondary mechanism for increasing the heart rate, however, as it becomes operative only after the first mechanism of vagal withdrawal has been utilized. This was confirmed by the finding that beta adrenergic receptor blockade alone had little effect on the heart rate response curve.
Abstract 5640: KRAS and BRAF in rectal cancer treated with preoperative chemoradiotherapy
Authors: Jochen Gaedcke, Marian Grade, Klaus Jung, Hendrik A. Wolff, Tim Beissbarth, Heinz Becker, Thomas Ried, Michael Ghadimi
Journal: Cancer Research (2010)

Abstract KRAS and BRAF are mutated in 35% and 10% of colorectal cancers, respectively. However, data for locally advanced rectal cancer patients specifically are scarce and the frequency of KRAS mutations in codons 61 and 146 remains to be established. Therefore DNA was isolated from pretherapeutic biopsies of 94 patients who were treated within the clinical trials receiving preoperative chemoradiotherapy. Mutation status of KRAS exon 1-3 as well as BRAF exon 15 was established using ABI PRISM Big Dye Sequencing Kit and subsequently correlated with clinical parameters. KRAS was mutated in 49 patients (52%). 29 mutations (64%) were located in codon 12, ten (22%) in codon 13, and three (7%) in each codons 61 and 146. No V600E BRAF mutation was detected. The presence of KRAS mutations was not correlated with tumor response or lymph node status after preoperative chemotherapy. When KRAS exon 1 mutations were separated based on the amino acid exchange, we again failed to detect significant correlations (p=0.052). However, G12V mutations appeared to be associated with higher rates of tumor regression than G13D mutations (p=0.0124). We are therefore the first to report the mutation status of KRAS and BRAF in pretherapeutic biopsies. The high number of KRAS mutations in codons 61 and 146 emphasizes the importance to expand current mutation analyses whereas BRAF mutations are not relevant for carcinogenesis. Although KRAS mutation status was not correlated with response, the subtle difference between G12V and G13D mutations warrants analysis of a larger patient population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5640.
Racial Differences in the Survival of Cadaveric Renal Allografts
Authors: Donald E. Butkus, Edward F. Meydrech, Seshadri S. Raju
Journal: New England Journal of Medicine (1992)

The long-term survival of cadaveric renal allografts is lower in black recipients than in white recipients, although the one-year graft survival is similar in these racial groups. We sought to determine what factors account for this disparity.
Push-up Palmar Palsy
Authors: Francis O. Walker
Journal: JAMA (1988)

<h3>To the Editor.</h3> —Despite their occasional use as punishment, push-ups are widely and voluntarily practiced by our fitness-conscious population. We would like to report a previously undescribed but preventable complication of this activity. <h3>Report of a Case.</h3> —Following several weeks of a program of persistent push-ups on a hard floor, an otherwise healthy, 38-year-old man developed progressive weakness and atrophy of the left hand. Initially he had noted a brief bout of pain in the base of his palm, but when weakness developed he discontinued the push-ups. In the first four weeks he had only partial return of strength. Examination revealed atrophy and weakness of his first dorsal and other interosseous muscles, with preserved hypothenar bulk, fifth digit abduction, and sensation. Electrodiagnostic studies showed an absent ulnar motor-evoked response, marked spontaneous resting activity, and absent motor unit potentials in the left first dorsal interosseous muscles. However, results of ulnar sensory,
Differential regulation of the 2′,3′-cyclic nucleotide 3′-phosphodiesterase gene during oligodendrocyte development
Authors: Steven S. Scherer, Peter E. Braun, Judith Grinspan, Ellen Collarini, D.-y. Wang, John Kamholz
Journal: Neuron (1994)

The two major isoforms of 2',3'-cyclic nucleotide phosphodiesterase (CNP), 48 and 46 kDa, have recently been shown to be produced from a single gene by alternative splicing. In addition, messenger RNA encoding the larger isoform is transcribed from a separate promoter, approximately 1 kb upstream from that encoding the smaller isoform. We have investigated the expression of these two CNP isoforms and have found that they are differentially expressed during the process of oligodendrocyte maturation. In oligodendrocyte precursors, only the mRNA encoding the larger protein is found. At the time of oligodendrocyte differentiation, however, both CNP mRNAs are induced. These patterns of CNP expression are likely due to stage-specific transcriptional regulation of the two CNP promoters during the process of oligodendrocyte differentiation.
Chronic lymphocytic leukemia supervening in non-Hodgkin's lymphoma (diffuse, mixed-cell type)
Authors: Norimasa Yasuda, Sei-Ichi Ohmori, Tadao Usui
Journal: American Journal of Hematology (1997)

administered to reduce the drug's cost, remains to be determined.This case demonstrates that a short-term regimen of erythropoietin and iron supplementation may allow high-dose chemotherapy to be offered to those individuals unwilling to accept blood products.
The Safety Sphincterotome: The Device, the Technique and Preliminary Results
Authors: D. F. Martin, R. England, O. Martin
Journal: Endoscopy (1998)

Endoscopic sphincterotomy is a widely used and safe procedure for the management of common bile duct stones, but little attention has been paid to the design of the sphincterotome and its influence upon risk of sphincterotomy. This study was undertaken to evaluate a sphincterotome, designed to incorporate known and original aspects which may contribute to safety.144 patients with bile duct stones were evaluated in an open prospective study of the use of the sphincterotome in performing endoscopic sphincterotomy. Evaluation included post-sphincterotomy complications, 30-day morbidity and mortality and effective duct clearance.Only one complication (0.7%) occurred in the group of 144 patients. Duct clearance of stones was ultimately achieved in 94%.Whilst more experience is necessary using the sphincterotome in the manner described, the absence of significant complications in all but one patient appears to support the philosophy behind the design of the sphincterotome.
Proapoptotic Effects of Caspase-1/Interleukin-Converting Enzyme Dominate in Myocardial Ischemia
Authors: Faisal M. Syed, Harvey S. Hahn, Amy Odley, Yiru Guo, Jesus G. Vallejo, Roy A. Lynch, Douglas L. Mann, Roberto Bolli, Gerald W. Dorn
Journal: Circulation Research (2005)

Caspase-1/interleukin-converting enzyme (ICE) is a cysteine protease traditionally considered to have importance as an inflammatory mediator, but not as an apoptotic effector. Because of the dual functions of this caspase, the pathophysiological impact of its reported upregulation in hypertrophy and heart failure is not known. Here, the consequences of increased myocardial expression of procaspase-1 were examined on the normal and ischemically injured heart. In unstressed mouse hearts with a 30-fold increase in procaspase-1 content, unprocessed procaspase-1 was well tolerated, without detectable pathology. Cardiomyocyte processing and activation of caspase-1 and caspase-3 occurred after administration of endotoxin or with transient myocardial ischemia. In post-ischemic hearts, procaspase-1 overexpression was associated with strikingly increased cardiac myocyte apoptosis in the peri- and noninfarct regions and with 50% larger myocardial infarctions. Tissue culture studies revealed that procaspase-1 processing/activation is stimulated by hypoxia, and that caspase-1 acts in synergy with hypoxia to stimulate caspase-3 mediated apoptosis without activating upstream caspases. These data demonstrate that the proapoptotic effects of caspase-1 can significantly impact the myocardial response to ischemia and suggest that conditions in which procaspase-1 in the heart is increased may predispose to apoptotic myocardial injury under conditions of physiological stress.
Progress is slow in narrowing the health research divide
Authors: K. Abbasi
Journal: BMJ (2001)

Progress has been slow in addressing the research needs of the developing world, speakers and delegates at last week's fifth global forum for health research in Geneva conceded.

The aim of the conference was to assess progress in addressing the disparity between the global burden of disease and health research in the world's poorest countries. This is the so called 10/90 gap, whereby only 10% of the estimated yearly £47bn ($70bn) spent on health research is used to research 90% of the world's health problems.

“Things have moved on but maybe not …
The oxygen free radical system: from equations through membrane-protein interactions to cardiovascular injury and protection
Authors: R. C Kukreja, M. L Hess
Journal: Cardiovascular Research (1992)

Highly toxic oxygen radicals and their metabolites have been implicated in the pathogenesis of ischaemia/ reperfusion injury. These reactive oxygen species include the superoxide anion, hydrogen peroxide, hydroxyl radical, and singlet oxygen. The central theme of this review is first to discuss the basic mechanisms of free radical generation from various potential sources, to point out and emphasise the growing importance of the role of singlet oxygen, and then to discuss in depth membrane-protein interactions that ultimately lead to myocardial damage and dysfunction. With this background, we highlight several novel therapeutic strategies aimed at interrupting the oxygen free radical mediated component of ischaemia/reperfusion injury. It is hoped that this thesis will then serve as a future impetus to challenge these hypotheses and further build on this truly unique system that has assumed such an important role in the pathophysiology of myocardial ischaemia/reperfusion and inflammation. "To those of us who are humbly exploring the mysteries of science, we must project our findings and model our systems. For if correct, we have made a small contribution and, if wrong, we have forced others to eventually think." A V Hill, on the occasion of the 50th anniversary of E H Starling's Linacre lecture (University College, London, 1968).