tbuckley/cabot-search huggingface dataset:
A Tale of Coronary Artery Disease and Myocardial Infarction
Authors: Elizabeth G. Nabel, Eugene Braunwald
Journal: New England Journal of Medicine (2012)

The remarkable facts, that the paroxysm, or indeed the disease itself, is excited more especially upon walking up hill, and after a meal; that thus excited, it is accompanied with a sensation, which threatens instant death if the motion is persisted in; and, that on stopping, the distress immediately abates, or altogether subsides; have . . .formed a constituent part of the character of Angina Pectoris. 1 " R emarks on Angina Pectoris" by John Warren, M.D., appeared in 1812 as the first article in the first issue of The New England Journal of Medicine and Surgery. 1 Warren's description of angina pectoris (derived from the Latin angina, "infection of the throat"; from the Greek άγχο′νη, "strangling"; and from the Latin pectus, "chest") is equally apt for physicians and medical students today.At the time, the pathogenesis was unknown, and treatment consisted of bloodletting, a tincture of opium, bed rest, or a combination thereof.In 1799, Caleb H. Parry speculated that Syncope Anginosa was related to coronary-artery ossification (i.e., calcification), occurring predominantly in men at about 50 years of age and rarely in women or children. 2 Medical knowledge in the 18th and 19th centuries was grounded in clinical observation and anatomical dissection.Cardiovascular science emerged in the physiological era of the late 19th and early 20th centuries, first in Europe and subsequently in North America.To celebrate the 200th anniversary of the New England Journal of Medicine, our essay focuses on the themes of coronary artery disease and myocardial infarction to highlight the interplay between science and medicine, emphasizing how the remarkable advances in our understanding of the pathogenesis of heart disease have produced life-saving and life-extending therapies. The Emergence of Corona r y A rter y Dise a seAfter Heberden's clinical description of angina 3 in 1772, it took almost a century for pathologists to focus their attention on the coronary arteries and describe thrombotic occlusions in addition to "ossification."However, for decades thereafter, these observations were not related to the symptoms of myocardial ischemia, which had become well known to physicians.Near the end of the 19th century, cardiovascular physiologists noted that occlusion of a coronary artery in the dog caused "quivering" of the ventricles and was rapidly fatal. 4,5These three great branches of medical knowledge -clinical medicine, pathology, and physiology -advanced in separate yet parallel universes.In 1879, the pathologist Ludvig Hektoen concluded that myocardial infarction is caused by coronary thrombosis "secondary to sclerotic changes in the coronaries." 6In 1910, two Russian clinicians who were trained in pathology described five patients with the clinical picture of acute myocardial infarction, which was confirmed at postmortem examination. 7Two years later,The New England Journal of Medicine Downloaded from nejm.org
Alzheimer Researchers Focus Efforts on Early Development and Earlier Detection
Authors: M. J. Friedrich
Journal: JAMA (2008)

WITH MORE THAN 5 MILLION people in the United States diagnosed with Alzheimer disease (AD)—a number that is expected to triple in the next few decades— researchers are hotly pursuing effective therapies to treat the condition. One of the keys to doing so, say experts in the field, is finding a way to detect AD in its earliest stages, as well as gaining a better understanding of AD pathogenesis.
Corticosteroids in Croup
Authors: James W. Bass
Journal: JAMA (1972)

<h3>To the Editor.—</h3> There is considerable controversy concerning the use of corticosteroids in the treatment of croup.<sup>1-3</sup>Eden and associates have conducted two double-blind studies evaluating the effectiveness of these drugs in the treatment of this disorder and were unable to show any significant benefit in patients treated with corticosteroids when compared to controls treated with placebo.<sup>4,5</sup>In both reports, the author advised that although he was unable to show any benefit resulting from this form of therapy, further studies are indicated before it can be concluded that they are ineffective. Indeed, a review of the literature, including all double-blind, controlled studies published to date on this subject, reveals that most<sup>6-8</sup>have shown a statistically significant benefit in several clinical measurements. The dosages of steroids used in those studies showing a positive effect were generally higher than those used by Eden, but duration of therapy was similar,
Comparison between irrigation and conventional treatment for empyema and pneumonectomy space infection.
Authors: F L Rosenfeldt, D McGibney, M V Braimbridge, D A Watson
Journal: Thorax (1981)

A new method of treating pleural empyema or pneumonectomy space infection by irrigation was evaluated in 11 patients. The infected cavities were filled with an antibiotic or antiseptic solution for three hours, and allowed to drain for one hour. This cycle was repeated every four hours for seven to 10 days. When cultures of the infected cavity became sterile the irrigation tube was removed and the wound sealed. Using this method, infection was eradicated after an average of 11 days in five of six patients with pleural empyema and in all five patients treated for an infected pneumonectomy space, including one with a bronchopleural fistula. The results of treating 58 similar cases of intrapleural sepsis over a 10-year period by the standard methods of aspiration, open drainage, decortication, or thoracoplasty were compared with the results of irrigation. In general, cyclical irrigation resulted in a shorter hospital stay and a shorter period of wound drainage than other methods.
Biopsy Confirmation of Metastatic Disease in Breast Cancer: Results from a Large Prospective Study.
Authors: E. Amir, O. Freedman, C. Simmons, N. Miller, W. Geddie, G. Dranitsaris, H. Maung, J. Napolskikh, M. Lax, M. Clemons
Journal: Cancer Research (2009)

Abstract Purpose: Decisions about systemic treatment of women with metastatic breast cancer are often based on estrogen receptor (ER), progesterone receptor (PgR), and HER2/neu status of the primary tumour. This study prospectively investigated concordance in receptor status between primary tumour and distant metastases at various stages of progression and assessed the impact of any discordance on patient management.Methods: Biopsies of suspected metastatic lesions were obtained from patients and analyzed for ER/PgR and HER2/neu. Receptor status of metastases was compared to the primary tumour. The treating physician completed questionnaires before and after biopsy to determine whether the biopsy result lead to a change in treatment plan.Results: One hundred and sixteen women were enrolled and 102 underwent biopsy. Of these 52 (51%) were newly diagnosed with metastatic disease, 17 (17%) had received one line of metastatic treatment and 35 (34%) had received 2 or more lines of treatment in the metastatic setting. 86/102 (84%) of samples were sufficient analysis; of these 5/86 biopsies (6%) showed benign disease and one biopsy (1%) confirmed a different malignancy (indolent lymphoma). Changes in hormone receptor status were observed in 33%. Among these, ER discordance was seen in 11%, PgR discordance in 27% and discordance in both ER and PgR in 5%. Loss of PgR was the most common change in hormone receptor status (25%). HER2/neu showed 4% discordance. Three patients (3%) gained and one patient (1%) lost HER2/neu expression. Biopsy results led to a change of management in 12% of patients. Patients with newly diagnosed metastatic disease were more likely to show discordance than those previously treated in the metastatic setting. Among triple negative primary tumours, no changes in receptor expression of metastases were seen.Conclusions: This is the largest prospective biopsy study we are aware of. Results demonstrate the presence of substantial discordance in receptor status between primary tumour and metastases. The number needed to biopsy to alter immediate management was 8.5, although biopsy information could also be useful in planning subsequent treatments. Tissue confirmation should therefore, be considered in all patients with suspicion of metastatic recurrence or progression. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2023.
AIDS Projections: How Farr Out?-Reply
Authors: Dennis J. Bregman
Journal: JAMA (1990)

<h3>In Reply.—</h3> We appreciate Mr Artzrouni calling our attention to his research presented at the Fourth International Conference on AIDS, where he stated: "Under the model's assumptions the AIDS epidemic curve will reach its maximum in the early 1990s." We therefore amend the sentence in our article to the following: "Only one of 13 models in the GAO [General Accounting Office] report considered the concept that the epidemic might crest then decline." We welcome Mr Artzrouni into the small but growing group of epidemiologists who believe the epidemic curve in the United States has or soon will crest and then progressively decline toward a still-to-be-determined low endemic level. To our knowledge, AIDS is the first epidemic whose trends are repeatedly graphed in terms of cumulative incidence. We believe this method of presenting epidemiologic trends confuses many people because cumulative incidence<i>always</i>increases with the passage of time. The General
Respirators and Tuberculosis
Authors: Harold L. Israel
Journal: Annals of Internal Medicine (1995)

Letters1 January 1995Respirators and TuberculosisHarold L. Israel, MD, MPHHarold L. Israel, MD, MPHThomas Jefferson University; Philadelphia, PA 19107Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-1-199501010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The illuminating article by Nettleman and colleagues [1] places the cost of particulate respirator use in preventing tuberculosis in Veterans Administration hospital workers at $7 million per case prevented and $100 million per life saved. They assumed a case mortality rate of 7% on the basis of the national 1992 incidence and mortality rate figures. That mortality rate, however, is heavily concentrated in patients with the acquired immunodeficiency syndrome, homeless persons, alcoholic persons, and those born outside the United States. The case mortality rate among cooperative and well-nourished Veterans Administration health care workers should be less than ...Reference1. Nettleman MD, Fredrickson M, Good NL, Hunter SA. Tuberculosis control strategies: the cost of particulate respirators. Ann Intern Med. 1994; 121:37-40. Google Scholar Author, Article, and Disclosure InformationAuthors: Harold L. Israel, MD, MPHAffiliations: Thomas Jefferson University; Philadelphia, PA 19107 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1995Volume 122, Issue 1Page: 70-71KeywordsAIDSAlcoholicsDeath ratesHealth care providersParticulatesPrevention, policy, and public healthRespirators ePublished: 15 August 2000 Issue Published: 1 January 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Propranolol, Epinephrine, and Accelerated Hypertension During Hemodialysis
Authors: THOMAS V. WHELAN
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 February 1987Propranolol, Epinephrine, and Accelerated Hypertension During HemodialysisTHOMAS V. WHELAN, M.D.THOMAS V. WHELAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-2-327_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Eighty percent of patients with severe renal insufficiency have hypertension before the institution of dialysis (1). Once on maintenance dialysis, approximately 25% will still require at least one antihypertensive medication (2). In certain instances, this dialysis-resistant hypertension is due to a relative or absolute increase in renin activity. Treatment has traditionally been with beta-blockers and more recently with angiotensin-converting enzyme inhibitors. As a group, the beta-blockers are the most commonly prescribed agents for control of hypertension, and they are usually well tolerated. The most dangerous adverse reactions are well known and include congestive heart failure, aggravation of...References1. LAZARUSHAMPERSMERRILL JCJ. Hypertension in chronic renal failure. Arch Intern Med. 1974;133:1059-66. CrossrefMedlineGoogle Scholar2. WHITERUBIN RA. Blood pressure control in chronic dialysis patients. In: DRUKKER W, PARSONS FM, MAHER JF, eds. Replacement of Renal Function by Dialysis. 2nd ed. Boston: Martinus Nijhoff; 1983:575-87. CrossrefGoogle Scholar3. HANSBROUGHNEAR JA. Propanolol-epinephrine antagonism with hypertension and stroke [Letter]. Ann Intern Med. 1980;92:717. LinkGoogle Scholar4. FOSTERASTON CS. Propanolol-epinephrine interaction: a potential disaster. Plast Reconstr Surg. 1983;72:74-8. CrossrefMedlineGoogle Scholar5. CAIRNSMARSHALL SA. Clonidine withdrawal. Lancet. 1976;1:368. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Naval Hospital Uniformed Services University of the Health Sciences Bethesda, MD 20814The views expressed herein are those of the author and not of the Department of Defense or of the Department of the Navy. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDrug Interactionsβ-Adrenoceptor antagonists and antianginal drugsHigh Blood Pressure: Side Effects of Drugs, Poisons, and Food 1 February 1987Volume 106, Issue 2Page: 327-327KeywordsAdverse reactionsAngiotensin converting enzyme inhibitorEpinephrineHeart failureHypertensionMedical dialysis Issue Published: 1 February 1987 PDF DownloadLoading ...
Src family kinases mediate neutrophil adhesion to adherent platelets
Authors: Virgilio Evangelista, Zehra Pamuklar, Antonio Piccoli, Stefano Manarini, Giuseppe Dell'Elba, Romina Pecce, Nicola Martelli, Lorenzo Federico, Mauricio Rojas, Giorgio Berton, Clifford A. Lowell, Licia Totani, Susan S. Smyth
Journal: Blood (2006)
Biomarkers of Chronic Cardiac Injury and Hemodynamic Stress Identify a Malignant Phenotype of Left Ventricular Hypertrophy in the General Population
Authors: Ian J. Neeland, Mark H. Drazner, Jarett D. Berry, Colby R. Ayers, Christopher deFilippi, Stephen L. Seliger, Vijay Nambi, Darren K. McGuire, Torbjørn Omland, James A. de Lemos
Journal: Journal of the American College of Cardiology (2012)
Adverse Birth Outcomes and Maternal Exposure to Trichloroethylene and Tetrachloroethylene through Soil Vapor Intrusion in New York State
Authors: Steven P. Forand, Elizabeth L. Lewis-Michl, Marta I. Gomez
Journal: Environmental Health Perspectives (2011)

Industrial spills of volatile organic compounds (VOCs) in Endicott, New York (USA), have led to contamination of groundwater, soil, and soil gas. Previous studies have reported an increase in adverse birth outcomes among women exposed to VOCs in drinking water.We investigated the prevalence of adverse birth outcomes among mothers exposed to trichloroethylene (TCE) and tetrachloroethylene [or perchloroethylene (PCE)] in indoor air contaminated through soil vapor intrusion.We examined low birth weight (LBW), preterm birth, fetal growth restriction, and birth defects among births to women in Endicott who were exposed to VOCs, compared with births statewide. We used Poisson regression to analyze births and malformations to estimate the association between maternal exposure to VOCs adjusting for sex, mother's age, race, education, parity, and prenatal care. Two exposure areas were identified based on environmental sampling data: one area was primarily contaminated with TCE, and the other with PCE.In the TCE-contaminated area, adjusted rate ratios (RRs) were significantly elevated for LBW [RR = 1.36; 95% confidence interval (CI): 1.07, 1.73; n = 76], small for gestational age (RR = 1.23; 95% CI: 1.03, 1.48; n = 117), term LBW (RR = 1.68; 95% CI: 1.20, 2.34; n = 37), cardiac defects (RR = 2.15; 95% CI: 1.27, 3.62; n = 15), and conotruncal defects (RR = 4.91; 95% CI: 1.58, 15.24; n = 3). In the PCE-contaminated area, RRs for cardiac defects (five births) were elevated but not significantly. Residual socioeconomic confounding may have contributed to elevations of LBW outcomes.Maternal residence in both areas was associated with cardiac defects. Residence in the TCE area, but not the PCE area, was associated with LBW and fetal growth restriction.
Purtscher‐like retinopathy as an initial presentation of a thrombotic microangiopathy associated with antineoplastic therapy
Authors: C. Parc
Journal: American Journal of Hematology (2007)

Abstract We describe the case of a 31‐year‐old female with Hodgkin's lymphoma who developed renal and retinal thrombotic microangiopathy (TM) months after autologous bone marrow transplantation. Presenting symptoms were ocular and examination findings were consistent with a Purtscher‐like retinopathy. This case demonstrates that patients being treated with antineoplastic therapy who develop TM should have an ocular examination for Purtscher retinopathy. The visual prognosis of Purtscher retinopathy is guarded. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
SYSTOLIC MURMURS IN CHILDREN
Authors: MURRAY H. BASS
Journal: JAMA (1933)

There are few differential diagnoses more difficult, and at the same time more important, than the differentiation between organic and functional murmurs. This question assumes a particular significance in childhood, when functional murmurs are common and when early rheumatic infection may give rise to faint systolic murmurs. In a given case the diagnosis of such soft blowing murmurs calls for most careful judgment, for the evaluation of the type of murmur is of extreme importance as regards the subsequent treatment of the child. Various diagnostic criteria have been proposed to aid in distinguishing between organic and functional murmurs. Briefly stated, they are as follows: <h3>Time in Cycle.</h3> —A functional murmur is almost invariably systolic, rarely diastolic, in time. <h3>Quality.</h3> —Generally speaking, the functional murmur is very short and blowing. It rarely has the rough, rasping, or even musical qualities that are characteristic of organic murmurs. <h3>Duration.</h3> —As a rule, the
Other Side of Table Mountain
Authors: R. Hoffenberg
Journal: BMJ (1970)

Furthermore, these antibodies have been characterized as being heat-labile, non- precipitating, and non-complement binding.Because of their non-precipitating nature several methods have been described to detect them: inhibition of the Prausnitz- Kustner reaction,1 the red cell-linked- antigen-antiglobulin-reaction,2 radioactive methods of Rowe3 and Wide et al.'Micromethods of diffusion in agar gels are now routinely used for quantitative measurements of immunoglobulins, and we have recently developed a technique of immunodiffusion in agar gel which demon- strates that IgE forms a visible precipitate (Fig. ) given certain optimum conditions, which may be used as a quantitative measurement of IgE levels.-Weare, etc.,
Effect of conservative treatment on the renal outcome of children with primary hyperoxaluria type 1
Authors: Sonia Fargue, Jérôme Harambat, Marie-France Gagnadoux, Michel Tsimaratos, Françoise Janssen, Brigitte Llanas, Jean-Pierre Berthélémé, Bernard Boudailliez, Gérard Champion, Claude Guyot, Marie-Alice Macher, Hubert Nivet, Bruno Ranchin, Rémi Salomon, Sophie Taque, Marie-Odile Rolland, Pierre Cochat
Journal: Kidney International (2009)
ACUTE TRANSITORY CEREBRAL MANIFESTATIONS IN INFANTS AND IN CHILDREN
Authors: ABRAHAM LEVINSON
Journal: JAMA (1933)

Among the many problems confronting the physician are those of the differential diagnosis and treatment of acute transitory cerebral manifestations in infants and in children.  The cases usually occur during the autumn and winter, and often at night. They rank next to croup in the frequency with which they disturb the sleep of the practicing physician and of the hospital intern. The patient, an infant or an older child, becomes ill suddenly, with fever, apathy or convulsions. On examination the child is drowsy or comatose, his neck is usually rigid, and the Brudzinski and Kernig signs are positive. There may even be a facial paralysis, hemiplegia or diplegia. The chest may have an occasional râle; the throat may be red, and the ear drums congested. The physical examination may, however, give negative results except for the cerebral manifestations.  It is true that the diagnosis often establishes itself within a day
Effect on airways resistance of prostaglandin E1 given by aerosol to healthy and asthmatic volunteers
Authors: M. F. Cuthbert
Journal: BMJ (1969)

The forced expiratory volume in one second (F.E.V.(1)) was measured in healthy and asthmatic volunteers and the inhalation of prostaglandin E(1) (PGE(1)) was compared with that of isoprenaline, using metered aerosols.In healthy volunteers PGE(1), either as the free acid or the neutral triethanolamine salt, did not affect the F.E.V.(1); the free acid was irritant to the upper respiratory tract. In five out of six asthmatic volunteers with reversible airways obstruction, inhalation of 55 mug of PGE(1) (triethanolamine salt) produced an increase in F.E.V.(1) comparable in both degree and duration to that produced by an inhalation of 550 mug. of isoprenaline sulphate.Though the triethanolamine salt was well tolerated in most of the asthmatic subjects studied, in one asthmatic subject this preparation caused coughing and there was a progressive reduction in the F.E.V.(1) associated with bronchospasm.
S7 Influence of Beta-2 Adrenoceptor Genotype on Response to Regular Racemic or Levosalbutamol in Steroid Treated Asthmatics
Authors: WJ Anderson, PM Short, PA Williamson, AE Morrison, CNA Palmer, R Tavendale, BJ Lipworth
Journal: Thorax (2012)

<h3>Background</h3> Asthmatic patients receiving inhaled corticosteroids often take frequent add-on therapy with albuterol despite on-demand prescription. We wished to evaluate trough methacholine airway hyper-responsiveness (the primary outcome) following regular treatment with racemic salbutamol and levosalbutamol compared to placebo, in steroid treated asthmatics stratified according to beta-2 adrenoceptor 16 genotype. <h3>Methods</h3> We performed a randomised, double-blind, placebo-controlled, triple crossover trial comparing 2 weeks of regular therapy with inhaled racemic salbutamol (200µg qid); levosalbutamol (100µg qid); or placebo on methacholine PC20 6 hours post dose in 30 persistent asthmatics (15 homozygous Arg16 and Gly16) receiving inhaled corticosteroids. <h3>Results</h3> There was no rebound worsening of trough airway hyper-responsiveness to methacholine after chronic exposure to either racemic (p=0.53) or levosalbutamol (p=0.84) compared to placebo; nor between genotypes - as doubling dilution (dd) difference in methacholine PC20 from placebo (Figure 1): salbutamol/Arg16= 0.36dd (95% CI: –0.43, 1.15); salbutamol/Gly16=0.01dd (95% CI: –0.47, 0.49); levosalbutamol/Arg16=–0.01dd (95% CI: –0.89, 0.87); levosalbutamol/Gly16=0.28dd (95% CI: –0.22, 0.77). Both active treatments improved morning PEF in Gly16 (p=0.04) but not Arg16 patients (p=0.50); while evening PEF improved in both Gly16 (p&lt;0.001) and Arg16 patients (p=0.006). <h3>Conclusions</h3> Chronic exposure to either racemic or levosalbutamol added to inhaled corticosteroids did not cause rebound worsening of airway hyper-responsiveness at trough compared to placebo; with no difference seen between beta-2 adrenoceptor 16 genotypes.