tbuckley/cabot-search huggingface dataset:
Primary Ventricular Tachycardia in Acute Myocardial Infarction: Clinical Characteristics and Mortality
Authors: Michael Eldar, Zahavit Sievner, Uri Goldbourt, Henrietta Reicher-Reiss, Elieser Kaplinsky, Solomon Behar
Journal: Annals of Internal Medicine (1992)

To examine the immediate and long-term clinical and prognostic significance of primary ventricular tachycardia, defined as tachycardia of ventricular origin occurring within 48 hours of acute myocardial infarction in patients without hemodynamic compromise (Killip class I).Prospective cohort study.Intensive coronary care units in eight regional, referral, and university hospitals.A total of 162 patients with primary ventricular tachycardia, both sustained and nonsustained (study group), and 2578 counterparts without ventricular tachycardia (reference group).In-hospital rates of atrial fibrillation, atrioventricular block, congestive heart failure, cardiogenic shock, and cardiac arrest. In-hospital and 1-year follow-up rates of sudden death, nonsudden cardiac death, and noncardiac death.The study and reference groups had similar mortality (in-hospital, 6.8% and 9.6%, P greater than 0.2 and at 1 year after discharge, 3.7% and 5.4%, P greater than 0.2, respectively) and in-hospital complication rates (atrioventricular block, 13.0% and 9.7%, P greater than 0.2; cardiogenic shock, 3.7% and 3.0%, P greater than 0.2; cardiac arrest, 1.8% and 4.4%, P greater than 0.2, respectively). Patients with sustained ventricular tachycardia (28 patients) compared with those with nonsustained ventricular tachycardia (134 patients) had higher rates of polymorphic tachycardia (50% compared with 6%, P = 0.001), in-hospital total cardiac mortality (21% compared with 4%, P = 0.003) and sudden-death mortality (14% compared with 2%, P = 0.001); they also showed a trend toward a higher in-hospital mortality than the reference group (21.4% compared with 9.6%, P = 0.15) but had no increased mortality 1 year after discharge (4.6% compared with 5.4%, P greater than 0.2).As a group, patients with primary ventricular tachycardia do not differ from counterparts without primary ventricular tachycardia in their in-hospital clinical course and 1-year prognosis. Primary sustained ventricular tachycardia is often polymorphic and carries worse in-hospital prognosis than nonsustained tachycardia. However, it does not predict recurrent ventricular tachycardia or increased sudden-death rates during the next year.
The Physician, the Patient, and Statistics
Authors: Ernest L. Wynder
Journal: JAMA (1963)

MAN'S APPARENT LACK OF CONCERN for factors that contribute to disease presents an important challenge to those dedicated to the prevention of disease and the maintenance of health. Both the physician and the patient are faced with this challenge. Granting that a given clinical or laboratory finding is followed by a higher than average risk of incurring a given disease, there is still great difficulty in translating this concept of increased risk to the individual patient. This difficulty is increased by the fact that the risk is still relatively small for the individual patient if the period of increased risk considered is short. But even a small annual risk can become important when one considers its effect over periods of such length as to be beyond the physician's willingness or ability to project. The physician's difficulties are compounded further when the finding indicative of increased risk is not of
Suppression of Retinoic Acid Receptor–β in Premalignant Oral Lesions and Its Up-Regulation by Isotretinoin
Authors: Reuben Lotan, Xiao-Chun Xu, Scott M. Lippman, Jae Y. Ro, Jin S. Lee, J. Jack Lee, Waun K. Hong
Journal: New England Journal of Medicine (1995)

Retinoids are effective in the treatment and prevention of certain human cancers. Most of their actions are thought to result from changes in gene expression mediated by nuclear retinoic acid receptors and retinoid X receptors. We conducted a study to determine whether the expression of these receptors was altered in premalignant oral lesions and, if so, whether their expression could be restored by treatment with isotretinoin.
Whistle blowing consultant suspended again
Authors: R. Dobson
Journal: BMJ (2003)

A whistle blowing orthopaedic consultant has been suspended for a second time. Sian Caiach initially went on to what was described as extended maternity leave in 2000 when allegations were made about her clinical practice. Those allegations were made shortly after the Audit Commission began to investigate complaints she made about private practice at Prince Philip Hospital, Llanelli.

That investigation found that because of changes in the way doctors conducted private practice, the hospital had lost income, private patients were not correctly charged for prostheses, and private outpatients were not …
CAN WE ACHIEVE A BENEFIT IN ALL-CAUSE MORTALITY BY ROUTINE CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY IN ASYMPTOMATIC DIABETIC PATIENTS?
Authors: Byung-Hee Hwang, Sungmin Lim, Ik Jun Choi, Mineok Chang, Jin Jin Kim, Donggyu Moon, Jae Gyung Kim, Eun ho Choo, Minkyu Kang, Byung-Hee Hwang, Tae-Hun Kim, Suk Min Seo, Yoon Seuk Koh, Pum Joon Kim, Kiyuk Chang, Wook Sung Chung, Ki-Bae Seung
Journal: Journal of the American College of Cardiology (2013)
Married Quarters in Hospital
Authors: None Cromwell
Journal: BMJ (1963)

<h3>Abstract</h3> A field experiment was performed in wheat to investigate the responses of flag leaf and grain to sink/source manipulations. The results showed that half-degraining delayed but defoliation (only flag leaf left) enhanced the leaf senescence. Sink/source manipulations influenced the content of reactive oxygen species of flag leaf and the content of phytohormones including cytokinins, indoleacetic 3-acid, gibberellin 3, salicylic acid and jasmonic acid in the defoliated flag leaf (DL) and grain (DG), half-degrained flag leaf (HL) and grain (HG). An iTRAQ based quantitative proteomic analysis indicated that at 16 days after manipulation a total of 97 and 59 differentially expressed proteins (DEPs) from various functional categories were observed in HL and DL groups, respectively, compared with control and 115 and 121 DEPs were observed in HG and DG groups, respectively. GO annotation terms of DEPs mainly included carbon fixation, hydrogen peroxide catabolic process, chloroplast and cytoplasm, oxidoreductase activity and glutamate synthase activity in flag leaf of manipulated plants; organonitrogen compound metabolic process, cytoplasm, vacuolar membrane, CoA carboxylase activity, starch synthase activity and nutrient reservoir activity in grain of manipulated plants. KEGG pathway enrichment analysis revealed that photosynthesis, carbon, nitrogen and pyruvate metabolisms and glycolysis/gluconeogenesis were the most remarkable processes for sink/source manipulations. Sink/source manipulations affected the activities of α- and β- amylases and proteinases. Ultimately, manipulations changed the mass per grain. In conclusion, manipulations to change the sink/source ratio affect the levels of hormones, activities of hydrolytic enzymes, metabolisms of carbon, nitrogen and other main compounds, stress resistance, the leaf senescence, and ultimately influence the grain mass.
THE DIETETIC CARE OF THE VERTICAL PATIENT
Authors: E. M. GERAGHTY
Journal: JAMA (1930)

Have you ever lived on a diet? There is much being said these days about dieting to reduce, to gain, to grow; in fact, the very name diet begins to take on the aspect of a patent medicine—a cure for all ills. The result is that many people arch an eyebrow or laugh when a diet is suggested to them. Perhaps the woman next door has undertaken to regain her youthful figure by dieting. No doubt she began the treatment in a spirit of fun, but after a week or so the self denial ceased to provoke humor. Probably she struggled seriously for a few days more and finally succumbed to a box of chocolates. Cases of this kind tend to produce the popular notion that dieting is one of the new fangled ideas which may be taken up or dropped at will.  However, such is not the case; to
Gall stone pulverisation strategy in patients treated with extracorporeal lithotripsy and follow up results of maintenance treatment with ursodeoxycholic acid.
Authors: M Boscaini, M Piccinni-Leopardi, F Andreotti, A Montori
Journal: Gut (1994)

Between November 1988 and July 1992 70 patients with radiolucent gall stones were treated with extracorporeal lithotripsy (ESL) and ursodeoxycholic acid (UDCA; mean (SD) dose 11.2 (1.9) mg/kg/day). Fifty three patients have been followed for one year. One week after lithotripsy, 30.6% had completely eliminated all stone fragments from the gall bladder and one year later 93.9% were free of stones. Three factors were considered important in achieving these results. 9Pulverisation9 of the stone--that is, its fragmentation into echogenic dust (crystalline aggregates, some few hundred mu in size) or particles similar to grains of sand, smaller than 1 mm in diameter, or both, is required. Secondly, dust and particles were rapidly eliminated, strongly suggesting a mechanical elimination process by physiological gall bladder contractions. Thirdly, there must be chemical dissolution with biliary acids. This therapeutic approach gave excellent results without causing any clinically relevant side effects. The first 20 patients who became free of stones after ESL were given oral bile acid maintenance treatment--300 mg/day of UDCA at bedtime, for two years. All were asymptomatic and none had suffered a recurrence after two years. In four patients, crystalline aggregates, detected in gall bladder bile by ultrasound, were subsequently dissolved between one and three months after resuming a full dose regimen of UDCA.
Reducing Vulnerability to Climate Change in Sub-Saharan Africa: The Need for Better Evidence
Authors: Nothemba Kula, Andy Haines, Robert Fryatt
Journal: PLoS Medicine (2013)

Robert Fryatt and colleagues argue for more attention to climate change in sub-Saharan Africa, a region that has contributed the least greenhouse gas emissions to the world's total but is more vulnerable to the impacts of climate change than any other.
NOTES ON ADDER BITE
Authors: M. R. Taylor
Journal: BMJ (1930)

MARCH 9 I9301 MEDICAL JOURNAS.~~~~~~~~~~~~~~Jrtac(ria.Menaglh: 260 cases; 32.6 per cent.Rackemauin and Colmes: 25 per cent;.Rowe: 20 cases; 55 per cent.A agioneurotic Ocdc 01f.Ensor 33 of 80 persons in five generations; 41 per cent.'sler: 22 of 36 persons in five generations; 61 perl cenit.Rowe 14 cases; 43 per cent.gave hiistoly of simtilar conmplaint.Wh'hiting-; 205 cases; 53 per cent.110 in famrily grotips conmprising total of 207 iindividuals. Eczem1a.O'Keefe and Rackemann: 239 cases; 28 per cent.Rackeniann: 36 per cent.childreni, 50 per cent.adullts.Powe; 16 cases; 69 per cent. Migraine..iraiiwell: 50 per cent.cases slhow
Tumor Suppressor RARRES1 Interacts with Cytoplasmic Carboxypeptidase AGBL2 to Regulate the α-Tubulin Tyrosination Cycle
Authors: Ziad J. Sahab, Michael D. Hall, You Me Sung, Sivanesan Dakshanamurthy, Yun Ji, Deepak Kumar, Stephen W. Byers
Journal: Cancer Research (2011)

Abstract Even though it is among the most commonly methylated loci in multiple cancers, the retinoic acid–induced tumor suppressor retinoic acid receptor responder 1 (RARRES1) has no known function. We now show that RARRES1 is lost in many cancer cells, particularly those with a mesenchymal phenotype, and is a transmembrane carboxypeptidase inhibitor that interacts with ATP/GTP binding protein-like 2 (AGBL2), a cytoplasmic carboxypeptidase. Knockdown of AGBL2 results in a failure of the cell to detyrosinate the C-terminal EEY region of α-tubulin and indicates that it is a candidate for the long sought-after tubulin tyrosine carboxypeptidase important in the regulation of microtubule dynamics. In contrast, knockdown of RARRES1 increases the level of detyrosinated α-tubulin consistent with a role as the cognate inhibitor of AGBL2. We conclude that RARRES1, its interacting partners AGBL2, Eg5/KIF11, another EEY-bearing protein (EB1), and the microtubule tyrosination cycle are important in tumorigenesis and identify a novel area for therapeutic intervention. Cancer Res; 71(4); 1219–28. ©2011 AACR.
Emerging Targeted Therapies for Breast Cancer
Authors: Ricardo H. Alvarez, Vicente Valero, Gabriel N. Hortobagyi
Journal: Journal of Clinical Oncology (2010)

Increased understanding of the molecular events involved in cancer development has led to the identification of a large number of novel targets and, in parallel, to the development of multiple approaches to anticancer therapy. Targeted therapy focuses on specific molecules in the malignant cell signal transduction machinery, including crucial molecules involved in cell invasion, metastasis, apoptosis, cell-cycle control, and tumor-related angiogenesis. In breast cancer, two new targeted agents have recently been approved: lapatinib, directed against the human epidermal growth factor receptor 2 (HER2); and bevacizumab, directed against vascular endothelial growth factor (VEGF). Multiple other targeted agents are under evaluation in clinical trials, including inhibitors of the epidermal growth factor receptor (EGFR), dual EGFR and HER2 inhibitors, other VEGF or VEGF-receptor inhibitors, and agents that alter crucial signaling pathways, such as RAS/MEK/ERK; phosphatidylinositol-3-kinase/Akt/ mammalian target of rapamycin; insulin-like growth factor/insulin-like growth factor receptor; poly (ADP-ribose) polymerase 1; and others. In this review, we present the most promising studies of these new targeted therapies and novel combinations of targeted therapies with traditional cytotoxic agents.
Deletion of the Platelet-Specific Alloantigen PlA1 from Platelets in Glanzmann's Thrombasthenia
Authors: Thomas J. Kunicki, Richard H. Aster
Journal: Journal of Clinical Investigation (1978)

Expression of a Platelet-specific alloantigen (PlA1) was studied in five unrelated patients with Glanzmann's thrombasthenia using immunologic techniques based on release of 51Cr from tagged platelets by PlA1-specific antibody. Less than 1% of the normal quantity of PlA1 could be detected on platelets of patients 1, 2, and 3; platelets from patients 4 and 5 contained 22 and 12% of normal levels, respectively. After treatment with bromelain, platelets from patients 4 and 5, but not those from patients 1, 2, and 3, released 51Cr as well as normal PlA1-positive platelets when exposed to anti-PlA1. Platelets from each of the five patients reacted normally with drug-dependent antibodies and with autoantibodies specific for platelets.
Scarlatiniform Rashes and Scarlatina
Authors: W. B. Cheadle
Journal: BMJ (1879)

quent examination showed extensive dead black tissue, extending from the neck into both mediastina, and along the pericardial and pleural membranes.Half the heart, and the upper half of each lung, were enveloped in a stratum of wholly gangrenous tissue nearly half-an-inch in thickness, the serous membrane remaining smooth and unbroken.A diagram (Fig. 3) will help to give clearness to my brief descriptions.In all the diagrams, the shaded portion suggests the area and direction of the dead cellular tissue.]
The Conference of Medical College Delegates.
Authors: John B. Roberts
Journal: JAMA (1890)

<h3>To the Editor:</h3> —The recent communication of Dr. Davis seems to indicate his belief that there is a possibility, perhaps a probability, of very little good arising from the conference of Medical College Faculties to be held in Nashville. I, at any rate, greatly fear that the attempt will not soon give us a graded compulsory course of three years in all colleges. The truth is this: The only way to have a high standard of education in all medical colleges, is for each medical school to raise its own standard without waiting for other schools to do likewise. Corporate morality is subject to the same laws and rules of growth as personal morality. So soon as a merchant becomes convinced that to put a 1 lb. label on ⅞ of a lb. of tea is wrong, so soon as he believes that to sell a mixture of terra-alba and
Evidence based medicine: does it make a difference?
Authors: Birte Twisselmann
Journal: BMJ (2005)

Because economic evaluations of health care services are being published with increasing frequency it is important to (a) evaluate them rigorously and (b) compare the net benefit of the application of one technology with that of others. Four "levels of evidence" that rate economic evaluations on the basis of their methodologic rigour are proposed. They are based on the quality of the methods used to estimate clinical effectiveness, quality of life and costs. With the use of the magnitude of the incremental net benefit of a technology, therapies can also be classified into five "grades of recommendation." A grade A technology is both more effective and cheaper than the existing one, whereas a grade E technology is less or equally effective and more costly. Those of grades B through D are more effective and more costly. A grade B technology costs less than $20,000 per quality-adjusted life-year (QALY), a grade C one $20,000 to $100,000/QALY and a grade D one more than $100,000/QALY. Many issues other than cost effectiveness, such as ethical and political considerations, affect the implementation of a new technology. However, it is hoped that these guidelines will provide a framework with which to interpret economic evaluations and to identify additional information that will be useful in making sound decisions on the adoption and utilization of health care services.
A Functional Germline Variant in <i>GLI1</i> Implicates Hedgehog Signaling in Clinical Outcome of Stage II and III Colon Carcinoma Patients
Authors: Joanna Szkandera, Martin Pichler, Gudrun Absenger, Michael Stotz, Melanie Weissmueller, Hellmut Samonigg, Martin Asslaber, Sigurd Lax, Gerhard Leitner, Thomas Winder, Wilfried Renner, Armin Gerger
Journal: Clinical Cancer Research (2014)

Abstract Purpose: Cumulating evidence indicates that germline variants in the Wnt, Notch, and Hedgehog pathways are involved in colon carcinoma progression and metastasis. We investigated germline polymorphisms in a comprehensive panel of Wnt, Notch, and Hedgehog pathway genes to predict time to recurrence (TTR) and overall survival in patients with stage II and III colon carcinoma. Experimental Design: A total of 742 consecutively collected patients with stage II and III colon carcinoma were included in this retrospective study. Genomic DNA was analyzed for 18 germline polymorphisms in Wnt, Notch, and Hedgehog pathway genes (SFRP, DKK 2 and 3, AXIN2, APC, MYC, TCF7L2, NOTCH2, and GLI1) by TaqMan 5′-exonuclease assays. Results: In univariate analysis, the homozygous mutant variant of GLI1 rs2228226 G&amp;gt;C was significantly associated with decreased TTR in a recessive genetic model after adjustment for multiple testing [HR = 2.35; confidence interval (95% CI), 1.48–3.74; P &amp;lt; 0.001] and remained significant in multivariate analysis including clinical stage, lymphovascular-, vascular-, and perineural-invasion (HR = 2.43; CI 95%, 1.52–3.87; P &amp;lt; 0.001). In subanalyses, the association was limited to patients with surgery alone (HR = 3.21; CI 95%, 1.59–6.49; P = 0.001), in contrast with patients with adjuvant chemotherapy (HR = 0.82; CI 95%, 0.35–1.95; P = 0.657). When the subgroup of patients with “high-risk” GLI1 rs2228226 C/C genotype was analyzed, no benefit of adjuvant 5-fluorouracil–based chemotherapy could be found. Conclusion: This is the first study identifying GLI1 rs2228226 G&amp;gt;C as an independent prognostic marker in patients with stage II and III colon carcinoma. Prospective studies are warranted to validate our findings. Clin Cancer Res; 20(6); 1687–97. ©2014 AACR.
Brain Ischemic Anoxia
Authors: Blaine C. White
Journal: JAMA (1984)

THE DEVELOPMENT of effective therapy to preserve normal neurological function in patients surviving a cardiac arrest hinges on our growing understanding of the pathophysiology of ischemic anoxia. It is worthwhile, then, to review our new understanding of these mechanisms, as well as the laboratory search for therapies to protect neurons injured by cardiac arrest. The early doctrine that four to six minutes of ischemic anoxia leads to irreversible brain injury was based on work done in the 1940s with dogs subjected to breathing 100% nitrogen.<sup>1,2</sup>However, it became apparent from work by Ames and Guarian<sup>3</sup>and Hossman and Kleihues<sup>4</sup>that the neurons themselves have substantial intrinsic resistance to complete ischemic anoxia. The evidence suggests that CNS neurons can tolerate between 20 and 60 minutes of complete ischemic anoxia without irreversible injury. Following these severe insults, neurons regain the ability to synthesize protein, produce adenosine triphosphate (ATP), and
NICE issues new guidelines on Ritalin
Authors: R. Dobson
Journal: BMJ (2000)

New guidelines from the National Institute for Clinical Excellence (NICE) for the use of methylphenidate in England and Wales advise that the drug should be used as part of a comprehensive treatment programme for children with a diagnosis of severe attention deficit hyperactivity disorder.

In its latest guidance, the institute said that an estimated 1% of school aged children—69 000 children aged 6 to 16 in England and 4200 in Wales—meet the diagnostic criteria for severe, “combined-type” attention deficit …
516 GLYCOGEN SYNTHASE KINASE 3 (GSK3) IN IMMUNE CELLS IS A MAJOR PLAYER INTLR4-MEDIATED CYTOKINE STORM IN PATIENTS WITH ADVANCED CIRRHOSIS
Authors: T. Gustot, M. Simon-Rudler, M. Fasseu, S. Gandoura, W. Abdel-Razek, J. Devière, D. Lebrec, R. Moreau
Journal: Journal of Hepatology (2010)
The Clinical Professor
Authors: Alex S. Tulsky
Journal: JAMA (1983)

<h3>To the Editor.—</h3> I am compelled to respond to the COMMENTARY (1982; 248:2851) regarding the clinical professor. This unnamed veteran hero (heroine?) of the clinical faculty has recited a history of disadvantages perceived in the unsalaried (voluntary) staff of several medical schools, with recommendations for some kind of correction. Well, I, too, am a clinical professor of some years and am not only comfortable but happy with this rank and its attendant responsibilities. I am grateful to the COMMENTARY because it rekindled in me those basic feelings that prompted me to seek such rank originally. It happens that I love to teach; I have always loved to teach, whether it be on a graduate or undergraduate level. The classroom, the operating room, and the ward all give me an opportunity to foist myself on young (sometimes not so young) and innocent (sometimes not so innocent) aspirants to our profession and
Blue Clouds and Green Clouds: Virtual Biopsy via EUS Elastography?
Authors: A. Fritscher-Ravens
Journal: Endoscopy (2006)

The quality of "elasticity" is part of everyday life and is integrated into one of the senses - that of touch. We evaluate the morphology of a vegetable such as a tomato by rotating it between our fingers and pressing it to feel whether the texture is harder or smoother (and therefore overripe), to determine whether it is suitable for eating. In medicine, we use the fact that diseases change the elastic properties of organs. As early as the Ebers papyrus, dating from 1500 BC in Egypt, malignant tumors were described as "hard swellings." The tactile sense of the physician's hand was therefore used even in ancient medicine, whilst "percussion" and "auscultation" are relatively recent additions to the physician's diagnostic armamentarium, dating from the end of the 18th century.