tbuckley/cabot-search huggingface dataset:
Echocardographic Findings in Different Types of Mitral Regurgitation
Authors: JUDITH BURGESS, RALPH CLARK, MASANOBU KAMIGAKI, KEITH COHN
Journal: Circulation (1973)

Forty-eight patients with mitral regurgitation were studied by echocardiography to establish differential diagnostic features. Six patients with rheumatic mitral insufficiency manifested broad and bright echoes from the anterior mitral leaflets and slowed EF slopes. In the majority of patients with prolapse of the mitral valve leaflets due to rupture or redundancy of the chordae tendineae, a posterior sagging of the CD portion of the thin mitral leaflet echoes was evident. Cases with anterior leaflet rupture revealed increased rate and amplitude of anterior cusp opening with a spiked E point. Eight patients with posterior ruptured chordae tendineae were noted to have a paradoxical diastolic anterior motion of the posterior mitral leaflet. Eight instances of mitral insufficiency due to papillary muscle dysfunction manifested a flat CD segment and characteristic double diamond-shaped pattern of the leaflets, lying within an enlarged left ventricular cavity. In two patients with mitral insufficiency associated with calcification of the mitral annulus, a thickened, intense echo was seen posterior to the leaflets. Echocardiograms taken in the patients with severe mitral insufficiency also demonstrated enlarged left ventricular end-diastolic dimensions, increased stroke volume, and increased amplitude of septal motion. The ejection fraction was usually normal, but in 11 it was reduced, suggesting impaired left ventricular function. Echocardiography is an extremely useful technique in evaluating patients with mitral insufficiency, delineating the etiology and severity of the disease, and aiding in grossly assessing left ventricular function.
Adjuvant Radiation for Stage II-B Soft Tissue Sarcoma of the Extremity
Authors: K. M. Alektiar
Journal: Journal of Clinical Oncology (2002)

PURPOSE: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with high-grade soft tissue sarcoma (STS) of the extremity. This study sought to define the optimal management in patients with stage II-B (high-grade, size ≤ 5 cm) tumors. PATIENTS AND METHODS: Between July 1982 and December 1998, 204 adult patients with primary stage II-B STS underwent limb-sparing surgery with negative microscopic margins. Eighty-eight patients (43%) received RT; 116 (57%) did not. The RT and no-RT groups were balanced with regard to age, site (upper v lower extremity), whether patients had prior unplanned excision, and location (central, ie, shoulder/groin v noncentral). The RT group had more deep tumors (P = .03). Adjuvant RT was delivered with brachytherapy in 60% and external-beam radiation in 40% of patients. RESULTS: With a median follow-up of 67 months, the 5-year local control, distant relapse-free survival, and disease-specific survival rates were 82%, 80%, and 88%, respectively. There was no significant difference in local control between the RT and no-RT groups (84% v 80%, respectively, P = .3). Tumor depth, site, and prior unplanned excision did not correlate with local control. The only independent predictors of poor local control were central tumor location (relative risk [RR] = 3; 95% confidence interval [CI], 2 to 7; P = .005) and age more than 50 years (RR = 6; 95% CI, 2 to 13; P = .001). CONCLUSION: In this retrospective study, adjuvant RT did not significantly improve local control in patients with stage II-B STS of the extremity. The outcome of patients with central tumor location was poor, and efforts to identify the optimal local treatment approach for such patients are warranted.
Physiologic and Psychological Characteristics Associated With Deaths due to Asthma in Childhood
Authors: Robert C. Strunk
Journal: JAMA (1985)

Several reports have documented characteristics of children who die of asthma; however, to the best of our knowledge, no studies have used case controls to clarify the clinical characteristics associated with death. We conducted a case-controlled study of 21 patients with severe asthma hospitalized between 1973 and 1982 who died of asthma sometime following discharge. Average age at death was 13 years (range, 8 to 18 years). Twenty-one asthmatic control cases were matched for age at the time of hospitalization, sex, and severity of illness. Hospital records were evaluated for 57 physiologic and psychological variables. A stepwise discriminant analysis determined that the following eight variables could discriminate the two groups effectively: history of seizures associated with an asthma attack; conflicts between the patient's parents and hospital staff regarding medical management of the patient; self-care of asthma while in the hospital that was not appropriate for age; prednisone dosage having been decreased by more than 50% during the course of hospitalization; inhaled beclomethasone dipropionate required for treatment; increased asthmatic symptoms during the week preceding discharge; depressive symptoms; and disregard of asthmatic symptoms. Most of the clinical characteristics previously thought to place patients at greater risk for a fatal asthmatic attack were found as often in the control cases as in the children who died. This study indicates that psychologic risk factors were prominent in severely asthmatic children who subsequently died of asthma. The variables defined in this study may be important in identifying patients who are at high risk for dying of asthma and in developing treatment plans to prevent deaths.
Visiting Nurse Service
Authors: Martha D. Adam, Richard C. Sheretz
Journal: JAMA (1964)

"AN ORGANIZED SERVICE whose contribution to medical care should not be underestimated is that provided by visiting nurse associations." So wrote Dr. William P. Shepard and Dr. George M. Wheatley more than ten years ago.<sup>1</sup>"Visiting nurse service," they went on to say, "... is the practicing physician's partner in caring for the sick." The statements are even more true today than they were when they first appeared. Nursing services offering care of the sick at home are more frequently being provided in response to community demands. Some of the reasons are obvious—an increase in the proportion of our population in the over-65 age group and a corresponding increase in the incidence of chronic and longterm illness, the increasing cost of hospital care, and the limited number of hospital beds in some communities. There is growing recognition that many patients make better progress when cared for at home than when
Midterm Follow-up of High-Grade Genital Prolapse Repair by the Trans-obturator and Infracoccygeal Hammock Procedure after Hysterectomy
Authors: Loïc Sentilhes, Fabrice Sergent, Benoît Resch, Eric Verspyck, Philippe Descamps, Loïc Marpeau
Journal: European Urology (2006)
A semi-invariant Vα10+ T cell antigen receptor defines a population of natural killer T cells with distinct glycolipid antigen–recognition properties
Authors: Adam P Uldrich, Onisha Patel, Garth Cameron, Daniel G Pellicci, E Bridie Day, Lucy C Sullivan, Konstantinos Kyparissoudis, Lars Kjer-Nielsen, Julian P Vivian, Benjamin Cao, Andrew G Brooks, Spencer J Williams, Petr Illarionov, Gurdyal S Besra, Stephen J Turner, Steven A Porcelli, James McCluskey, Mark J Smyth, Jamie Rossjohn, Dale I Godfrey
Journal: Nature Immunology (2011)
Hostility to kith and kin.
Authors: S Behrman
Journal: BMJ (1975)

Ten male patients who shared a similar behaviour disorder have been seen. Their behaviour was characterized by extreme hostility towards close members of the family without aggressiveness towards others. The first manifestations of an increase in hostility may be acts aimed to injure of denigrate the spouse or close members of the family. The dynamics of Capgras's syndrome may be similar. This behaviour disorder must be recognized as one of many causes of conjugal conflict.
Abstract 3855: Inhibitors of apoptosis (IAPs) in gastrointestinal stromal tumors
Authors: Johanna Falkenhorst, Thomas Mühlenberg, Susanne Simon, Sonja Ecken, Joern Henze, Florian Grabellus, Frank Breitenbücher, Martin Schuler, Jonathan A. Fletcher, Sebastian Bauer
Journal: Cancer Research (2012)

Abstract Introduction Gastrointestinal stromal tumors (GIST) are characterized by gain-of-function-mutations of c-KIT or PDGFRA. Despite long-lasting remissions with the KIT inhibitor imatinib (IM) most patients eventually progress. While inhibitors of apoptosis proteins (IAPs) may confer resistance in other cancers little is known about the role of IAPs in GIST. Material and Methods IAP expression (cIAPs, XIAP, survivin) in patient samples (TMA, n=163), IM-sensitive (GIST-T1, GIST882, GIST430) and IM-resistant (GIST48B, GIST48) GIST cell lines (RT-PCR, western blot) was analyzed. The impact of KIT and growth inhibitory drugs on IAP expression (24h of treatment) was determined by western blot. Biological consequences of IAP modulation (YM155: transcriptional repressor of survivin; Embelin: biochemical XIAP inhibitor; lentiviral shRNA knockdown [KD] of survivin, XIAP) were investigated alone and in combination with KIT-related pathway inhibitors (IM, LY294002, 17-AAG). Results cIAPs, XIAP and survivin were expressed at various levels in all KIT-positive and negative GIST cell lines. Resistant cell lines did not exhibit higher levels of IAPs. Survivin expression was found to vary over time in GIST-T1 and 48B (2- and 4-fold within 5 days. Survivin expression (immunoreactivity score α3) was found in 40% of GIST patients. PI3K inhibition led to survivin downregulation of 20 to 65% (24h) in all tested cell lines whereas KIT inhibition (IM, 24h) reduced survivin and XIAP expression only in GIST-T1 (52%). The protein levels of both XIAP and survivin were decreased following HDAC (SAHA: 44-71%, except GIST430) and MDM2 inhibition (survivin: 40 - 90%). YM155 downregulated survivin and exhibited proapoptotic and antiproliferative effects in all cell lines at low nM levels (IC50: GIST-T1: 4nM, GIST48P: 40nM, GIST48B, GIST 882: 80nM) except GIST430 (IC50&amp;gt;1µM). No antagonistic effects were seen with combinational treatment. Embelin treatment resulted in IC50 levels of 40µM - 300µM while lacking a specific XIAP inhibition. A stable XIAP KD was established in GIST-T1 resulting in slower growth (25% in 3d). Conclusion IAPs are commonly expressed in GIST cell lines regardless of resistance to IM. Expression levels are mostly independent from KIT inhibition but proapoptotic effects from HDAC and MDM2 inhibitors may in part be conferred by IAPs. The survivin repressor YM155 showed antiproliferative and proapoptotic effects at levels that are therapeutically achievable suggesting a potential therapeutic role in GIST. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3855. doi:1538-7445.AM2012-3855
Four in 10 cases of alleged abuse of vulnerable adults occur in own homes
Authors: A. Gulland
Journal: BMJ (2011)

New NHS figures on the numbers of complaints that local councils receive on abuse of vulnerable adults show that four in 10 of the allegations centre on abuse in adults’ own homes.

The figures from the NHS Information Centre show that of the 94 200 alerts and referrals submitted to 101 councils that have adult social services responsibilities, a third (32 700) were about abuse in residential homes and 40% (39 300) concerned abuse in their own homes. The remainder (26%) were related to other healthcare settings, public places, and workplaces.

The collection of the figures was piloted among 31 councils in 2008-9 and then rolled …
Azathioprine in pemphigus vulgaris.
Authors: J L Burton, M W Greaves, J Marks, R P Dawber
Journal: BMJ (1970)

Lipid Levels in Hyperosmolar Diabetic Coma-Bewsher et al. MEDICJoURNAhydroxy-,B-methyl glutaryl CoA.If the greatly raised cholesterol levels in hyperosmolar non-ketotic diabetic coma are due to accelerated formation rather than decreased degra- dation or excretion, then any block in ketone production should occur beyond the initial stage of synthesis.Further explanations for the lack of ketosis in this condition would be increased urinary excretion of ketones or an increase in their utilization.The lack of significant ketonuria does not support the former suggestion, and there are no reports that the turnover of ketone bodies is increased.
Children's consent to treatment
Authors: W G Brooks, L Bahar-Posey, L Weathers, W Pardue
Journal: BMJ (1994)

EDITOR, - We wish to respond to the strong position taken by J P H Shield and J D Baum with respect to children's informed consent to treatment.1 A doctor's responsibility to his or her patient is to diagnose and treat the patient skilfully and to disclose adequate information to enable the patient to become informed about any contemplated …
Abstract 647: Novel promoter hypermethylation marker for prognostic in cervicouterine cancinogenesis.
Authors: Priscilla Brebi, Alejandra Andana, Rene Hoffstetter, Carmen Ili, Tamara Viscarra, Ramon Silva, Patricia Garcia, Pamela Leal, Helga Weber, Juan C. Roa
Journal: Cancer Research (2013)

Abstract New biomarkers are needed to improve cervical cancer screening technologies, which are mostly based on cytological examination and HPV detection. However, PAP-smear has a low-sensitivity to detect low grade squamous intraepithelial lesions and not all HPV infected women will develop preneoplastic or neoplastic lesions. Previous results of our group showed that genes Gen Z (patent pending), CDH1 and MEGF9 could be hypermethylated in cervical cancer and not in normal epithelia. The aim of this study was to determinate if promoter methylation status of genes (Gen Z, CDH1 and MEGF9) are related with progression or diagnosis of cervical carcinogenesis. For this study, 107 citobrush, urine and blood samples were collected from women who attended to gynecological care in a public health center in Temuco, Chile. Citobrush DNA from 50 normal, 40 low grade squamous intraepithelial lesion (LSIL), 40 high grade squamous intraepithelial lesion (HSIL) and 17 squamous cervical cancer were bisulfite converted for methylation specific PCR (MSP). Bisulfite conversion was confirmed by amplification of a 133-bp fragment of the β-actin. MSP primers were specifically design for CpG island of promotor region of each gene. Gen Z was found 100% methylated in SCC samples, 65% in HSIL, 43% in LSIL and in normal samples only a 26%. MEGF9 and CDH1 genes were found methylated in 36% and 48% of normal samples, 45% and 55% of LSIL, 70% and 77% of HSIL and 47% and 71% of SCC, respectively. All promoter regions studied showed a higher methylation frequency in LSIL, HSIL and SCC than normal samples. Significant statistical differences in Gen Z and CDH1 Methylation frequencies between normal and SCC samples were found (P&amp;lt;0.05). Methylation of Gen Z increased in a sequential and cumulative way as the lesion progress. Our results suggest that the Gen Z could be useful tool for identifying women with a higher risk of progression to cervical cancer. Examination of these biomarkers in a larger, independent cohort is warranted. Grant Support: This investigation was financed by Proyect CORFO-INNOVA N°07CN13PBT-222 and Proyect CORFO N° 09CN14-5960 (CEGIN). CI is recipient of grants from FONDECYT Postdoctoral Proyect N° 3130630. PB is recipient of grants from FONDECYT Postdoctoral Proyect N° 3120141 Citation Format: Priscilla Brebi, Alejandra Andana, Rene Hoffstetter, Carmen Ili, Tamara Viscarra, Ramon Silva, Patricia Garcia, Pamela Leal, Helga Weber, Juan C. Roa. Novel promoter hypermethylation marker for prognostic in cervicouterine cancinogenesis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 647. doi:10.1158/1538-7445.AM2013-647
Toxicology, structure-function relationship, and human and environmental health impacts of polychlorinated biphenyls: progress and problems.
Authors: S Safe
Journal: Environmental Health Perspectives (1993)

Polychlorinated biphenyls (PCBs) are industrial compounds that have been detected as contaminants in almost every component of the global ecosystem including the air, water, sediments, fish, and wildlife and human adipose tissue, milk, and serum. PCBs in commercial products and environmental extracts are complex mixtures of isomers and congeners that can now be analyzed on a congener-specific basis using high-resolution gas chromatographic analysis. PCBs are metabolized primarily via mixed-function oxidases into a broad spectrum of metabolites. The results indicate that metabolic activation is not required for PCB toxicity, and the parent hydrocarbons are responsible for most of the biochemical and toxic responses elicited by these compounds. Some of these responses include developmental and reproductive toxicity, dermal toxicity, endocrine effects, hepatotoxicity, carcinogenesis, and the induction of diverse phase I and phase II drug-metabolizing enzymes. Many of the effects observed for the commercial PCBs are similar to those reported for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds. Structure-function relationships for PCB congeners have identified two major structural classes of PCBs that elicit "TCDD-like" responses, namely, the coplanar PCBs (e.g., 3,3',4,4'-tetraCB, 3,3'4,4',5-pentaCB and 3,3',4,4',5,5'-hexaCB) and their mono-ortho coplanar derivatives. These compounds competitively bind to the TCDD or aryl hydrocarbon (Ah) receptor and exhibit Ah receptor agonist activity. In addition, other structural classes of PCBs elicit biochemical and toxic responses that are not mediated through the Ah receptor. The shor-term effects of PCBs on occupationally exposed humans appear to be reversible, and no consistent changes in overall mortality and cancer mortality have been reported. Recent studies have demonstrated that some developmental deficits in infants and children correlated with in utero exposure to PCBs; however, the etiologic agent(s) or structural class of PCBs responsible for these effects have not been delineated. In contrast, based on a toxic equivalency factor approach, the reproductive and developmental problems in certain wildlife populations appear to be related to the TCDD-like PCB congeners.
Lipid-lowering therapy for the primary prevention of coronary heart disease
Authors: Antonio M Gotto
Journal: Journal of the American College of Cardiology (1999)

For more than 40 years, observational epidemiologic studies have consistently documented that individuals with elevated serum total cholesterol are at increased risk for a first coronary heart disease (CHD) event [(1–4)][1]. In general, clinical data indicate that CHD risk is 2% to 3% lower for
Reviews and Notes: Quinine's Predecessor: Francesco Torti and the Early History of Cinchona
Authors: J. Joseph Marr
Journal: Annals of Internal Medicine (1994)

Literature of Medicine1 March 1994Reviews and Notes: Quinine's Predecessor: Francesco Torti and the Early History of CinchonaJ. Joseph MarrJ. Joseph MarrRibozyme Pharmaceuticals, Inc., Boulder, CO 80301Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-5-199403010-00036 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Quinine's Predecessor: Francesco Torti and the Early History of CinchonaSaul Jarcho. 354 pages. Baltimore: The Johns Hopkins University Press; 1993. $55.00.Few disciplines in medicine are as visibly linked with their historical derivations as tropical diseases. Within this discipline, perhaps no story captures the romance of the renaissance of medical investigation better than the understanding of malaria and the development of quinine. Despite the therapeutic importance of quinine, its congeners, and the newer agents that have been developed, most students and practitioners of infectious and tropical diseases have little understanding of the history of this fascinating group of compounds. ... Author, Article, and Disclosure InformationAffiliations: Ribozyme Pharmaceuticals, Inc., Boulder, CO 80301 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1994Volume 120, Issue 5Page: 445KeywordsFeversInfectious diseasesMalariaQuinineScientistsTropical diseases ePublished: 15 August 2000 Issue Published: 1 March 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Release of RANTES, MIP-1 α , and MCP-1 into Asthmatic Airways Following Endobronchial Allergen Challenge
Authors: STEPHEN T. HOLGATE, KATHLEEN S. BODEY, ALENKA JANEZIC, ANTHONY J. FREW, ALLEN P. KAPLAN, LUIS M. TERAN
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

We have investigated the presence of regulated on activation, normal T-cell expressed and probably secreted (RANTES), macrophage inflammatory peptide-1 α (MIP-1 α ), and macrophage chemotactic peptide (MCP-1) in the bronchoalveolar lavage fluid (BALF) obtained from normal (n = 7) and stable asthmatic subjects (n = 8), and studied their kinetic release into asthmatic airways following endobronchial allergen challenge (n = 18). Measurements of RANTES, MIP-1 α , and MCP-1 in 10 times (10 × ) concentrated BALF showed that these three chemokines were present in both normal controls and stable asthmatic patients, but no significant difference between the two groups was found in the levels of the three chemokines. However, at 4 h after allergen challenge, BALF levels of RANTES, MIP-1 α , and MCP-1 were significantly increased in fluid obtained from the allergen-challenge site when compared with the saline-challenge control site (median: 175 pg/ml versus 11.5 pg/ml, 258 pg/ml versus 88 pg/ml, and 900 pg/ml versus 450 pg/ml, respectively). At 24 h, levels of the three chemokines returned to baseline values. To investigate whether cells in BALF obtained 4 h after allergen exposure release chemokines, they were cultured for 24 h. BALF cells from the allergen site released more RANTES and MCP-1 than those from the saline site, but released similar amounts of MIP-1 α . These findings suggest that RANTES, MIP-1 α , and MCP-1 may regulate cell trafficking in asthma in response to allergen exposure.
Resistant Hypertension: Diagnosis and Management
Authors: RAY W. GIFFORD
Journal: Annals of Internal Medicine (1978)

Fortunately, hypertension resistant to a good drug regimen is rare. When hypertension fails to respond to medical treatment there is usually another explanation, such as poor patient compliance, excessive salt ingestion, drug interactions, spuriously high office readings, or an unsuspected secondary cause for the hypertension. Management of resistant hypertension can be aided by identifying the hemodynamic and humoral mechanisms responsible for its resistance and redesigning the therapeutic regimens accordingly. When they become available, two investigational drugs, minoxidil and an oral converting enzyme inhibitor, both of which lower total peripheral resistance, will offer a new approach to controlling truly resistant hypertension.
Total Hip Replacement in Osteoarthrosis using the Charnley Prosthesis
Authors: R. C. Todd, C. D. R. Lightowler, J. Harris
Journal: BMJ (1972)

Charnley low-friction arthroplasty was performed on 352 osteoarthritic hips, usually because of severe pain. Three hundred and twenty hips were reviewed at a special follow-up clinic or by postal questionnaire. After operation 89% of hips were pain-free or caused only occasional discomfort, and in 76% there was an increased range of movement. Of those patients actually seen for review 79% were judged to have a good or excellent result. The most frequent single complication was deep infection, which occurred in 5.3% of hips.