tbuckley/cabot-search huggingface dataset:
Nifedipine
Authors: Curt D. Furberg, Bruce M. Psaty, Jeffrey V. Meyer
Journal: Circulation (1995)

Background The purpose of this study was to assess the effect of the dose of nifedipine, a dihydropyridine calcium antagonist, on the increased risk of mortality seen in the randomized secondary-prevention trials and to review the mechanisms by which this adverse effect might occur. Methods and Results We restricted the dose-response meta-analysis to the 16 randomized secondary-prevention trials of nifedipine for which mortality data were available. Recent trials of any calcium antagonist and formulation were also reviewed for information about the possible mechanisms of action that might increase mortality. Overall, the use of nifedipine was associated with a significant adverse effect on total mortality (risk ratio, 1.16, with a 95% CI of 1.01 to 1.33). This summary estimate fails to draw attention to an important dose-response relationship. For daily doses of 30 to 50, 60, and 80 mg, the risk ratios for total mortality were 1.06 (95% CI, 0.89 to 1.27), 1.18 (95% CI, 0.93 to 1.50), and 2.83 (95% CI, 1.35 to 5.93), respectively. In a formal test of dose response, the high doses of nifedipine were significantly associated with increased mortality ( P =.01). While the mechanism of this adverse effect is not known, there are several plausible explanations, including the established proischemic effect, negative inotropic effects, marked hypotension, recently reported prohemorrhagic effects attributed to antiplatelet and vasodilatory actions of calcium antagonists, and possibly proarrhythmic effects. Conclusions In patients with coronary disease, the use of short-acting nifedipine in moderate to high doses causes an increase in total mortality. Other calcium antagonists may have similar adverse effects, in particular those of the dihydropyridine type. Long-term safety data are lacking for most calcium antagonists.
Triggers of myocardial ischemia during daily life in patients with coronary artery disease: Physical and mental activities, anger and smoking
Authors: Frances H. Gabbay, David S. Krantz, Willem J. Kop, Susan M. Hedges, Jacob Klein, John S. Gottdiener, Alan Rozanski
Journal: Journal of the American College of Cardiology (1996)

Objectives. This study assessed the potency of physical and mental activities and emotions (anger and anxiety) and smoking and other substance use as proximate triggers of ischemia in patients with coronary artery disease during daily life. Background. Myocardial ischemia occurs during a wide variety of activities in patients with coronary artery disease, but frequency and relative potency of physical and mental activities, smoking and use of caffeine and alcohol as triggers of ischemia during daily life have not been established. Methods. Patients (n = 63) with coronary artery disease and evidence of out-of-hospital ischemia kept a validated structured diary of physical and mental activities and psychologic states while undergoing ambulatory electrocardiographic monitoring for 24 to 48 h. Results. Ischemia occurred most frequently during moderately intense physical and mental activities. Patients spent the largest proportion of time engaged in low intensity physical and mental activities (p < 0.05), but the likelihood of ischemia was greatest during intense physical (p < 0.0001) and stressful mental activities (p < 0.03). The percentage of time in ischemia was elevated and approximately equivalent for high intensity physical and high intensity mental activities (5%) compared with 0.2% when patients were engaged in low intensity activities. Strenuous physical activity (e.g., effortful walking, p < 0.05) and the experience of intense anger were potent ischemic triggers, and heart rates at onset of ischemia increased with the intensity of physical and mental activity and with anger. Among smokers, ischemia was more than five times as likely when patients smoked than when they did not (during 27% vs. 5% of diary entries, p < 0.0001). Coffee and alcohol consumption were also related to ischemia (p < 0.05), but this association disappeared after controlling for concurrent cigarette smoking. Conclusions. Triggers of ischemia in patients with coronary artery disease during daily life include not only strenuous exercise, but also activities involving low levels of exertion, such as anger and smoking. Mental activities appear to be as potent as physical activities in triggering daily life ischemia. Coffee and alcohol consumption are related to ischemia only by virtue of their associations with smoking.
Sulfonylureas: Effects in Vivo and in Vitro
Authors: JESSE ROTH
Journal: Annals of Internal Medicine (1971)

To evaluate the effects of therapy on the vascular complications of adult diabetes, the University Group Diabetes Program (UGDP) carried out a prospective double-blind study in 12 centers of 823 newly diagnosed adult-type diabetics, who were randomly assigned to different treatment groups. Over a period of 8 years the overall incidence of nonfatal complications were the same for all groups, irrespective of the therapy—oral placebo, oral sulfonylureas, a small fixed dose of insulin, or a variable dose of insulin sufficient to normalize the blood glucose. Only the variable-dose insulin group maintained nearly normal blood glucose concentrations. In contrast to this, the sulfonylurea-treated group had a significantly increased incidence of fatal cardiovascular events. In vitro, sulfonylureas inhibited the important regulatory enzyme, cyclic AMP phosphodiesterase, in the pancreatic beta cell and in all other tissues tested, including the heart and platelets. In addition to inhibiting phosphodiesterase, sulfonylureas affected other processes in the platelet and in heart muscle. These studies confirm, in vitro, the direct multiple effects of sulfonylureas in many tissue sites outside of the beta cell.
Intra-uterine Infection of Foetus by Gas-gangrene Organisms
Authors: F. H. Kemp, J. A. Stallworthy
Journal: BMJ (1942)

JOURNALwith a severe infection may have to be retained in hospital for three months or longer.Where evidence of a myocardial lesion has been found the patient should not be discharged until the electrocardiogram has returned to normal.I wish to express my thanks to Dr.
Cutaneous T-cell lymphoma: clinicopathological relationships, therapy and survival in ninety-two patients
Authors: L. HAMMINGA, J. HERMANS, E.M. NOORDIJK, C.J.L.M. MEIJER, E. SCHEFFER, W.A. VLOTEN
Journal: British Journal of Dermatology (1982)

Clinicopathological findings, methods of treatment and survival in ninety-two patients with cutaneous T-cell lymphoma (CTCL) (eighty-five mycosis fungoides and seven Sézary syndrome), seen in the Leiden University Hospital between 1974 and 1980, are reported. All patients were staged and treatment was given accordingly. Patients without signs of extracutaneous disease (74%) were treated with eigher total-skin electron-beam irradiation (E beam), topical mechlorethamine (HN2) or PUVA. Topical HN2 and E beam had an equal effect on survival. Electron-beam induced a higher number of initial complete remissions than HN2, but fewer patients relapsed while on maintenance treatment with HN2. In the patients with lymph node and/or visceral involvement, E beam followed by systemic chemotherapy--cyclophosphamide, vincristin (Oncovin) and prednisone (COP)--gave better results than topical therapy or COP alone. Survival was influenced most by the type of skin lesion, the presence or absence of lymph node and/or visceral involvement, and the ability to induce a complete remission initially.
Dying Is Worked to Death
Authors: Alfred Coodley
Journal: JAMA (1975)

<h3>To the Editor.—</h3> Dr. Samuel Vaisrub comments that "dying is worked to death" and he concludes in his editorial that "it is much too easy to write about death." I must assume that the mysterious protective reflex he spoke of is keeping him "oblivious to the certainty of his death." Emotionally, all of us tend, to a greater or lesser extent, to deny the inevitability of death for ourselves. As a result, each time one's patient dies, considerable anxiety is mobilized over the realization that "There but for the grace of God go I." Accordingly, I must disagree with Dr. Vaisrub's suggestion that "it is possible to argue that our neglect of the dying has been exaggerated." I believe it is unfortunate that too many physicians have "been trained to cure, not to comfort; to relieve pain, not to dispel dread." I think that comforting and relieving dread is fully
Improved survival with postoperative uracil-tegafur in stage 1 adenocarcinoma of the lung
Authors: M H Lawson
Journal: Thorax (2004)

▴Kato H, Ichinose Y, Ohta M, et al . A randomized trial of adjuvant chemotherapy with uracil-tegafur for adenocarcinoma of the lung. N Engl J Med2004;350:1713–21[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Tegafur is a pro-drug that is converted to fluorouracil, and the serum concentration of fluorouracil is … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.aulast%253DKato%26rft.auinit1%253DH.%26rft.volume%253D350%26rft.issue%253D17%26rft.spage%253D1713%26rft.epage%253D1721%26rft.atitle%253DA%2BRandomized%2BTrial%2Bof%2BAdjuvant%2BChemotherapy%2Bwith%2BUracil-Tegafur%2Bfor%2BAdenocarcinoma%2Bof%2Bthe%2BLung%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa032792%26rft_id%253Dinfo%253Apmid%252F15102997%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa032792&link_type=DOI [3]: /lookup/external-ref?access_num=15102997&link_type=MED&atom=%2Fthoraxjnl%2F59%2F7%2F573.atom [4]: /lookup/external-ref?access_num=000220947300005&link_type=ISI
Deep Dermatophytosis and Inherited CARD9 Deficiency
Authors: Fanny Lanternier, Saad Pathan, Quentin B. Vincent, Luyan Liu, Sophie Cypowyj, Carolina Prando, Mélanie Migaud, Lynda Taibi, Aomar Ammar-Khodja, Omar Boudghene Stambouli, Boumediene Guellil, Frederique Jacobs, Jean-Christophe Goffard, Kinda Schepers, Véronique del Marmol, Lobna Boussofara, Mohamed Denguezli, Molka Larif, Hervé Bachelez, Laurence Michel, Gérard Lefranc, Rod Hay, Gregory Jouvion, Fabrice Chretien, Sylvie Fraitag, Marie-Elisabeth Bougnoux, Merad Boudia, Laurent Abel, Olivier Lortholary, Jean-Laurent Casanova, Capucine Picard, Bodo Grimbacher, Anne Puel
Journal: New England Journal of Medicine (2013)

Deep dermatophytosis is a severe and sometimes life-threatening fungal infection caused by dermatophytes. It is characterized by extensive dermal and subcutaneous tissue invasion and by frequent dissemination to the lymph nodes and, occasionally, the central nervous system. The condition is different from common superficial dermatophyte infection and has been reported in patients with no known immunodeficiency. Patients are mostly from North African, consanguineous, multiplex families, which strongly suggests a mendelian genetic cause.We studied the clinical features of deep dermatophytosis in 17 patients with no known immunodeficiency from eight unrelated Tunisian, Algerian, and Moroccan families. Because CARD9 (caspase recruitment domain-containing protein 9) deficiency has been reported in an Iranian family with invasive fungal infections, we also sequenced CARD9 in the patients.Four patients died, at 28, 29, 37, and 39 years of age, with clinically active deep dermatophytosis. No other severe infections, fungal or otherwise, were reported in the surviving patients, who ranged in age from 37 to 75 years. The 15 Algerian and Tunisian patients, from seven unrelated families, had a homozygous Q289X CARD9 allele, due to a founder effect. The 2 Moroccan siblings were homozygous for the R101C CARD9 allele. Both alleles are rare deleterious variants. The familial segregation of these alleles was consistent with autosomal recessive inheritance and complete clinical penetrance.All the patients with deep dermatophytosis had autosomal recessive CARD9 deficiency. Deep dermatophytosis appears to be an important clinical manifestation of CARD9 deficiency. (Funded by Agence Nationale pour la Recherche and others.).
Health-related quality of life in COPD: why both disease-specific and generic measures should be used
Authors: C.P. Engström, L.O. Persson, S. Larsson, M. Sullivan
Journal: European Respiratory Journal (2001)

Although research has consistently demonstrated that chronic obstructive pulmonary disease (COPD) impairs health-related quality of life (HRQL), little agreement has been evidenced regarding the factors identified as contributing to impaired HRQL. The aim was to study such factors using well established generic and specific HRQL instruments. The patients (n=68) were stratified by forced expiratory volume in one second (FEV 1 ) to represent a wide range of disease severity. Pulmonary function, blood gases and 6-min walking distance test (6MWD) were assessed. HRQL instruments included: St George's Respiratory Questionnaire (SGRQ), Sickness Impact Profile (SIP), Hospital Anxiety and Depression Scale and Mood Adjective Check List. The strength of the impact of COPD on HRQL was represented along a continuum ranging from lung function, functional status (physical and psychosocial) to wellbeing. Although correlations between FEV 1 versus SGRQ total and SIP overall scores (r=−0.42 and −0.32) were stronger than previously reported, multiple regression analyses showed that lung function contributed little to the variance when dyspnoea-related limitation, depression scores and 6MWD were included in the models. These three factors were important to varying degrees along the whole range of HRQL. Physiological, functional and psychosocial consequences of chronic obstructive pulmonary disease are only poorly to moderately related to each other. The present study concludes that a comprehensive assessment of the effects of chronic obstructive pulmonary disease requires a battery of instruments that not only tap the disease-specific effects, but also the overall burden of the disease on everyday functioning and emotional wellbeing.
CLINICAL RESULTS OF PERCUTANEOUS CORONARY INTERVENTION FOR CHRONIC TOTAL OCCLUSIONS LATEST ANNUAL REPORT FROM JAPANESE MULTICENTER REGISTRY BY RETROGRADE SUMMIT
Authors: Makoto Kadotani, Atsunori Okamura, Toshiya Muramatsu, Tsutomu Fujita, Makoto Muto, Tomoyuki Oida, Masahisa Yamane, Yuji Oikawa, Hisayuki Okada, Etsuo Tsuchikane
Journal: Journal of the American College of Cardiology (2014)
Vasomotor Symptom Duration in Midlife Women—Research Overturns Dogma
Authors: Gloria Richard-Davis, JoAnn E. Manson
Journal: JAMA Internal Medicine (2015)

Vasomotor symptoms (VMS) affect up to 80% of menopausal women and are the most common reason these women seek treatment. Approximately 60% of midlife women seek medical care or advice at least once because of VMS, 1 which adversely affect quality of life in domains that include work, social and leisure activities, and sexual health. 2 Previous research from the Study of Women’s Health Across the Nation (SWAN) 2,3 demonstrated that having VMS at least 6 days in the previous 2 weeks was highly associated with other conditions such as anxiety, depression, sleep problems, qualityof-life impairment, cardiovascular risks, and poorer bone health. Despite the high prevalence of VMS among midlife women, surprisingly little research has been done on the underlying etiology, individual differences in symptom presentation, sociodemographic and clinical correlates, or duration of symptoms. Early publications reported the duration of VMS to be generally less than 2 years, 4 whereas recent evidence (eg, the study by Avis et al 5 in the current issue of JAMA Internal Medicine) suggests that the mean duration of symptoms is considerably longer. The findings from recent studies underscore the limitations of the earlier evidence base on VMS that has guided clinical practice for many decades. 4 The study by Avis et al 5 contributes important data on duration and correlates of VMS from the SWAN, a large multiracial/ multiethnic cohort of women followed up through the menopausal transition and into the postmenopausal years. The
Circadian pattern of large neutral amino acids, glucose, insulin, and food intake in anorexia nervosa and bulimia nervosa
Authors: Wolfgang Schreiber, Ulrich Schweiger, Detlev Werner, Gerhard Brunner, Reinhard J. Tuschl, Reinhold G. Laessle, Jürgen-Christian Krieg, Manfred M. Fichter, Karl-Martin Pirke
Journal: Metabolism (1991)
Year in review in Intensive Care Medicine 2009: I. Pneumonia and infections, sepsis, outcome, acute renal failure and acid base, nutrition and glycaemic control
Authors: Massimo Antonelli, Elie Azoulay, Marc Bonten, Jean Chastre, Giuseppe Citerio, Giorgio Conti, Daniel De Backer, François Lemaire, Herwig Gerlach, Goran Hedenstierna, Michael Joannidis, Duncan Macrae, Jordi Mancebo, Salvatore M. Maggiore, Alexandre Mebazaa, Jean-Charles Preiser, Jerôme Pugin, Jan Wernerman, Haibo Zhang
Journal: Intensive Care Medicine (2010)

Year in review in Intensive Care Medicine 2009 : I. Pneumonia and infections, sepsis, outcome, acute renal failure and acid base, nutrition and glycaemic control
A Probable Case of Pulmonary Histoplasmosis Diagnosed in England
Authors: J. Crofton
Journal: Thorax (1950)

Arblaster (see page 333) has reviewed pulmonary histoplasmosis and reported a case diagnosed in England.His case appears to be the third to be reported in which this diagnosis has been made in England.The present contribution records another probable case.CASE REPORT A man aged 43 was referred to Dr. J. G. Scadding's out-patient clinic at Brompton Hospital because of unusual findings in a radiograph of his chest.He complained that following a bombing raid in May, 1941, he had developed a dry, unproductive cough which had persisted since.The cough was worse in the early morning and was most troublesome in the winter.He had never coughed up blood and did not complain of breathlessness on exertion.He had had no previous illnesses.Examination revealed little abnormal.There was some evidence of emphysema and a few soft lymph nodes were palpable in the posterior triangles of the neck and in the axillae.The radiograph showed numbers of calcified foci, 2-3 mm. in diameter, scattered throughout both lung fields (Figs. 1 and2).A previous film taken in 1941 was not substantially different.At first glance, of course, the calcified lesions suggested tuberculosis, but the wide dissemination and the symmetry of the lesions are very unusual in this disease.Pulmonary histoplasmosis seemed the most likely alternative, and on direct questioning the patient stated that some 30 years previously on May 30, 2023 by guest.
Effect of nasal or oral breathing route on upper airway resistance during sleep
Authors: M.F. Fitzpatrick, H. McLean, A.M. Urton, A. Tan, D. O'Donnell, H.S. Driver
Journal: European Respiratory Journal (2003)

Healthy subjects with normal nasal resistance breathe almost exclusively through the nose during sleep. This study tested the hypothesis that a mechanical advantage might explain this preponderance of nasal over oral breathing during sleep. A randomised, single-blind, crossover design was used to compare upper airway resistance during sleep in the nasal and oral breathing conditions in 12 (seven male) healthy subjects with normal nasal resistance, aged 30±4 (mean±sem) yrs, and with a body mass index of 23±1 kg·m 2 . During wakefulness, upper airway resistance was similar between the oral and nasal breathing routes. However, during sleep (supine, stage two) upper airway resistance was much higher while breathing orally (median 12.4 cmH 2 O·L −1 ·s −1 , range 4.5–40.2) than nasally (5.2 cmH 2 O·L −1 ·s −1 , 1.7–10.8). In addition, obstructive (but not central) apnoeas and hypopnoeas were profoundly more frequent when breathing orally (apnoea-hypopnoea index 43±6) than nasally (1.5±0.5). Upper airway resistance during sleep and the propensity to obstructive sleep apnoea are significantly lower while breathing nasally rather than orally. This mechanical advantage may explain the preponderance of nasal breathing during sleep in normal subjects.
Psychotropic Drugs in Psychiatry
Authors: Herbert Y. Meltzer
Journal: JAMA (1982)

<i>Psychotropic Drugs in Psychiatry</i>is a collection of previously published essays on psychopharmacology by Michael Shepherd, one of England's leading psychiatrists and the editor of<i>Psychological Medicine</i>, one of the best-edited journals in the field of psychiatry. Written over the 20-year period from 1956 to 1975, the essays provide testimony from a participant and observer to the phenomenal growth and impact of psychopharmacology on the treatment of the major mental illnesses. At the same time, they constantly urge the clinician and investigator to evaluate critically the claims being made, to improve the standards of evidence, and to keep in perspective the psychological and social therapies that have as much or more to offer some of the seriously mentally ill than the full range of psychotropic drugs. The essays are organized into three sections. The first, "Drugs," includes five essays evaluating various systems of classification, reserpine as an antipsychotic, benzodiazepines as
Hepatotoxicity Due to Treatment with Papaverine
Authors: V. Rønnov-Jessen, A. Tjernlund
Journal: New England Journal of Medicine (1969)

Hepatotoxicity due to papaverine was observed in four patients. A cause and effect relation was demonstrated by repeated rechallenge with the drug. The patients had abdominal discomfort, but jaundice was not prominent. Serum alkaline phosphatase and transaminases were elevated. Liver biopsies in Cases 2 and 3 showed numerous eosinophils in the periportal spaces. Both symptoms and signs appeared to be fully reversible. The most likely mechanism is a hypersensitivity reaction.
CONSTIPATION—TUBERCULOSIS—HYDROTHORAX
Authors: Jacob Lanski
Journal: JAMA (1923)

<h3>To the Editor:</h3> —Constipation is generally considered to be due to sluggish bowels. All our numerous attempts at treatment are based on the notion of sluggish bowels. Has it ever been shown that the bowels are ever unduly sluggish? Is it not a fact that the rectum and not the intestine is loaded in constipation? H. A. Kelly (Medical Gynecology, 1908, p. 191) conceives constipation to be an inertia of the defecation reflex, a conception that is in harmony with all clinical data. It explains the correlation of constipation with neurasthenia, and also the paradox that while we have numerous cathartics we have no cure for constipation. A simple motor function reacts to any change in the environment, while a depressed reflex is out of the range of our materia medica, which contains no analeptics, no sensory stimulants, and no drug or combination of drugs that might affect simultaneously all
Giant Abdominal Aortic Aneurysm
Authors: Nicola Mumoli, Claudio Invernizzi, Riccardo Luschi, Giovanni Carmignani, Alberto Camaiti, Lorenzo Bocci, Simona Milianelli, Gianluigi Occhipinti, Patrizio Chiavistelli, Fabrizio Orlandi, Giovanni Niccoli
Journal: Circulation (2010)