tbuckley/cabot-search huggingface dataset:
Are β-Blockers Efficacious as First-line Therapy for Hypertension in the Elderly?
Authors: Franz H. Messerli, Ehud Grossman, Uri Goldbourt
Journal: JAMA (1998)

Objective.—To assess antihypertensive efficacy of β-blockers and their effects on cardiovascular morbidity and mortality and all-cause morbidity compared with diuretics in elderly patients with hypertension.Data Source.—A MEDLINE search of English-language articles published between January 1966 and January 1998 using the terms hypertension (drug therapy) and elderly or aged or geriatric, and cerebrovascular or cardiovascular diseases, and morbidity or mortality. References from identified articles were also reviewed.Data Selection.—Randomized trials lasting at least 1 year, which used as first-line agents diuretics and/or β-blockers, and reported morbidity and mortality outcomes in elderly patients with hypertension.Data Synthesis and Results.—Ten trials involving a total of 16164 elderly patients (≥60 years) were included. Two thirds of the patients assigned to diuretics were well controlled on monotherapy, whereas less than a third of the patients assigned to β-blockers were well controlled on monotherapy. Diuretic therapy was superior to β-blockade with regard to all end points and was effective in preventing cerebrovascular events (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.51-0.72), fatal stroke (OR, 0.67; 95% CI, 0.49-0.90), coronary heart disease (OR, 0.74; 95% CI, 0.64-0.85), cardiovascular mortality (OR, 0.75; 95% CI, 0.64-0.87), and all-cause mortality (OR, 0.86; 95% CI, 0.77-0.96). In contrast, β-blocker therapy only reduced the odds for cerebrovascular events (OR, 0.75; 95% CI, 0.57-0.98) but was ineffective in preventing coronary heart disease, cardiovascular mortality, and all-cause mortality (ORs, 1.01, 0.98, and 1.05, respectively).Conclusions.—In contrast to diuretics, which remain the standard first-line therapy, β-blockers, until proven otherwise, should no longer be considered appropriate first-line therapy of uncomplicated hypertension in the elderly hypertensive patient.
Controlling Health Care Expenditures
Authors: D Blumenthal
Journal: New England Journal of Medicine (2001)

After a few years of success in controlling the costs of health care, the United States once again faces the challenge of what, if anything, to do about skyrocketing health care expenditures. Dealing with this challenge, which dominated the health policy agenda from the late 1960s until the mid-1990s, will be extremely difficult under any circumstances. It may prove impossible unless the factors that prevent poor and uninsured persons from obtaining medical care are addressed simultaneously.Evidence of rising health care expenditures is widespread. Hogan and colleagues1 estimate that private expenditures increased by 6.6 percent per insured person in 1999, . . .
Curative endoscopic resection of a huge pedunculated esophageal liposarcoma
Authors: U. Will, P. Lorenz, H. Urban, F. Meyer
Journal: Endoscopy (2007)

This is the first report of successful endoscopic resection of an esophageal liposarcoma, in which the patient's main symptom was dysphagia as a nonspecific sign [1] [2]. The differential diagnosis of this type of lesion includes leiomyoma, lipoma, gastrointestinal stromal tumor (GIST), and sarcoma [2] [3] [4] [5] [6]. The first case of a liposarcoma within the esophagus was reported in 1983 [2] [7].
Coumarin and the Fetus
Authors: PARVIN SAIDI
Journal: Annals of Internal Medicine (1971)

Letters and Comments1 March 1971Coumarin and the FetusPARVIN SAIDI, M.D.PARVIN SAIDI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-3-453_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent article by Fillmore and McDevitt (Ann Intern Med73:731-735, 1970), "Effects of Coumarin Compounds on the Fetus," was read with great interest, as this topic is indeed beginning to command the concern and attention of many specialists. The authors present their own clinical experience and discuss the clinical findings and conclusions of similar series but, surprisingly, fail to mention and take account in the discussion of the fact that transplacental transfer of bishydroxycoumarin has been demonstrated in the human fetus and its disappearance rate as well as its effect on clotting factors documented in the...Reference1. SAIDIHOAGAGGELER PMP: Transplacental transfer of bishydroxycoumarin in the human. JAMA 191:761-762, 1965 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1971Volume 74, Issue 3Page: 453-453KeywordsCoumarinsFetuses Issue Published: 1 March 1971 PDF DownloadLoading ...
DETECTION OF MYOCARDIAL ISCHEMIA SECONDARY TO MYOCARDIAL BRIDGING: A COMPARATIVE STUDY OF EXERCISE SPECT AND CT MYOCARDIAL PERFUSION IMAGING
Authors: Carolina Valdiviezo, Frank M. Bengel, Armin Arbab-Zadeh, Andrea L. Vavere, Lewis Becker, Albert C. Lardo, Joao AC Lima, Richard T. George
Journal: Journal of the American College of Cardiology (2011)
Glucose-Stimulated Genes and Prospects of Gene Therapy for Type I Diabetes
Authors: D. Mitanchez
Journal: Endocrine Reviews (1997)

I. Introduction II. Transcriptional Regulation of Glucose-Responsive Genes A. The insulin gene 1. Glucose-signaling pathway in pancreas β-cells 2. E elements of the insulin gene promoter 3. A elements of the insulin gene promoter 4. Role of the E and A boxes of the insulin gene promoters in glucose-dependent transcriptional regulation 5. Role of the cAMP pathway in glucose responsiveness of the insulin gene promoters B. Transcriptional regulation of glucose-responsive genes in the liver 1. The general outlook for glucose metabolism in the liver 2. Transcriptional glucose signaling mechanisms in the liver 3. Glucose/carbohydrate response elements III. Cell and Gene Therapies for IDDM A. Islet and cell transplantations 1. Transplantation of islets 2. Transplantation of established lines B. Bioartificial pancreas C. Transplantation of genetically engineered cells 1. The “ideal” engineered cell for glucose-dependent insulin secretion 2. Engineering established neuroendocrine cells 3. Engineering endogenous he...
The Biology of Clinical Encounters: Psychoanalysis as a Science of Mind
Authors: Edward J. Khantzian
Journal: JAMA (1993)

This new book by John E. Gedo, erudite and provocative, is characteristic of his four decades of effort as a psychoanalyst. In it, he addresses two fundamentally important problems in psychoanalytic theory and practice, namely, linking or connecting the clinical observations of psychoanalytic practitioners to a scientific understanding of the mind, and appreciating the influence of preverbal phases of development on matters of concern to clinicians. Psychoanalysis is a method to study human psychology and a method to treat human psychological disorders. It is also a discipline that abounds in controversies, especially in the realm of theory. Since Freud originated psychoanalysis nearly a century ago, he and his early followers introduced us to the now familiar ideas that much of our lives is governed by sexual and aggressive drives, which in turn are opposed or contained by psychological (ego) structures. This foundation of psychoanalysis has since been buttressed by theoretical
Detection of circulating antibodies against malondialdehyde-acetaldehyde adducts in patients with alcohol-induced liver disease
Authors: Roberta Rolla, Daria Vay, Elisa Mottaran, Monica Parodi, Nicola Traverso, Sarino Aricó, Massimo Sartori, Giorgio Bellomo, Lynell W. Klassen, Geoffrey M. Thiele, Dean J. Tuma, Emanuele Albano
Journal: Hepatology (2000)

Acetaldehyde and malonildialdehyde can form hybrid protein adducts, named MAA adducts that have strong immunogenic properties. The formation of MAA adducts in the liver of chronic alcohol-fed rats is associated with the development of circulating antibodies that specifically recognized these adducts. The aim of this study was to examine whether MAA adducts might participate in the immune response associated with human alcohol-induced liver disease. Circulating antibodies against MAA adducts were evaluated in 50 patients with alcohol-induced hepatitis or cirrhosis, in 40 patients with non-alcohol-induced liver disease, in 15 heavy drinkers without liver damage and in 40 healthy controls by enzyme-linked immunosorbent assays (ELISA). Immunoglobulin G (IgG) reacting with MAA-modified proteins were significantly increased in the patients with alcohol-induced cirrhosis or hepatitis. The individual levels of anti-MAA IgG in those patients were associated with the severity of liver damage. Anti-MAA antibodies were also positively correlated with the levels of IgG recognizing epitopes generated by acetaldehyde and malonildialdehyde. However, competitive inhibition experiments indicated that the anti-MAA antibodies were unrelated to those against acetaldehyde- or malonildialdehyde-derived antigens and mainly recognized a specific, cyclic MAA epitope. Some degree of immune reactivity towards MAA adducts was also observed in patients with non-alcohol-induced liver injury. However, competitive ELISA showed that the antigens recognized by these sera were not the cyclic MAA adducts. Altogether, these results showed the formation of MAA antigens during alcohol-induced liver disease and suggest their possible contribution to the development of immunologic reactions associated with alcohol-related liver damage.
Milk in Diverticula of Colon
Authors: D. C. Corry
Journal: BMJ (1963)

HYPERSENSITIVITY AND HYPNOSISMEDI&BORm 929the pressure applied in the single-prick-through-drop technique used throughout the experimental series could not have been responsible for the results recorded following D.S.U.H. Conclusions It is concluded that instant inhibition of the I.T.H. response can occur in certain individuals by direct suggestion under hypnosis.One experiment indicated that inhibition of this response could eventually be produced in a larger proportion of individuals, if treat- ment were continued over a longer period by repeated suggestion in this way.Further work to investigate the significance of psychic factors in relation to the Prausnitz-Kustner reaction and the delayed-type hypersensitivity response has also been carried out and the results of these experiments will shortly be published.Summary Direct suggestion under hypnosis was employed as an experimental tool to investigate psychological control of the immediate-type hypersensitivity response in a series of experiments in which the normal allergic response was measured in the waking state on one arm, and again on the other arm, after giving direct suggestion under hypnosis that the subject would not react.The temperature change of the reaction was measured with thermocouples and the oedema with skinfoldthickness callipers, and a record of the colour change was kept by colour photography.The results showed evidence of very marked to moderate degrees of instant inhibition in 8 subjects out of 12. Deep-trance subjects had the greatest ability to inhibit the response in this way.It is concluded that instant inhibition of the immediate-type hypersensitivity response is possible in certain individuals by direct suggestion under hypnosis.
Control of defecation in patients with spinal injuries by stimulation of sacral anterior nerve roots.
Authors: R P MacDonagh, W M Sun, R Smallwood, D Forster, N W Read
Journal: BMJ (1990)

OBJECTIVE--To observe the effects of stimulation of the sacral anterior roots on anorectal and low colonic pressures and to programme implanted stimulators to produce defecation. DESIGN--Prospective study of 12 consecutive patients. SETTING--Spinal injuries unit and university gastrointestinal physiology department. PATIENTS--12 Patients with complete supraconal spinal cord lesions. Their injuries had been sustained at least two years before the study. INTERVENTIONS--A Brindley-Finetech intradural sacral anterior root stimulator was implanted in all patients. Three months postoperatively the stimulator settings were adjusted after measurement of simultaneous anorectal and low colonic pressures. MAIN OUTCOME MEASURES--Full defecation. RESULTS--Six patients achieved complete rectal evacuation of faeces using the implant and subsequently did not require manual help for defecation. For all but one of the patients the total time taken to complete defecation was reduced, and all were free from constipation, the most prevalent gastrointestinal symptom in patients with spinal injuries. CONCLUSIONS--Sacral anterior root stimulators can be programmed to achieve complete unassisted defecation and can considerably improve the quality of life of patients with spinal injuries.
Effect of Ventricular Rate on the Cardiac Output in the Dog with Chronic Heart Block
Authors: D. Edmond Miller, William L. Gleason, Robert E. Whalen, James J. Morris, Henry D. Mclntosh
Journal: Circulation Research (1962)

The effect of heart rate on cardiac output and associated rate induced hemodynamic changes in dogs with chronic heart block is presented and discussed. At heart rates below 60/min., the stroke volume was maximum and relatively constant, and the cardiac output was largely rate-dependent. These relationships did not exist at ventricular rates above 60/min. Cinefluorographic evidence of decreased diastolic ventricular filling with increasing ventricular rates is presented. At very slow and very fast ventricular rates, the cardiac output decreased despite an increase in right atrial and right ventricular end-diastolic pressure. At slow rates the decreased output was due to rate alone, while at rapid rates it was attributed to the decreased diastolic filling period and resistance to ventricular distention, resulting in decreased diastolic filling.
408-1 Genetic polymorphism G894T on endothelial nitric oxide synthase gene as a risk factor for premature, nonfatal myocardial infarction in young male smokers
Authors: Charalambos Antoniades, Dimitris Tousoulis, Christos Pitsavos, Carmen Vasiliadou, Christina Chrysochoou, Marina Toutouza, Demosthenis Panagiotakos, Costas Tentolouris, Pavlos Toutouzas, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2004)
Percutaneous transluminal gene transfer into canine myocardium in vivo by replication-defective adenovirus
Authors: J.-J. Li, H. Ueno, Y. Pan, H. Tomita, H. Yamamoto, Y. Kanegae, I. Saito, A. Takeshita
Journal: Cardiovascular Research (1995)

Objective: The aim was to examine the feasibility, efficiency and safety of adenovirus-mediated in vivo gene transfer into the canine myocardium by a percutaneous transluminal method using a needle-catheter. Methods: Either a replication-defective adenovirus (Adex1SRLacZL) or a plasmid (pSRLacZ), both expressing E. colilacZ coding β-galactosidase (β-gal), was directly injected into the left ventricle of dogs through a needle-catheter inserted via a femoral artery. Expression of lacZ was examined by histochemical staining and quantified by measuring β-gal activity. Results: Injections with Adex1SRLacZL induced lacZ expression as a result of 40 out of 41 injections; the expression level was 10 times higher than that obtained with pSRLacZ. Induced β-gal activity was detected within 24 h, peaked at 7 days and retained for 2 weeks after gene transfer. A repetitive administration of the same adenovirus at 14 days after the first injection also evoked a reduced but significant level of expression despite neutralizing antibodies to adenovirus in serum. Although injection induced an inflammatory response that peaked at 3 days after injection and gradually subsided without a second peak, the temporal change and the extent of inflammation induced by adenovirus injection was not significantly different from those induced by injection with either saline or plasmid. Neither leakage of enzymes such as CPK or LDH nor alteration in the ECG was detected in the 30 days following gene transfer. Conclusions: Our findings demonstrate that a catheter-mediated direct injection with an adenovirus can induce gene expression in the ventricle more efficiently without additional myocardial damage and inflammation compared with injection with a plasmid. A repeat dose of the same adenovirus elicited gene expression at an attenuated but significant level. This method may potentially have clinical applications: in modifying myocardial phenotype and/or improving general circulation under certain circumstances.
A NONOPERATIVE TREATMENT OF INFLAMMATORY GLAUCOMA
Authors: F. PARK LEWIS
Journal: JAMA (1927)

The condition which confronts the ophthalmologist in his cases of glaucoma is sometimes so desperate that any measure of relief that can be afforded in addition to the means which are commonly employed will be most welcome. It not infrequently happens that he sees a patient for the first time when the sight has been lost in one or both eyes, and when little more can be expected by any methods than the relief of pain. In other instances, operative measures are refused by the patient and such means must be employed to prevent suffering, to retain vision and sometimes even to preserve the eyeball as may be found in any degree effective. These are often such as not to give the surgeon or the patient much comfort. A distinguished European ophthalmic surgeon, on being asked what his treatment of chronic glaucoma was, jestingly replied that he did not have
Asbestos or Ferruginous Bodies
Authors: Edward A. Gaensler, Whitney W. Addington
Journal: New England Journal of Medicine (1969)

THE health hazards of asbestos have been recognized for 40 years. Nevertheless, the problems of asbestos pneumoconiosis (asbestosis) and asbestos-related neoplasms have increased alarmingly despite much improved dust control.1 This is because of a rapidly rising use of asbestos and because of an ever larger variety of asbestos-containing products, which are often used without awareness of their composition and under poor supervision.2 In our laboratory in New England some 35 different occupations ranging from cigarette-filter manufacturing to wire braiding have been incriminated. Community "asbestos air pollution" is being recognized only now, and its importance is uncertain. Increasingly, practicing physicians are . . .
Two Cases of Bronchiogenic Cyst Associated with Anomalous Arteries arising from the Thoracic Aorta
Authors: E. Tosatti, J. A. Gravel
Journal: Thorax (1951)

aorta and reached the cystic area of the affected lobe, were operated upon at Sabbatsbergs Hospital, Stockholm.The operations took place between July, 1947, and May, 1949.CASE REPORTS Case No. 1.-E.M., 23 years old, had a history of intermittent bronchitic attacks during the past 17 years, with variable amounts of sputum and a reduced vital capacity.The general condition was good.There was no clubbing of the fingers.The radio- graphs showed a thin-walled calcified cyst, in which there was a fluid level, situated in the right inferior lobe (Fig. 1).Lobectomy was performed by Professor C. Crafoord on May 23, 1949, when an abnormal artery was found arising from the aorta just above the diaphragm, close to the pulmonary ligament, and entering the base of the lung.A cyst, the size of a little orange communicating with several other smaller surround- ing cysts, was found in the apical segment of the lower lobe (Fig. 2).The cystic area communicated with the bronchial tree.There were no anomalies in the branches of the pulmonary artery, but an artery of a diameter of 5 or 6 mm. was found entering the cystic portion of the lobe (Fig. 3); its distribution appeared to be limited to this area.This artery, as was seen pre-operatively, arose from the thoracic aorta.By digestion with concentrated hydrochloric acid, it has been possible to demonstrate the presence of a large anastomosis (Fig. 4) in the operation specimen between the branches of the anomalous vessel and those of the pulmonary artery.The respiratory epithelium lining the surface of the cysts showed polymorphism; it was papillary in some areas, and adenomatous in others.Deep to the epithelium cartilage, glands, muscular cells, elastic fibres, and a few areas of small cell infiltration were found.Small cysts were found in the surrounding pulmonary tissue, and there were two minute fibrous tubercles in the posterior basal segment of the lobe.The anomalous artery and its branches were of normal structure, and showed no signs of atheromatous degeneration.Apart from the fact that presumably they carried oxygenated blood, and were not accompanied by a bronchial ar.tery, the greater thick- ness of their walls was the only structural difference between them and branches of the pulmonary artery.Figs. 5-7illustrate the structure of the anomalous artery, and the histology of the cysts.
Jejunal Sensitivity to Acid Peptic Digestion-Reply
Authors: Henry J. Heimlich
Journal: JAMA (1963)

I would like to call your attention to an inaccuracy which also appeared on p 118: "In the literature Beck and Carrell, Jianu, and Heimlich advocate the use of a gastric tube constructed of the greater curvature. This in itself seems to be an excellent solution to the problem since it eliminates two anastomoses necessary with a colon transplant. However, the obvious disadvantages are those of a high incidence of necrosis of this gastric tube inasmuch as it has to rely on its submucosal blood supply for its entire length." The point emphasized in the three references is that necrosis of the gastric tube does<i>not</i>occur because the tube does<i>not</i>depend on its submucosal blood supply. The gastric tubes, designed to form a permanent gastrostomy, as described by Beck and Carrell and by Jianu, derive an excellent blood supply from the gastroepiploic vessels which accompany the gastric tube.
Liquorice-induced cardiac arrect.
Authors: J Montoliu
Journal: BMJ (1977)

examination.However, if the tail is cut with the loop of tail left in the uterus after insertion entanglement with tampons or introducers of vaginal preparations may result in the tail being pulled down to the introitus, with resultant vulval discomfort.The tail is then naturally cut shorter and may again disappear into the uterus as it reverts to the looped position.Confirmation of the presence of the device in the cavity now necessitates uterine sounding, ultrasonic scanning, or x-raying, and, if it cannot be changed otherwise, the risks of a general anaesthetic with impairment of patient confidence in the method.Although tail complications are not usually serious, they lead to inconvenience and worry for the patient.The design of the tail and introducer is as important as the design of the device itself.
Measurement of Leukotrienes in Humans
Authors: MARIA KUMLIN
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

This article focuses on strategies to appreciate in vivo release of the cysteinyl-leukotrienes (LTs; LTC 4 , LTD 4 , and LTE 4 ) and presents some results obtained by such measurements. Whereas analyses of leukotriene formation in isolated tissues and cells primarily reflect ex vivo biosynthesis, measurement of intact leukotrienes or metabolites thereof in different biological fluids may be used as an index of in vivo production of the primary leukotrienes.
Monitoring of residual disease by next-generation deep-sequencing of RUNX1 mutations can identify acute myeloid leukemia patients with resistant disease
Authors: A Kohlmann, N Nadarajah, T Alpermann, V Grossmann, S Schindela, F Dicker, A Roller, W Kern, C Haferlach, S Schnittger, T Haferlach
Journal: Leukemia (2013)