tbuckley/cabot-search huggingface dataset:
Prognostic Value of Placental Growth Factor in Patients With Acute Chest Pain
Authors: Christopher Heeschen
Journal: JAMA (2004)

Experimental data suggest that placental growth factor (PlGF), a member of the vascular endothelial growth factor family, acts as a primary inflammatory instigator of atherosclerotic plaque instability and thus may be useful as a risk-predicting biomarker in patients with acute coronary syndromes (ACS).To determine whether blood levels of PlGF predict risk for death or nonfatal myocardial infarction in patients with acute chest pain.Measurement of PlGF levels as well as levels of markers of myocardial necrosis (troponin T [TnT]), platelet activation (soluble CD40 ligand [sCD40L]), and inflammation (high-sensitivity C-reactive protein [hsCRP]) in an inception cohort of 547 patients with angiographically validated ACS participating in the CAPTURE (c7E3 Fab Anti-Platelet Therapy in Unstable Refractory Angina) trial and in a heterogeneous cohort of 626 patients presenting with acute chest pain to an emergency department in Germany between December 1996 and March 1999.Risk for death or nonfatal myocardial infarction after 30 days.In patients with ACS, elevated PlGF levels (>27.0 ng/L; 40.8% of patients) indicated a markedly increased risk of events at 30 days (14.8% vs 4.9%; unadjusted hazard ratio [HR], 3.34; 95% confidence interval [CI], 1.79-6.24; P<.001). In a multivariable model, elevated levels of TnT (HR, 1.83; 95% CI, 1.05-3.86; P =.03), sCD40L (HR, 2.65; 95% CI, 1.41-4.99; P =.002), and PlGF (HR, 3.03; 95% CI, 1.54-5.95; P<.001) were independent predictors, while elevated hsCRP level was not (HR, 0.98; 95% CI, 0.53-1.98; P =.94). In patients with acute chest pain, elevated levels of PlGF predicted risk (21.2% vs 5.3%) (unadjusted: HR, 4.80; 95% CI, 2.81-8.21; P<.001; adjusted: HR, 3.00; 95% CI, 1.68-5.38; P<.001). Patients negative for all 3 markers (TnT, sCD40L, and PlGF) were at very low cardiac risk (7 days: no event; 30 days: 2.1% event rate).Plasma PlGF levels may be an independent biomarker of adverse outcome in patients with suspected ACS. A single initial measurement of plasma PlGF appears to extend the predictive and prognostic information gained from traditional inflammatory markers.
Endoscopic Cholangiography for Biliary System Diagnosis
Authors: JACK A. VENNES
Journal: Annals of Internal Medicine (1974)

We evaluated the results of endoscopic cholangiography in 108 patients who were examined for possible biliary tract obstruction. The clinical diagnosis of extrahepatic obstruction was confirmed in 48 and reversed in 13 of 70 patients. Nine studies were unsuccessful. The site of ductal obstruction was evident before surgery in 47 patients, and in 42 patients cholangiographic features led to a correct diagnosis. In a second group of 38 patients with primary liver disease the clinical possibility of extrahepatic obstruction required study. Such obstruction was shown in six patients in this group. Endoscopic cholangiography was of major importance in patient management. Preoperative cholangiograms were valuable in planning and, often, in shortening surgery. Previously scheduled surgery was unnecessary in 25 patients shown to have unobstructed extrahepatic ducts. Nine patients had complications from the procedure.
Thymectomy in acute systemic lupus erythematosus and rheumatoid arthritis.
Authors: J. A. Milne, J. R. Anderson, R. N. MacSween, K. Fraser, I. Short, J. Stevens, G. B. Shaw, H. I. Tankel
Journal: BMJ (1967)

Much of the mystery surrounding the function of the thymus gland was dispelled by the demonstration that its removal shortly after birth resulted in an impaired capacity to respond to various antigenic stimuli, including tissue homografts and injections of bacteria and of foreign proteins (Archer and Pierce, 1961 ; Miller, 1961). These observations have now been made in several mam malian species, and it is well established that the thymus plays a vital part in the development of the lymphoid tissues and of normal immune responses: much of the evidence has been reviewed by Miller et al. (1962) and is described in a recent symposium (Good and Gabrielsen, 1964). There is good evidence that the thymus secretes a humoral factor capable of stimulating lymphopoiesis in other lymphoid tissues (Levey et al., 1963 ; Osoba and Miller, 1964), and it is also likely that it produces large numbers of lymphocytes (Nossal and Gorrie, 1964 ; Sainte-Marie and Leblond, 1964), though this has not been established with certainty. Though the thymus undergoes involution in adult life, lymphocytic mitotic activity, while not as prominent as in early life, maintains a high level, and in recent observations Metcalf (1965), Miller (1965), Miller et al. (1965), and Taylor (1965) provide evidence that thymectomy in the adult mouse is followed after an interval of several months by a depression of immune responsiveness. Apart from thymic tumours, the only condition for which thymectomy is commonly performed in man is myasthenia gravis. The changes in the thymus in this condition commonly include the formation of germinal centres, and both this and the demonstration of immunoglobulin (IgG) in the thymus in myasthenia (White and Marshall, 1962) suggest that it may be the site of an abnormal immune response. The detection of auto-antibodies reacting with skeletal muscle in the serum of some patients with myasthenia raises the further possibility that the, abnormal response is of an autoimmune nature. The thymus has not been studied extensively in the various other diseases in which auto-antibodies are commonly present, but thymic abnormalities, including formation of germinal centres, have been described in some cases of Hashimoto's disease, thyrotoxicosis, Addison's disease, systemic lupus erythematosus,
Endocrine-Disrupting Chemicals (EDCs): <i>In Vitro</i> Mechanism of Estrogenic Activation and Differential Effects on ER Target Genes
Authors: Yin Li, Colin J. Luh, Katherine A. Burns, Yukitomo Arao, Zhongliang Jiang, Christina T. Teng, Raymond R. Tice, Kenneth S. Korach
Journal: Environmental Health Perspectives (2013)

Endocrine-disrupting chemicals (EDCs) influence the activity of estrogen receptors (ERs) and alter the function of the endocrine system. However, the diversity of EDC effects and mechanisms of action are poorly understood.We examined the agonistic activity of EDCs through ERα and ERβ. We also investigated the effects of EDCs on ER-mediated target genes.HepG2 and HeLa cells were used to determine the agonistic activity of EDCs on ERα and ERβ via the luciferase reporter assay. Ishikawa cells stably expressing ERα were used to determine changes in endogenous ER target gene expression by EDCs.Twelve EDCs were categorized into three groups on the basis of product class and similarity of chemical structure. As shown by luciferase reporter analysis, the EDCs act as ER agonists in a cell type- and promoter-specific manner. Bisphenol A, bisphenol AF, and 2-2-bis(p-hydroxyphenyl)-1,1,1-trichloroethane (group 1) strongly activated ERα estrogen responsive element (ERE)-mediated responses. Daidzein, genistein, kaempferol, and coumestrol (group 2) activated both ERα and ERβ ERE-mediated activities. Endosulfan and kepone (group 3) weakly activated ERα. Only a few EDCs significantly activated the "tethered" mechanism via ERα or ERβ. Results of real-time polymerase chain reaction indicated that bisphenol A and bisphenol AF consistently activated endogenous ER target genes, but the activities of other EDCs on changes of ER target gene expression were compound specific.Although EDCs with similar chemical structures (in the same group) tended to have comparable ERα and ERβ ERE-mediated activities, similar chemical structure did not correlate with previously reported ligand binding affinities of the EDCs. Using ERα-stable cells, we observed that EDCs differentially induced activity of endogenous ER target genes.
Vascular Generation of Tumor Necrosis Factor-α Reduces Nitric Oxide Availability in Small Arteries From Visceral Fat of Obese Patients
Authors: Agostino Virdis, Ferruccio Santini, Rocchina Colucci, Emiliano Duranti, Guido Salvetti, Ilaria Rugani, Cristina Segnani, Marco Anselmino, Nunzia Bernardini, Corrado Blandizzi, Antonio Salvetti, Aldo Pinchera, Stefano Taddei
Journal: Journal of the American College of Cardiology (2011)
Rheumatoid stricture of oesophagus.
Authors: V John, A J Stirling, H R Mathews
Journal: BMJ (1978)

tetracyclines; and were identified as serotype 5 by specific rabbit antiserum.The pathogenicity of human ureaplasmas is still debated although some can cause non-specific urethritis.This case shows that they can at least produce disease in patients with depressed immunity.The arthritis in this case should not be confused with more chronic types of monoarthritis and polyarthritis that occur in patients with hypogammaglobulinaemia.4 Fluid aspirated from an acutely inflamed joint in such patients should be cultured for bacteria and myco- plasmas, including ureaplasmas.The results of culture and anti- biotic sensitivity testing may not be available for several days so intravenous tetracycline treatment should start immediately since only about 10 % of human ureaplasmas are insensitive to tetra- cyclines.Prolonged tetracycline treatment over some months is probably necessary.
Hospital indicators of poor sexual health
Authors: Helen Ward, Jackie Cassell, Susan Williams, Paul Aylin
Journal: BMJ (2005)

The recent UK white paper on public healthw1 included sexual health as one of the main targets for improvement. Poor sexual health is generally measured in terms of acute infections and unplanned pregnancies, with a focus within the UK on incident infections, and is obtained from returns from genitourinary medicine clinics. With the exception of HIV infection and some cases of hepatitis B, most people with a sexually transmitted infection are not admitted to hospital. However, many of the longer term sequelae (particularly, asymptomatic infections in women and untreated syphilis) may lead to hospital admission. Might these admissions be used as a proxy measure for trends in acute infections? We looked at hospital admissions data for congenital and acquired syphilis, pelvic inflammatory disease, and ectopic pregnancy. #### The bottom line
787 EFFECTS OF HEPATIC IMPAIRMENT ON THE PHARMACOKINETICS OF BRIVANIB IN A PHASE I, OPEN-LABEL, MULTIDOSE STUDY IN PATIENTS WITH HEPATOCELLULAR CARCINOMA AND OTHER SOLID TUMORS
Authors: A. El-Khoueiry, H.J. Lenz, J. Posey, T. Wood, B. Fischer, V. Sankar, S. Shariq, G. Kollia, E. Masson, I. Walters
Journal: Journal of Hepatology (2009)
Glucocorticoids Suppress Tumor Angiogenesis and <i>In vivo</i> Growth of Prostate Cancer Cells
Authors: Akihiro Yano, Yasuhisa Fujii, Aki Iwai, Yukio Kageyama, Kazunori Kihara
Journal: Clinical Cancer Research (2006)

Abstract Purpose: Glucocorticoids, such as prednisone, hydrocortisone, and dexamethasone, are known to produce some clinical benefit for patients with hormone-refractory prostate cancer (HRPC). However, the underlying mechanisms by which glucocorticoids affect HRPC growth are not well established as yet. Here, we hypothesize that the therapeutic effect of glucocorticoids on HRPC can be attributed to a direct inhibition of angiogenesis through the glucocorticoid receptor by down-regulating two major angiogenic factors, vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8). Experimental Design: The effects of dexamethasone on VEGF and IL-8 expression and cell proliferation were examined using DU145, which expresses glucocorticoid receptor. The effects of dexamethasone on DU145 xenografts were determined by analyzing VEGF and IL-8 gene expression, microvessel density, and tumor volume. Results: Dexamethasone significantly down-regulated VEGF and IL-8 gene expression by 50% (P &amp;lt; 0.001) and 89% (P &amp;lt; 0.001), respectively, and decreased VEGF and IL-8 protein production by 55% (P &amp;lt; 0.001) and 74% (P &amp;lt; 0.001), respectively, under normoxic condition. Similarly, hydrocortisone down-regulated VEGF and IL-8 gene expression. The effects of dexamethasone were completely reversed by the glucocorticoid receptor antagonist RU486. Even under hypoxia-like conditions, dexamethasone inhibited VEGF and IL-8 expression. In DU145 xenografts, dexamethasone significantly decreased tumor volume and microvessel density and down-regulated VEGF and IL-8 gene expression, whereas dexamethasone did not affect the in vitro proliferation of the cells. Conclusion: Glucocorticoids suppressed androgen-independent prostate cancer growth possibly due to the inhibition of tumor-associated angiogenesis by decreasing VEGF and IL-8 production directly through glucocorticoid receptor in vivo.
Inverse Relationship Between Electrode Size and Lesion Size During Radiofrequency Ablation With Active Electrode Cooling
Authors: Hiroshi Nakagawa, Fred H. M. Wittkampf, William S. Yamanashi, Jan V. Pitha, Shinobu Imai, Barclay Campbell, Mauricio Arruda, Ralph Lazzara, Warren M. Jackman
Journal: Circulation (1998)

Clinical efficacy has driven the use of larger electrodes (7F, length > or =4 mm) for radiofrequency ablation, which reduces electrogram resolution and causes variability in tissue contact depending on electrode orientation. With active cooling, ablation electrode size may be reduced. The purpose of this study was to examine the effect of electrode length on tissue temperature and lesion size with saline irrigation used for active cooling.In 11 anesthetized dogs, the thigh muscle was exposed and bathed with heparinized canine blood. A 7F ablation catheter with a 2- or 5-mm irrigated tip electrode was positioned perpendicular or parallel to the thigh muscle. Radiofrequency current was delivered at constant voltage (50 V) for 30 seconds during saline irrigation (20 mL/min) to 148 sites. Tissue temperature at depths of 3.5 and 7 mm and lesion size were measured. In the perpendicular electrode-tissue orientation, radiofrequency applications at 50 V with the 2-mm electrode compared with the 5-mm electrode resulted in lower power at 50 V (26 versus 36 W) but higher tissue temperatures, larger lesion depth (8.0 versus 5.4 mm), and greater diameter (12.4 mm versus 8.4 mm). Also, in the parallel orientation, overall power was lower with the 2-mm electrode (25 versus 33 W), but tissue temperatures were higher and lesions were deeper (7.3 versus 6.9 mm). Lesion diameter was similar (11.1 versus 11.3 mm) for both electrodes.The smaller electrode resulted in transmission of a greater fraction of the radiofrequency power to the tissue and resulted in higher tissue temperature, larger lesions, and lower dependency of lesion size on the electrode orientation.
Laser Photocoagulation - Results of a Randomised Controlled Clinical Trial
Authors: P.R. Salmon, C.P. Swain
Journal: Endoscopy (1986)

A large two-centre randomised controlled trial of Nd:YAG photocoagulation in acute upper alimentary bleeding is described. Prospective stratification of the nature of the bleeding point (presence or absence of stigmata of recent haemorrhage) has been a fundamental aim to reduce bias, and matching of other risk factors has been carried out. This study demonstrates that with this method Nd:YAG laser photocoagulation reduces the rebleeding rate from those with SRH, emergency surgery, and mortality.
Reduction of Pulled Elbow
Authors: Megan Aylor, JoDee M. Anderson, Paula Vanderford, Matthew Halsey, Susanna Lai, Dana A.V. Braner
Journal: New England Journal of Medicine (2014)

Pulled elbow, a common childhood injury, can be reduced by a simple intervention that can be performed in an outpatient setting with rapid results. This video is intended to instruct clinicians in treating this injury.
TREATMENT OF GALLSTONES.Read before the New York State Medical Society, February, 1891.
Authors: WILLIAM WOTKYNS SEYMOUR
Journal: JAMA (1891)

In considering the treatment of gallstones we have to consider the treatment during the paroxysm, during the intervals between the paroxysms, medical and surgical measures for their radical relief and the constitutional vice leading to their formation. During the paroxysms I do not think anything superior to hypodermatic injections of morphine and atropine. They are capable of very accurate dosage, but must be very carefully employed, for some patients are extremely susceptible to these drugs and one who has long had the drugs only with benefit may suddenly be thrown into a very alarming condition by the usual dose. I should in an adult prefer to administer repeated doses of a ¼ grain of morphine and a 1-150 grain of atropine, than to give as some do at the very outset ½, 3-4, or even a grain of morphine. To the hypodermics, chloroform or ether by inhalation are the only
P4-09-06: The Prognostic Value of Tumour-Stroma Ratio in Triple Negative Breast Cancer.
Authors: AM Moorman, R Vink, HJ Heijmans, der Palen J van, EA Kouwenhoven
Journal: Cancer Research (2011)

Abstract Background: Triple-negative cancer constitutes one of the most challenging groups of breast cancer given its aggressive clinical behaviour, poor outcome and lack of targeted therapy. Until now, profiling techniques have not been able to distinguish between patients with good and poor outcome. Recent studies suggested an important role for stroma in tumour growth and progression. In colorectal-, oesophageal- and breast cancer, the tumour-stroma ratio was found to be of prognostic value. Objective: to evaluate the prognostic value of the tumour-stroma ratio in triple-negative breast cancer. Methods: During the period January 2004–2008, 124 consecutive triple negative breast cancer patients treated in our hospital were retrospective evaluated. Routine Haematoxylin-Eosin (H&amp;E) stained histological sections were evaluated by two investigators (kappa 0.735) for stroma percentage, growth pattern (pushing margin), necrosis and amount of lymphocytic infiltrate. Patients with less than 50% stroma were classified as stroma-low and patients with ≥ 50% stroma were classified as stroma-high. Results: of 124 triple-negative breast cancer patients, 50 (40%) had a stroma-high and 74 (60%) had a stroma-low tumour. Survival analysis revealed a 5 years relapse free period (RFP) of 85% in the stroma-low and 45% in the stroma-high group. Overall survival (OS) was 89% for stroma-low and 65% in the patients with a stroma-high tumour. Both RFP and OS were significantly worse in patients with stroma-high tumours compared to stroma-low. In a multivariate cox-regression analysis, tumour stroma remained an independent prognostic variable for RFP (HR 2.39; 95% CI 1.07−5.29; p=0.033) and OS (HR 3.00; 95% CI 1.08−8.32; 0.034) when corrected for other clinical-pathological variables. In addition, tumour-stroma proved to be a strong prognostic variable when compared to nodal status, tumour grade and tumour size, with respectively a HR of 2.39 (95% CI 1.37−6.26) versus HR 2.18 (95% CI 1.06−4.48), HR 2.10 (95% CI 0.89−4.91) and HR 0.53 (95% CI 0.70−3.91) for RFP with comparable numbers for OS. Conclusion: Tumour-stroma ratio is a strong independent prognostic variable in triple-negative breast cancer. It is easy to determine, reproducible (kappa 0.735) and can be easily incorporated into routine histological examination. This parameter optimizes risk stratification and could be target for future therapies. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-06.
Ship's doctor wins claim after demanding better care
Authors: C. Dyer
Journal: BMJ (1999)

A ship's doctor has won an unfair dismissal claim against a British shipping company which sacked him for demanding better medical care on board.

Laurence Tinckler, a former consultant surgeon, will now seek reinstatement as medical officer with Curnow Shipping, which runs three cruises a year on the royal mail ship St Helena between Cardiff in Wales and the …
Uricosuric Agents in the Treatment of Gout
Authors: G. D. Kersley, A. R. Gibbs
Journal: Annals of the Rheumatic Diseases (1960)

During the past 2 years an attempt has been made to assess the relative value and toxicity of various uricosuric agents.Previous Investigations Kersley, Cook, and Tovey (1958) reported the therapeutic value of G.28 315 (sulphinpyrazone), a phenylbutazone derivative now known as Anturan (Geigy), in a group of fifteen patients with gout in a clinical trial lasting 3 to 8 months.Benemid and Longacid (Urelim), a benemid-like drug (Ward, Blenkinsop and Co.), were also given in selected cases.The results, as shown by estimations of the urinary uric acid excretion and the serum uric acid, are summarized in the Table (Rows 1-4).Anturan was the most efficacious drug, although the other two also had a definite uricosuric effect.Inter- mittent administration 3 days per week was not effective.It was found that the use of 3 5 g.aspirin as an analgesic completely inhibited the effect of Anturan in the doses given (Table ,Row 5).
Die Totung Geisteskranker in Deutschland
Authors: M. Burleigh
Journal: BMJ (1995)

Alice Platen-Hallermund, Psychiatrie Verlag, pp 131, ISBN 3 88414 149 X

In postwar Germany, fitful attempts to publish books on medical criminality under the Nazis were dogged by misfortune. Manuscripts mysteriously disappeared doing the rounds of publishers or were neutralised after publication through purposive critical oblivion. Publications such as Alice Platen-Hallermund's 1948 book on Nazi “euthanasia” killings were studiously ignored by the West German medical profession, many of whose leading lights were erstwhile Nazis.

Although based on an inevitably restricted range of source material (the records of the United States Nuremberg Doctors Trial), Platen-Hallermund's work anticipated most of the themes explored in the numerous studies of German medicine and psychiatry produced since …
Frequency of Major Complications of Aspirin, Warfarin, and Intravenous Heparin for Secondary Stroke Prevention: A Population-Based Study
Authors: George W. Petty
Journal: Annals of Internal Medicine (1999)

Background: Complication rates of medical therapy for secondary stroke prevention derived from clinical trials may or may not be applicable to patients with cerebrovascular disease in the general population. Objective: To determine complication rates for aspirin, warfarin, and intravenous heparin administered for secondary stroke prevention after first episodes of ischemic stroke, transient ischemic attack, or amaurosis fugax in a community. Design: Population-based historical cohort study. Setting: Rochester, Minnesota. Patients: All residents of Rochester who, between 1985 and 1989, received aspirin (n = 339) or warfarin (n = 145) within 2 years after first ischemic stroke, transient ischemic attack, or amaurosis fugax or received intravenous heparin (n = 201) within 2 weeks after first ischemic stroke, transient ischemic attack, or amaurosis fugax. Measurements: Occurrence of major complications caused by therapy. Results: Twenty aspirin-associated complications (1 fatal) occurred during an average 1.7 years of treatment, 8 warfarin-associated complications occurred during an average 0.7 years of treatment, and 3 heparin-associated complications (1 fatal) occurred during an average 5.1 days of treatment. Complication rates were 3.5 per 100 person-years (95% CI, 2.1 to 5.4) for aspirin, 7.9 per 100 person-years (CI, 3.4 to 15.6) for warfarin, and 0.30 (CI, 0.06 to 0.86) per 100 person-days for heparin. Rates of fatal complications were 0.2 per 100 person-years (CI, 0 to 1.0) for aspirin, 0 per 100 person-years (CI, 0 to 3.6) for warfarin, and 0.10 per 100 person-days (0 to 0.55) for heparin. Conclusions: Complication rates for warfarin and intravenous heparin given as therapy for secondary stroke prevention in Rochester, Minnesota, were lower than rates reported from earlier trials and observational studies. However, complication rates for warfarin were higher than in more recent referral-based studies and multicenter randomized trials. After adjustment for duration of therapy, complication rates for heparin were higher than those for aspirin or warfarin. These rates can be used to judge the applicability of complication rates derived from ongoing clinical trials.