tbuckley/cabot-search huggingface dataset:
Pravastatin for Secondary Prevention of Cardiovascular Events in Persons with Mild Chronic Renal Insufficiency
Authors: Marcello Tonelli, Lemuel Moy, Frank M. Sacks, Bryce Kiberd, Gary Curhan
Journal: Annals of Internal Medicine (2003)

Background: Cardiovascular disease is a common cause of morbidity and death in persons with renal insufficiency. Although 3-hydroxy-3methylglutaryl coenzyme A reductase inhibitors (statins) are effective for secondary prevention of cardiovascular events in the general population, they have not been specifically studied in chronic renal insufficiency. Objective: To determine whether pravastatin is effective and safe for secondary prevention of cardiovascular events in persons with chronic renal insufficiency. Design: Post hoc subgroup analysis of a randomized, double-blind, placebo-controlled trial. Setting: The Cholesterol and Recurrent Events (CARE) study, a randomized trial of pravastatin versus placebo in 4159 participants with previous myocardial infarction and total plasma cholesterol levels less than 6.21 mmol/L (<240 mg/dL). Participants: 1711 participants with chronic renal insufficiency defined by creatinine clearance less than or equal to 75 mL/min, using the Cockcroft–Gault equation. Measurements: The primary outcome was death from coronary disease or symptomatic nonfatal myocardial infarction. Results: After a median follow-up of 58.9 months, the incidence of the primary end point was lower in participants receiving pravastatin than in those receiving placebo (adjusted hazard ratio, 0.72 [95% CI, 0.55 to 0.95]; P = 0.02). Pravastatin was associated with lower adjusted hazard ratios for major coronary events (0.72 [CI, 0.59 to 0.88]; P = 0.001) and coronary revascularization (0.65 [CI, 0.50 to 0.83]; P = 0.001), but not total mortality (0.81 [CI, 0.61 to 1.08]; P = 0.14) or stroke (0.62 [CI, 0.39 to 1.00]; P = 0.051). Tests for interaction suggested that the observed benefit was independent of the presence and severity of renal insufficiency. Incidence of side effects was similar in persons receiving pravastatin and those receiving placebo. Conclusions: These data suggest that pravastatin is effective and appears safe for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. Since statins may be underused in this setting, physicians should consider prescribing them for patients with chronic renal insufficiency and known coronary disease.
NECESSITY FOR MORE CARE IN THE TREATMENT OF SKULL FRACTURES.
Authors: W. H. EARLES
Journal: JAMA (1903)

The substance of this paper is based on the following propositions: 1. Fractures of the skull are not always recognized as such until too late to receive proper treatment. 2. Fractures of the skull when not properly treated at or about the time of the fracture, occasionally result in death. and if not in death in serious remote consequences. 3. Fractures of the skull, when properly treated, usually terminate satisfactorily. Every practitioner is aware that a large number of skull depressions, with their usual concomitants, are constantly forcing themselves on our attention. It is, we believe, right to assume that surgeons are familiar with the mischief that such depressions create, and would not knowingly allow them to remain were they recognized at the time of injury. As no special reasons exist fot these ommission, we are forced to the conclusion that carelessness at the time of the first examination is
Fetuin-A and Incident Diabetes Mellitus in Older Persons
Authors: Joachim H. Ix
Journal: JAMA (2008)

<h3>Context</h3>Fetuin-A is a hepatic secretory protein that binds the insulin receptor and inhibits insulin action in vitro. In prior cross-sectional studies in humans, higher fetuin-A levels were associated with insulin resistance. However, the longitudinal association of fetuin-A with incident type 2 diabetes mellitus is unknown.<h3>Objective</h3>To determine whether fetuin-A levels are associated with incident diabetes in older persons.<h3>Design, Setting, and Participants</h3>Observational study among 3075 well-functioning persons aged 70 to 79 years. In this case-cohort study, we retrospectively measured fetuin-A levels in baseline serum among 406 randomly selected participants without prevalent diabetes, and all participants who developed incident diabetes mellitus during a 6-year follow-up (to August 31, 2005).<h3>Main Outcome Measure</h3>Incident diabetes mellitus.<h3>Results</h3>Incident diabetes developed in 135 participants (10.1 cases/1000 person-years). Participants with fetuin-A levels within the highest tertile (&gt; 0.97 g/L) had an increased risk of incident diabetes (13.3 cases/1000 person-years) compared with participants in the lowest tertile (≤ 0.76 g/L) (6.5 cases/1000 person-years) in models adjusted for age, sex, race, waist circumference, body weight, physical activity, blood pressure level, fasting glucose level, high-density lipoprotein cholesterol concentration, triglyceride concentration, and C-reactive protein level (adjusted hazard ratio, 2.41; 95% confidence interval, 1.28-4.53; P = .007). The association was not affected by adipocytokine levels but was moderately attenuated by adjustment for visceral adiposity (adjusted hazard ratio of highest vs lowest tertile 1.72; 95% confidence interval, 0.98-3.05; P = .06).<h3>Conclusion</h3>Among well-functioning older persons, serum fetuin-A is associated with incident diabetes, independent of other markers of insulin resistance.
ECASS: Lessons for Future Thrombolytic Stroke Trials
Authors: Marc Fisher
Journal: JAMA (1995)

The European Cooperative Acute Stroke Study (ECASS)<sup>1</sup>marks an important milestone along the road toward an effective therapy for acute ischemic stroke. Well-conceived and performed, ECASS is the first large, randomized, blinded study of high-dose intravenous recombinant tissue plasminogen activator (rt-PA) designed to determine if this thrombolytic therapy is efficacious and safe in acute stroke patients. More than 600 patients were recruited within 6 hours of stroke onset at 75 centers in 14 countries, demonstrating that large multinational acute stroke therapy trials are feasible and can accrue patients more rapidly than anticipated. Most importantly, current hypotheses about preventing the conversion of ischemic tissue to completed infarction suggest that early initiation of thrombolytic or neuroprotective therapy<sup>2</sup>is essential. ECASS and the earlier monoganglioside GM1 trial<sup>3</sup>demonstrate that early initiation is possible. See also p 1017. Disappointingly, the intention-to-treat analysis for clinical efficacy revealed no benefit for rt-PA intervention;
Polymyositis and dermatomyositis: no persistence of enterovirus or encephalomyocarditis virus RNA in muscle.
Authors: P J Jongen, G J Zoll, M Beaumont, W J Melchers, L B van de Putte, J M Galama
Journal: Annals of the Rheumatic Diseases (1993)

<h3>Abstract</h3> Human immunodeficiency virus (HIV) infection is associated with a substantially increased risk of non-Hodgkin lymphoma (NHL). High plasma viral load, low CD4+ T cell counts and absence of antiretroviral treatment (ART) are known predictive factors for NHL. Even in the era of suppressive ART, HIV-infected individuals remain at increased risk of developing NHL compared to the general population. To search for human genetic determinants of HIV-associated NHL, we performed case-control genome-wide association studies (GWAS) in three cohorts of HIV+ patients of European ancestry and meta-analyzed the results. In total, 278 cases and 1924 matched controls were included. We observed a significant association with NHL susceptibility in the C-X-C motif chemokine ligand 12 (<i>CXCL12</i>) region on chromosome 10. A fine mapping analysis identified rs7919208 as the most likely causal variant (P = 4.77e-11). The G&gt;A polymorphism creates a new transcription factor binding site for BATF and JUND. Analyses of topologically associating domains and promoter capture Hi-C data revealed significant interactions between the rs7919208 region and the promoter of <i>CXCL12</i>, also known as stromal-derived factor 1 (<i>SDF-1</i>). These results suggest a modulatory role of <i>CXCL12</i> regulation in the increased susceptibility to NHL observed in the HIV-infected population.
Pneumonia during treatment of acute leukaemia.
Authors: M Slevin, A Rohatiner, J S Malpas, A Lister
Journal: BMJ (1981)

there is no standard doctor.Might not reluctance to discuss the problem represent an understandable failing in the physician co come to terms with the illness ?In our experience there is no substitute for the truth when communicating in medicine and it should very rarely be necessary to tell lies to patients.What is required is the ability to explain the nature of the problem clearly and sympathetically in terms that the patient and the relatives can understand and accept.A series of interviews is necessary and it is particularly helpful when husband and wife (or a close relative) can share in some of the discussion.We all know of the pain and suffering caused by acute leukaemia and these can extend far beyond the patient to affect relatives, loved ones, doctors, nurses, medical students, and anyone with whom the patient has contact.When communication has been successful the mututal atmosphere of fear, suspicion, and mistrust which ignorance produces can be dispelled and everyone concerned can con- centrate on looking after the patient.
THE TREATMENT OF PHTHISIS.A Lecture delivered at the Post-Graduate Medical School of Chicago January 23, 1891.
Authors: E. L. SHURLY
Journal: JAMA (1891)

cultivated in the same way as tubercle bacillus.Generation after generation was cultivated by a man as careful as Sattler was known to be.Klein made these cultivations and worked it out thoroughly, and I recall his saying to me, "If there is any one case in which it is proved to de¬ monstration that the bacillus is the virus of dis¬ ease it is this.' ' He made an infusion of the bean in sterilized water, with every precaution against contamination, and inoculated the eyes of eight rabbits, and eight tubes of sterilized peptones.He examined them every day for two or three weeks and not a trace of microorganisms grew in
Peginterferon alpha-2b plus adefovir induce strong cccDNA decline and HBsAg reduction in patients with chronic hepatitis B
Authors: Karsten Wursthorn, Marc Lutgehetmann, Maura Dandri, Tassilo Volz, Peter Buggisch, Bernhard Zollner, Thomas Longerich, Peter Schirmacher, Frauke Metzler, Myrga Zankel, Conrad Fischer, Graeme Currie, Carol Brosgart, Joerg Petersen
Journal: Hepatology (2006)

Hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) is responsible for persistent infection of hepatocytes. The aim of this study was to determine changes in intrahepatic cccDNA in patients with chronic hepatitis B (CH-B) during 48 weeks of antiviral therapy and its correlation to virological, biochemical, and histological parameters. Twenty-six HBsAg-positive CH-B patients received combination treatment with pegylated interferon alpha-2b (peg-IFN) and adefovir dipivoxil (ADV) for 48 weeks. Paired liver biopsies from before and at the end of treatment were analyzed for intrahepatic HBV-DNA. Median serum HBV-DNA had decreased by −4.9 log10 copies/mL at the end of treatment and was undetectable in 13 individuals (54%). Median intrahepatic total HBV-DNA and cccDNA had decreased by −2.2 and −2.4 log10, respectively. Changes in intracellular HBV-DNA positively correlated with HBsAg serum reduction and were accompanied by a high number of serological responders. Eight of 15 HBeAg-positive patients lost HBeAg, and five developed anti-HBe antibodies during treatment. These eight patients exhibited lower cccDNA levels before and at the end of therapy than did patients without HBeAg loss. Four patients developed anti-HBs antibodies. ALT normalized in 11 patients. The number of HBs-antigen- and HBc-antigen-positive hepatocytes was significantly lower after treatment, suggesting the involvement of cytolytic mechanisms. In conclusion , combination therapy with peg-IFN and ADV led to marked decreases in serum HBV-DNA and intrahepatic cccDNA, which was significantly correlated with reduced HBsAg.
The Schizophrenia Cognition Rating Scale: An Interview-Based Assessment and Its Relationship to Cognition, Real-World Functioning, and Functional Capacity
Authors: Richard S.E. Keefe, Margaret Poe, Trina M. Walker, Joseph W. Kang, Philip D. Harvey
Journal: American Journal of Psychiatry (2006)

Interview-based measures of cognition may serve as potential coprimary measures in clinical trials of cognitive-enhancing drugs for schizophrenia. However, there is no such valid scale available. Interviews of patients and their clinicians are not valid in that they are unrelated to patients' levels of cognitive impairment as assessed by cognitive performance tests. This study describes the reliability and validity of a new interview-based assessment of cognition, the Schizophrenia Cognition Rating Scale (SCoRS), that involves interviews with patients and informants.Sixty patients with schizophrenia were assessed with the SCoRS and three potential validators of an interview-based measure of cognition: cognitive performance, as measured by the Brief Assessment of Cognition in Schizophrenia (BACS); real-world functioning, as measured by the Independent Living Skills Inventory; and functional capacity, as measured by the University of California, San Diego, Performance-Based Skills Assessment (UPSA).The SCoRS global ratings were significantly correlated with composite scores of cognitive performance and functional capacity and with ratings of real-world functioning. Multiple regression analyses suggested that SCoRS global ratings predicted unique variance in real-world functioning beyond that predicted by the performance measures.An interview-based measure of cognition that included informant reports was related to cognitive performance as well as real-world functioning. Interview-based measures of cognition, such as the SCoRS, may be valid coprimary measures for clinical trials assessing cognitive change and may also aid clinicians desiring to assess patients' level of cognitive impairment.
BMS-214662 induces mitochondrial apoptosis in chronic myeloid leukemia (CML) stem/progenitor cells, including CD34+38− cells, through activation of protein kinase Cβ
Authors: Francesca Pellicano, Mhairi Copland, Heather G. Jorgensen, Joanne Mountford, Brian Leber, Tessa L. Holyoake
Journal: Blood (2009)
Cardiovascular Events in Diabetic and Nondiabetic Adults With or Without History of Myocardial Infarction
Authors: Chong Do Lee, Aaron R. Folsom, James S. Pankow, Frederick L. Brancati
Journal: Circulation (2004)

Whether diabetic patients without a history of myocardial infarction (MI) have the same risk of coronary heart disease (CHD) events as nondiabetic patients with a history of MI remains controversial. We compared risks of CHD and stroke events and mortality from cardiovascular disease (CVD) in diabetic and nondiabetic men and women with and without a history of MI.We followed a total of 13 790 African American and white men and women ages 45 to 64 years who participated in the Atherosclerosis Risk in Communities study, beginning in 1987 to 1989. There were 634 fatal CHD or nonfatal MI events, 312 fatal or nonfatal strokes, and 358 deaths from CVD during an average of 9 years of follow-up (125 998 person-years). After adjustment for age, sex, race, Atherosclerosis Risk in Communities field center, and multiple baseline risk factors, patients who had a history of MI without diabetes at baseline had 1.9 times the risk of fatal CHD or nonfatal MI (95% CI, 1.35 to 2.56; P<0.001) compared with diabetic patients without a prior history of MI. The nondiabetic patients with MI also had 1.8 times the risk of CVD mortality compared with diabetic patients without MI (95% CI, 1.22 to 2.72; P=0.003). However, stroke risk was similar between diabetic patients without MI and nondiabetic patients with MI (RR, 1.05; 95% CI, 0.61 to 1.79; P=0.87). We also observed that nondiabetic patients with MI had a carotid artery wall thickness similar to diabetic patients without MI (P=0.77).Diabetic patients without MI had lower risk of CHD events and mortality from CVD compared with nondiabetic patients with MI, but stroke risk was similar between these 2 groups.
Eosinophilie Leukemia
Authors: DAN S. BENVENISTI
Journal: Annals of Internal Medicine (1969)

The clinical, laboratory, and autopsy findings of eosinophilic leukemia in five cases seen by the authors and in 43 patients reported in the literature were reviewed. Heart failure, respiratory distress, central nervous system manifestations, and fever were characteristic symptoms. Hepatosplenomegaly was found in 31 patients and lymphadenopathy in 26 patients. Marked eosinophilia occurred in 48, leukocytosis in 37, blast forms in 27, shift to the left in 25, and normoblasts in 11 of the 48 cases. Bone marrow biopsy revealed fibrosis in three patients. Therapy failed in all instances, and 39 patients died within 12 months. At postmortem examination the liver, spleen, lymph nodes, bone marrow, heart, lung, central nervous system, skin, and other organs were infiltrated with eosinophilic granulocytes. Chloroma or myeloblastoma was found in six patients. Mural thrombi were present in 15, eosinophilic infiltration of myocardium in 18, and thromboses of small vessels of the heart, lung, or brain in 10 cases. Eosinophilic leukemia can manifest features of the myeloproliferative as well as the hyperallergic disorders.
Endoscopic Biopsies from Normal-Appearing Terminal Ileum and Cecum in Patients with Suspected Colonic Tuberculosis
Authors: S. P. Misra, M. Dwivedi, V. Misra, M. Gupta, B. K. Kunwar
Journal: Endoscopy (2004)

Colonic tuberculosis is generally diagnosed by colonoscopy and targeted biopsy of lesions. However, the diagnostic yield of colonic biopsies is not very good. So far as we are aware, there have been no studies investigating the role of biopsies from endoscopically normal-appearing cecum and terminal ileum in diagnosing colonic or ileal tuberculosis, or both.Patients with a clinical suspicion of colonic tuberculosis, in whom no endoscopic abnormalities were found on colonoscopy or ileoscopy, were included in the study. Multiple biopsies were obtained from the cecum and ileum.Fifty patients were studied. Intubation of the terminal ileum was possible in 43 patients (86 %). Histological examination of biopsies obtained from the cecum and terminal ileum showed noncaseating granuloma in two patients. Both of these biopsies were from the terminal ileum. In two other patients, collections of loosely arranged epithelioid cells were observed. This established the diagnosis in these four patients (8 %). In the remaining 46 patients, histology showed nonspecific inflammation in 18 patients (in the cecum in 15 and in the terminal ileum in seven). The other biopsies did not show any abnormalities (33 from the cecum, 34 from the terminal ileum).Histological examination of biopsies from the normal-appearing cecum and terminal ileum is useful in a small but significant number of patients with colonic tuberculosis.
EVISCERATION OF THE EYEBALL.
Authors: L. WEBSTER FOX
Journal: JAMA (1895)

This operation must not be confounded with abscission, although both are somewhat similar in character. The latter operation has been abandoned by the majority of ophthalmic surgeons on account of its risks. Evisceration first consists in excising the cornea and thoroughly removing the contents of the globe, and replacing the vitreous with a glass globe. Abscission of the cornea, as suggested by the older Critchett, was, probably, the best of this dangerous operation. In it, no attempt was made toward emptying the contents of the globe. We are indebted to three English surgeons for bringing evisceration prominently before the notice of the profession practically. Mules, of Manchester, first operation was performed in October, 1884. Brudnell Carter, who modified the abscission operation of Critchett some years ago, is now one of evisceration's most ardent advocates, while Bickerton, of Liverpool, performs it preferably to enucleation. Frolich was the first surgeon to perform
Hereditary Cancer Predisposition Syndromes
Authors: Judy E. Garber, Kenneth Offit
Journal: Journal of Clinical Oncology (2005)

Cancer genetics is increasingly becoming integrated into the practice of modern medical oncology. The ability to distinguish a growing proportion of the 5% to 10% of all cancers that develop in individuals who have inherited a genetic mutation conferring heightened susceptibility to specific cancers may permit targeted efforts in cancer surveillance and prevention. While these individuals comprise a small proportion of the overall burden of cancer, strategies successful in reducing their remarkable cancer risks may be generalizable to the broader population. In this review, we highlight the most common hereditary cancer syndromes, most attributable to genes inherited in an autosomal dominant manner with incomplete penetrance, and a number of rare syndromes in which particular progress has been made. The prevalence, penetrance, tumor spectrum, and underlying genetic defects are discussed and summarized in a large table in which a more comprehensive enumeration of syndromes is provided.
Review: Third-generation P2Y<sub>12</sub>inhibitors reduce mortality after PCI more than clopidogrel
Authors: William B. Hillegass
Journal: Annals of Internal Medicine (2011)

Source Citation Bellemain-Appaix A, Brieger D, Beygui F, et al. New P2Y12 inhibitors versus clopidogrel in percutaneous coronary intervention: a meta-analysis. J Am Coll Cardiol. 2010;56:1542-51. 20800407
Antisense oligonucleotides from the stage-specific myeloid zinc finger gene MZF-1 inhibit granulopoiesis in vitro.
Authors: L Bavisotto, K Kaushansky, N Lin, R Hromas
Journal: The Journal of Experimental Medicine (1991)

Zinc finger proteins are transcriptional regulators of other genes, often controlling developmental cascades of gene expression. A recently cloned zinc finger gene, MZF-1, was found to be preferentially expressed in myeloid cells. Using complementary radiolabeled MZF-1 RNA hybridized to human bone marrow smears in situ, it was discovered that the expression of MZF-1 is essentially limited to the myelocyte and metamyelocyte stages of granulopoiesis. Antisense but not sense oligonucleotides from MZF-1 significantly inhibited granulocyte colony-stimulating factor-driven granulocyte colony formation in vitro.
Genetics and the Law II
Authors: Walter G. Gunn
Journal: JAMA (1981)

In 1975 an illustrious group of experts convened to discuss developments in law and genetics with subsequent publication of that symposium on<i>Genetics and the Law</i>the following year. It was a general introduction to the field but tackled such specific questions as the XYY controversy, fetal experimentation, rights of the fetus, and cloning. The second national conference in Boston in 1979 presents its proceedings in the volume at hand. Fortunately, the material is well edited and organized and has avoided repetition of previous subjects. Since the whole field is almost brand-new, much of the subject matter is uneven and rough-cut, controversial and thought-provoking, and—like its subject—partly formed. The section on government intrusion into scientific research, for example, is a blend of sober discussion, outrage, and calm resignation from an able group of discussants. It is as current as this week'sJournalin pondering the problems inherent in research and