tbuckley/cabot-search huggingface dataset:
CONTROVERSY IN IDIOPATHIC THROMBOCYTOPENIC PURPURA
Authors: William Dameshek
Journal: JAMA (1960)

That the basic aspects of medicine—its chemistry, immunology, and genetics—should be becoming ever more complex is not difficult to understand. But that even relatively simple clinical decisions should have become matters for controversy is at first blush surprising. This has happened in the management of idiopathic thrombocytopenic purpura (ITP). Why it has happened, what are the controversial points, and how they can be resolved —these are the subjects of the present discussion. When in 1916 Kaznelson<sup>1</sup>of Prague, cognizant of the rather dramatic effects of splenectomy in some cases of hemolytic anemia as described by Banti and Micheli in 1913-1915, suggested that the operation might be beneficial in Werlhof's disease, it was fortunate that in the first cases the operation was successful; in others, the results were far from encouraging. Nevertheless, news of this new mode of therapy for a previously intractable and at times serious disease spread rapidly,
Atherosclerotic Disease in Type 2 Diabetes Is Associated With an Increase in Sclerostin Levels
Authors: Sonia Morales-Santana, Beatriz García-Fontana, Antonia García-Martín, Pedro Rozas-Moreno, José Antonio García-Salcedo, Rebeca Reyes-García, Manuel Muñoz-Torres
Journal: Diabetes Care (2013)

OBJECTIVE Wnt/β-catenin signaling is related to the pathogenesis of several diseases. Sclerostin is an inhibitor of Wnt/β-catenin signaling. However, there are few data regarding the sclerostin levels and vascular disease. Our aim was to examine the relationship between serum sclerostin and atherosclerotic disease (AD) in type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS We performed a cross-sectional study including 78 T2DM patients (45.3% females, mean age 59 ± 5.7 years; 54.7% males, 57.4 ± 6.7 years). RESULTS Serum sclerostin concentrations of T2DM patients in the AD group were significantly higher than in the non-AD group (P = 0.006). For each increase of 1 pmol/L in sclerostin level, there was a 4% increase of the risk of AD in T2DM patients. A concentration of ≥42.3 pmol/L showed a sensitivity of 69% and a specificity of 54.8% to detect an increased risk of AD. In males, sclerostin levels were higher in those with AD (P = 0.04), abnormal intima-media thickness (IMT) (P = 0.004), carotid plaques (P &amp;lt; 0.001), and aortic calcification (P &amp;lt; 0.001). In females, higher levels of sclerostin were related to abnormal IMT (P = 0.03) and aortic calcifications (P = 0.004). Homocysteine (β = 0.319 [95% CI 0.561–2.586], P = 0.003) and IMT (β = 0.330 [14.237–67.693], P = 0.003) were positively correlated with sclerostin. CONCLUSIONS Circulating sclerostin is increased in T2DM patients with atherosclerotic lesions. Although the sample size of our study was small, these data suggest that sclerostin levels could be a major modulator of Wnt signaling in AD with implications in T2DM patients.
The Actual Place and Function of the Tuberculosis Dispensary in the Tuberculosis Scheme
Authors: R. Philip
Journal: BMJ (1926)

EMzDxciLmJo 55Since the work of the heart bears a relation to the body weight, an attempt should be made to bring the bulk of the body, when it is excessive, within normal limits.Careful dieting to olBtain this result should be carried out and the results noted.An abnormally high blood pressure can gometimes be modified with definite relief to the over- loaded myocardium.Much can be done in the secondary anginas when by meticulous cross-examination the cause of the lowered Lhreshold to pain has been discovered.All possible sources 3f persistent low-grade infections should be investigated and radically treated-dental sepsis, sinus disease, abnormal in-testinal conditions, pyelitis, chronic appendicitis, etc. Ani attempt must be made-to eliminate worry and make sur'e of sleep.For this a mixture of ammonium bromide and phenazonum is especially helpful.In the readjust- ment of the patient's life, factors giving rise to mental strain and irritations should be obviated as far as possible.As my last word, may I lay stress again on the very great importance of an early diagnosis when the symptoms, though but -slight and -elusive, are both ominous and sinister.An accurate diagnosis then, followed by wise treatment, offers some chance of arresting, or at any rate of retarding, the development of the pathological changes responsible for angina.
Empirical Ethics: The “Missing Link” in Incidental Findings Recommendations
Authors: Gabrielle Christenhusz, Koenraad Devriendt, Kris Dierickx
Journal: The American Journal of Bioethics (2014)

While Clayton and colleagues (2014) rightly highlight the differences and tensions in the ethical justifications utilized by what they refer to as the American Academy of Pediatrics (AAP)/American ...
Pneumococcal Vaccine and Patients with Chronic Lung Disease
Authors: JAMES H. WILLIAMS
Journal: Annals of Internal Medicine (1986)

We reviewed data that evaluated both the risk for pneumococcal pneumonia in patients with chronic lung disease and the protection afforded these patients by current pneumococcal vaccines. No conclusive documentation of increased risk for pneumococcal pneumonia in this population exists, and data suggest that the protection provided by the vaccine in healthy persons may be reduced in patients with chronic lung disease. We conclude, on the basis of available data, that routine vaccination of all patients with chronic lung disease is not warranted.
PREVALENCE AND CLINICAL IMPLICATION OF NEWLY UNVEILED ABNORMAL ANKLE-BRACHIAL INDEX IN PATIENTS WHO UNDERWENT CORONARY ANGIOGRAM
Authors: Jong-Young Lee, Seung Mo Kang, Young-Rak Cho, Gyung-Min Park, Jung-Min Ahn, Won-Jang Kim, Soo-Jin Kang, Duk-Woo Park, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2013)
The Missing Waveform Information in the Orthogonal Electrocardiogram (Frank Leads)
Authors: F. KORNREICH, P. BLOCK, D. BRISMEE
Journal: Circulation (1974)

Nine surface electrocardiograms recorded on the thoracic surface at fixed and identical locations in 412 individuals were found to account for the maximal useful waveform information available in each individual. In other words, nine waveforms were capable of resynthesizing any waveform recorded on their thoracic surface. These nine waveforms were then submitted to multivariate statistical procedures and their diagnostic performance compared to the Frank leads on which the same procedures were applied. Before the data were fed into the computer, all waveforms were time-normalized and divided into eight equal parts, yielding 72 variables and 24 variables for the nine lead system and the Frank leads, respectively, for each individual. In this paper we attempted to discriminate between normal subjects and patients with documented angina pectoris (typical history and positive coronary angiography); myocardial infarction was excluded in these patients. Only the resting QRS complex was considered. With the 9-lead system, keeping the specificity (true negatives) at 90%, the sensitivity (true positives) is 76%; with the Frank leads, the same specificity yielded a sensitivity of 49%. The repeatability of the results on new independent controls was also found very satisfactory. The discrimination between patients with angina pectoris on one hand and left ventricular hypertrophy and myocardial infarction on the other hand resulted in a performance level of 89% and 87%, respectively, for the 9-lead system. A good correlation was also found between the extent of the coronary lesions (number of coronary vessels involved) and the fraction of correctly diagnosed patients. The present study concluded that the retrieval of more complete surface information results in an evident improvement of the diagnostic performance of electrocardiography.
Prevention of the Angiographic Progression of Coronary and Vein-Graft Atherosclerosis by Gemfibrozil After Coronary Bypass Surgery in Men With Low Levels of HDL Cholesterol
Authors: M. Heikki Frick, Mikko Syvänne, Markku S. Nieminen, Heikki Kauma, Silja Majahalme, Vesa Virtanen, Y. Antero Kesäniemi, Amos Pasternack, Marja-Riitta Taskinen
Journal: Circulation (1997)

Background Studies have shown that treatment of hyperlipidemia, especially lowering of plasma LDL levels, retards the progression of coronary atherosclerosis and prevents clinical cardiovascular events. No such studies have focused on subjects with low levels of HDL cholesterol. Methods and Results We randomly assigned 395 post–coronary bypass men, who had an HDL cholesterol concentration ≤1.1 mmol/L and LDL cholesterol ≤4.5 mmol/L, to receive gemfibrozil 1200 mg/d or placebo. Coronary angiography was performed at baseline and after, on average, 32 months of therapy. Changes in coronary dimensions were assessed by computer-assisted analysis. Average on-trial serum triglyceride concentrations were 1.69±0.68 and 1.02±0.37, total cholesterol 5.48±0.68 and 4.83±0.63, LDL cholesterol 3.84±0.59 and 3.39±0.56, and HDL cholesterol 0.88±0.15 and 0.98±0.17 mmol/L in the placebo and gemfibrozil groups, respectively (mean±SD, each P &lt;.001). The change in per-patient means of average diameters of native coronary segments was –0.04±0.11 mm in the placebo group and –0.01±0.10 mm in the gemfibrozil group ( P =.009). The equivalent changes in minimum luminal diameters of stenoses were –0.09±0.18 and –0.04±0.15 mm, respectively ( P =.002). A similar, albeit nonsignificant, trend toward treatment benefit was found in the predefined primary study end point, segments unaffected by grafts and those distal to graft insertions. In aortocoronary bypass grafts, 23 subjects (14%) assigned to placebo had new lesions in the follow-up angiogram, compared with 4 subjects (2%) assigned to gemfibrozil ( P &lt;.001). Conclusions Gemfibrozil therapy retarded the progression of coronary atherosclerosis and the formation of bypass-graft lesions after coronary bypass surgery in men with low HDL cholesterol as their main lipid abnormality.
Stem cell therapy doctor exploited desperate patients, GMC finds
Authors: C. Dyer
Journal: BMJ (2010)

A doctor who exploited vulnerable patients by providing unproved stem cell therapy could be struck off the UK medical register later this month after a finding by the General Medical Council that his fitness to practise is impaired.

A GMC panel held that the Dutch trained doctor Robert Trossel was guilty of serious misconduct in exploiting desperate patients with multiple sclerosis and abusing his position. His actions constituted “repeated and serious breaches” of many of the essential tenets of the GMC guide Good Medical Practice .

He had “seriously exaggerated” the benefits of stem cell treatment and injected …
Hematobilia Causing Complete Biliary Obstruction on Tc-99m DISIDA Scan
Authors: MICHAEL R. WILLIAMSON, ROBERT D. ROSENBERG, MICHAEL DAVIS, SUSAN L. WILLIAMSON
Journal: Clinical Nuclear Medicine (1990)

A 51-year-old woman suffered intraperitoneal hemorrhage while on warfarin. Ultrasonography of the liver and biliary tree revealed echogenic material filling the gallbladder and common bile duct. CT scanning showed dense material filling the gallbladder. The clinical diagnosis was hematobilia. Tc-99m DISIDA imaging showed a pattern consistent with complete biliary obstruction. Hematobilia as a cause for complete biliary obstruction on DISIDA imaging has not been reported previously.
Comparison of 18F-FDG and 68Ga DOTATATE PET/CT in Localization of Tumor Causing Oncogenic Osteomalacia
Authors: Kanhaiyalal Agrawal, Sanjay Bhadada, Bhagwant Rai Mittal, Jaya Shukla, Ashwani Sood, Anish Bhattacharya, Anil Bhansali
Journal: Clinical Nuclear Medicine (2014)

Background Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome, usually caused by small benign mesenchymal tumors. The localization of these tumors is challenging, however, essential for the management. We compared the utility of 18F-FDG PET/CT and 68Ga DOTATATE PET/CT to detect the site of primary tumor in patients with suspicion of TIO. Patients and Methods Retrospective analysis of 6 patients with hypophosphatemic osteomalacia and suspicion of TIO was performed. 68Ga DOTATATE PET/CT study was performed in all 6 patients to localize the tumor. 18F-FDG PET/CT was performed in 4 of 6 patients. 18F-FDG and 68Ga DOTATATE PET/CT studies were performed within 1 week of each other. Both studies were interpreted blindly without the knowledge of other imaging findings. Results All patients had symptoms of osteomalacia and hypophosphatemia. All except 1 patient had increased level of fibroblast growth factor 23. The lag time (symptoms to PET diagnosis) ranged from 1.5 to 22 years. In 4 patients, where both studies were performed, 18F-FDG and 68Ga DOTATATE PET/CT were able to localize the tumor in 2 and 3 patients. 68Ga DOTATATE PET/CT detected tumor in 5 (83.3%) of 6 patients. Conclusions 68Ga DOTATATE PET/CT performed better than 18F-FDG PET/CT and is useful in the detection of tumors causing oncogenic osteomalacia. Therefore, in clinically suspected cases of hypophosphatemic osteomalacia, 68Ga DOTATATE PET/CT may be performed as first-line imaging investigation to avoid delay in the treatment of this devastating but curable disease. However, further studies with large patient population are warranted to validate our data.
Very Low-Fat Diets for Coronary Heart Disease: Perhaps, But Which One?-Reply
Authors: Dean Ornish
Journal: JAMA (1996)

<h3>In Reply.</h3> —Unlike the patient described by Dr Siguel and colleagues, almost all of the patients in the experimental group of the Lifestyle Heart Trial<sup>1</sup>and in an earlier study<sup>2</sup>described improvements in well-being, energy, stamina, and concentration. Also, these patients reported a 91% reduction in frequency of angina after 1 year and a 71% reduction after 5 years. High-density lipoprotein cholesterol decreased and triglycerides increased slightly, although not significantly. However, HDL-C and triglycerides are only risk factors, not diseases. These patients showed some overall regression in percent diameter stenosis after 1 year and even more regression after 5 years. There was a dose-response correlation between adherence to the lifestyle program and changes in atherosclerosis at 1 year and at 5 years. Cardiac positron emission tomography scans showed overall improvement in myocardial perfusion in these patients after 5 years. Dr Gould's analyses indicated that the progression of disease
Compensatory recovery of liver mass by Akt-mediated hepatocellular hypertrophy in liver-specific STAT3-deficient mice
Authors: Sanae Haga, Wataru Ogawa, Hiroshi Inoue, Keita Terui, Tetsuya Ogino, Rumi Igarashi, Kiyoshi Takeda, Shizuo Akira, Shin Enosawa, Hiroyuki Furukawa, Satoru Todo, Michitaka Ozaki
Journal: Journal of Hepatology (2005)
Inhibition of Mnk kinase activity by cercosporamide and suppressive effects on acute myeloid leukemia precursors
Authors: Jessica K. Altman, Amy Szilard, Bruce W. Konicek, Philip W. Iversen, Barbara Kroczynska, Heather Glaser, Antonella Sassano, Eliza Vakana, Jeremy R. Graff, Leonidas C. Platanias
Journal: Blood (2013)
Risk Factors for Disseminated or Fatal Histoplasmosis
Authors: LAWRENCE JOSEPH WHEAT
Journal: Annals of Internal Medicine (1982)

An outbreak of histoplasmosis in Indianapolis involving 488 clinically recognized cases including 60 patients with disseminated or fatal infection permitted statistical analysis of risk factors. Being male, white, under 5 years of age, having chronic obstructive lung disease, and living near the presumed source of the outbreak were not risk factors for fatal or disseminated histoplasmosis. Age greater than 54 years and immunosuppression were the only risk factors for disseminated or fatal infection. Dissemination should be excluded in patients with histoplasmosis who are immunosuppressed or older than 54 years. Specific antifungal treatment is more likely to be required in those two groups rather than in patients without risk factors.
Viruses and Leukemias
Authors: Robert Gerner
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The staff of the Cell Laboratory at Roswell Park Memorial Institute, Buffalo, NY, has a critical need for blood samples from patients with (1) plasma cell leukemia, ( 2) erythremic myelosis ( Di Guglielmo's syndrome or erythroblastic leukemia), (3) megakaryocytic leukemia, (4) eosinophilic leukemia, (5) basophilic leukemia, or (6) major leukemoid reactions associated with malignancy. The white blood cell count must be greater than 20,000/cu mm for the collection procedures. Heparintreated blood samples are sedimented and the leukocytes put in cell cultures. The staff has successfully cultured cells from more than 35 patients with leukemia and leukemoid reactions. In nine instances virus-containing cells have been found. Samples of 20 to 50 ml of blood are needed in most cases. If acceptable, leukapheresis will be done by a member of the staff in the donor hospital. If you can help, please call collect.
Précis of Knowledge and the Flow of Information
Authors: Fred I. Dretske
Journal: Behavioral and Brain Sciences (1983)

Abstract A theory of information is developed in which the informational content of a signal (structure, event) can be specified. This content is expressed by a sentence describing the condition at a source on which the properties of a signal depend in some lawful way. Information, as so defined, though perfectly objective, has the kind of semantic property (intentionality) that seems to be needed for an analysis of cognition. Perceptual knowledge is an information-dependent internal state with a content corresponding to the information producing it. This picture of knowledge captures most of what makes knowledge an important cpistcmological notion. It also avoids many of the problems infecting traditional justificational accounts of knowledge (knowledge as [justified, true belief’). Our information pickup systems are characterized in terms of the way they encode incoming information (perception) for further cognitive processing. Our perceptual experience is distinguished from our perceptual beliefs by the different way sensory information is encoded in these internal structures. Our ropositional attitudes – those (unlike knowledge) having a content that can be either true or false (e.g., belief) – are described in terms of the way internal (presumably neural) structures acquire during learning a certain information-carrying role. The content of these structures (whether true or false) is identified with the kind of information they were developed to carry
Norepinephrine induces apoptosis in neonatal rat endothelial cells via down-regulation of Bcl-2 and activation of β-adrenergic and caspase-2 pathways
Authors: Y Fu
Journal: Cardiovascular Research (2004)

Objectives: Heart failure is associated with increased plasma norepinephrine (NE) and endothelial apoptosis. Recent reports have suggested that endothelial dysfunction is an important target for future therapies of heart failure. However, whether NE can induce endothelial apoptosis and its mechanism remains unknown. Methods: Endothelial cells from neonatal rat heart were treated with various concentrations of NE for different durations. Apoptosis was assessed by terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) and DNA fragmentation assays. Caspase activity was measured using specific fluorogenic substrates. Proteins of Bcl-2 family and cytochrome c were assayed by Western blotting. Results: NE induced endothelial apoptosis in a dose- and time-dependent manner. After treatment for 48 h, increasing NE concentration from 5, 10, 50, 100 to 200 μM resulted in 6±3%, 14±5%, 43±4%, 66±5%, and 89±6% apoptotic cells, respectively. The apoptosis was accompanied by down-regulation of Bcl-2 protein synthesis but not by cytosolic cytochrome c translocation. Caspase-2, -3, -6 and -9 were activated during apoptosis and caspase-2 inhibitor (Z-VDVAD-FMK) and caspase-3 inhibitor (Z-DEVD-FMK) significantly attenuated the apoptosis. Overexpression of Bcl-2 inhibited caspase activity and decreased the apoptosis. Moreover, the NE-mediated apoptotic effect was attenuated by β- (β2>β>β1) adrenergic antagonists (ICI-118,551>propranolol>atenolol) but was not affected by α1- or α2-adrenergic antagonists (prazosin or yohimbine). Conclusion: Our study is the first report documenting that NE induces apoptosis in neonatal rat endothelial cells mainly through down-regulation of Bcl-2 protein and activation of the β-adrenergic (β2>β1) and caspase-2 pathways. β-Adrenergic antagonists and caspases inhibitors may be useful in the prevention and management of NE-mediated endothelial apoptosis during heart failure.
Screening for Osteoporosis in Men: A Systematic Review for an American College of Physicians Guideline
Authors: Hau Liu, Neil M. Paige, Caroline L. Goldzweig, Elaine Wong, Annie Zhou, Marika J. Suttorp, Brett Munjas, Eric Orwoll, Paul Shekelle
Journal: Annals of Internal Medicine (2008)

Background: Screening for low bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) is the primary way to identify asymptomatic men who might benefit from osteoporosis treatment. Identifying men at risk for low BMD and fracture can help clinicians determine which men should be tested. Purpose: To identify which asymptomatic men should receive DXA BMD testing, this systematic review evaluates 1) risk factors for osteoporotic fracture in men that may be mediated through low BMD and 2) the performance of non-DXA tests in identifying men with low BMD. Data Sources: Studies identified through the MEDLINE database (1990 to July 2007). Study Selection: Articles that assessed risk factors for osteoporotic fracture in men or evaluated a non-DXA screening test against a gold standard of DXA. Data Extraction: Researchers performed independent dual abstractions for each article, determined performance characteristics of screening tests, and assessed the quality of included articles. Data Synthesis: A published meta-analysis of 167 studies evaluating risk factors for low BMD–related fracture in men and women found high-risk factors to be increased age (>70 years), low body weight (body mass index <20 to 25 kg/m2), weight loss (>10%), physical inactivity, prolonged corticosteroid use, and previous osteoporotic fracture. An additional 102 studies assessing 15 other proposed risk factors were reviewed; most had insufficient evidence in men to draw conclusions. Twenty diagnostic study articles were reviewed. At a T-score threshold of −1.0, calcaneal ultrasonography had a sensitivity of 75% and specificity of 66% for identifying DXA-determined osteoporosis (DXA T-score, −2.5). At a risk score threshold of −1, the Osteoporosis Self-Assessment Screening Tool had a sensitivity of 81% and specificity of 68% to identify DXA-determined osteoporosis. Limitation: Data on other screening tests, including radiography, and bone geometry variables, were sparse. Conclusion: Key risk factors for low BMD–mediated fracture include increased age, low body weight, weight loss, physical inactivity, prolonged corticosteroid use, previous osteoporotic fracture, and androgen deprivation therapy. Non-DXA tests either are too insensitive or have insufficient data to reach conclusions.
Assessing the Association of Appropriateness of Coronary Revascularization and Clinical Outcomes for Patients With Stable Coronary Artery Disease
Authors: Dennis T. Ko, Helen Guo, Harindra C. Wijeysundera, Madhu K. Natarajan, A. Dave Nagpal, Christopher M. Feindel, Kori Kingsbury, Eric A. Cohen, Jack V. Tu
Journal: Journal of the American College of Cardiology (2012)
Eating a yoghurt a day is linked to lower risk of type 2 diabetes
Authors: J. Wise
Journal: BMJ (2014)

A higher intake of yoghurt is associated with a reduced risk of type 2 diabetes, a new study has shown.

Researchers from the Harvard School of Public Health pooled data from three large prospective cohort studies in which participants gave information about their dairy intake.1 People were excluded if they had diabetes, cardiovascular disease, or cancer at baseline, and they were followed up every two years, …