tbuckley/cabot-search huggingface dataset:
Reducing Long-term Diazepam Prescribing in Office Practice
Authors: Wayne A. Ray
Journal: JAMA (1986)

We conducted a controlled, statewide trial of the efficacy of an educational visit by a physician counselor in the reduction of diazepam prescribing in outpatient practice. A novel aspect of this trial was the provision of a schedule for gradual withdrawal of long-term diazepam users from drug therapy; 51% of visited doctors attempted to withdraw patients from diazepam therapy and 26% utilized the withdrawal schedule. The entire group of 43 visited doctors reduced the rate of long-term diazepam users in their practice by 18% relative to the control group; the subgroup of doctors who utilized the withdrawal schedule had and even greater reduction of 33%. These results suggest that practicing doctors are concerned with long-term use of diazepam and that the educational visit by another physician is one method for reducing such use.
Pharmacologic Approaches to Correcting the Basic Defect in Cystic Fibrosis
Authors: Gergely L. Lukacs, Peter R. Durie
Journal: New England Journal of Medicine (2003)

Cystic fibrosis is a heterogeneous condition caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene.1 The gene product, a regulated chloride channel, is expressed in the apical plasma membrane of secretory and reabsorptive epithelia of affected organs and allows the transepithelial movement of water and solute by mediating chloride translocation across the plasma membrane. Although the mechanism underlying the CFTR-induced regulation of chloride transport activity has largely been elucidated, other effector functions are less well understood.More than 1000 alterations have been identified in the CFTR gene (for a list, see http://www.genet.sickkids.on.ca/cftr/). Cystic fibrosis is . . .
Prediction of Alexithymic Characteristics from Physiological, Personality, and Subjective Measures
Authors: John B. Martin, R.O. Pihl, Simon N. Young, Frank R. Ervin, Smadar V. Tourjman
Journal: Psychotherapy and Psychosomatics (1986)

Noting concerns for a comprehensive conceptualization of alexithymic characteristics, the present study examines the potential utility of considering these characteristics as manifestations of deficits in cognitive schemata. Research guided by this conceptualization has identified physiological, subjective, and personality features of alexithymic characteristics. It is reasoned that if this conceptualization has merit, it should be possible to predict the presence of alexithymic characteristics from these features. Results of the present study indicate that a combination of physiological, subjective, and personality variables significantly predicts the presence of alexithymic characteristics as measured by the Schalling-Sifneos Personality Scale. These results are discussed in terms of their implications for a more comprehensive description of alexithymia and the value of the cognitive schema conceptualization.
Cardiac Pain
Authors: JAMES C. WHITE
Journal: Circulation (1957)

It may be concluded that the pathways of cardiac pain have been thoroughly established, with the exception of the conduction of anginal attacks occasionally referred to the neck and jaws. Afferent impulses traverse axons that travel in the cervical and thoracic sympathetic cardiac nerves. In the case of the cervical pathway, all impulses on entering the paravertebral ganglionated chain in the neck must descend to the upper thoracic level before they can gain access to the spinal cord. Other impulses reach the 3 superior thoracic ganglia via the more direct thoracic cardiac nerves. Both the cervical and thoracic fibers join the spinal nerves over the communicant sympathetic rami. After passing through the intervertebral foramina, they enter the posterior roots and terminate in the lateral horn of the spinal cord. Here they establish synapses with secondary afferent neurons of the spinothalamic tract, decussate to the opposite anterior column, and are carried rostrally to the nucleus ventralis posterolateralis of the thalamus. This is the principal locus in the brain for the perception of visceral pain. In contrast to well-defined cutaneous sensibility, there is no cortical area for exact visceral localization in the postcentral region of the cerebral cortex. Another factor in the poor localization of cardiac pain is the paucity of sensory endings in the heart. A third appears to be the limited number of secondary sensory fibers in the spinothalamic tracts. These central axons must be shared with other impulses from the surface of the body. As a result, pain from the heart is in large part referred to the cutaneous distribution of the upper 4 thoracic spinal segments. Accounting for the superficial reference of visceral pain by Mackenzie's theory of a viscerocutaneous reflex is no longer justifiable. Even after cutaneous afferent fibers are interrupted by procaine or amputation of the arm, pain from the heart can still be felt over its previous distribution. Neither stimulation of the vagi nor interruption of transmission in these nerves has been found to have any beneficial effect in patients suffering from angina pectoris. Sensory denervation of the heart must therefore be carried out by destruction of the upper ganglia in the thoracic sympathetic trunks or by severing the corresponding posterior spinal roots.
Abstract 1064: Pim serine/threonine kinases regulate the phosphorylation and function of eIF4B protein
Authors: Jilong Chen, Jun Wang, Jianling Yang
Journal: Cancer Research (2011)

Abstract Eukaryotic initiation factor 4B (eIF4B) is a multidomain protein with a critical role in the initiation of protein synthesis, and has long been known as a hyperphosphorylated protein. It has been thought that function of eIF4B can be regulated by phosphorylation. The Pim family of Ser/Thr kinase, which is consisted of three members: Pim-1, Pim-2, and Pim-3, has been implicated in multiple cellular processes including cellular survival, anti-apoptosis and tumorigenesis. In this study, we identified eIF4B as a Pim kinase substrate. We found that Pim-1, Pim-2 but not Pim-3 can upregulate phosphorylation levels of eIF4B on Ser406 and Ser422 using 293T cell system, while kinase-dead mutants of Pim-1 or Pim-2 significantly inhibit phosphorylation of eIF4B. Furthermore, in vitro kinase assay revealed that Pim-1 kinase can directly phosphorylate eIF4B on Ser422. As expected, we found that Pim-1 kinase directly bound to eIF4B using GST-pull down assay and co-immunoprecipitation experiments. Interestingly, levels of eIF4B protein in v-Abl transformants treated with the Abl kinase inhibitor imatinib decreased markedly, indicating that expression of eIF4B is Abl kinase dependant. Our results suggest that Pim kinases regulate cellular processes via phosphorylating downstream eIF4B, and thereby alter the function of eIF4B in v-Abl transformants. Together, these data possibly provide new insights into molecular mechanisms of Abl oncogene-mediated cellular transformation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1064. doi:10.1158/1538-7445.AM2011-1064
New insights into nNOS regulation of vascular homeostasis
Authors: G. L. Semenza
Journal: Journal of Clinical Investigation (2005)

An important physiological response to changes in local or systemic oxygenation is the modulation of vascular tone, which is mediated in part by changes in the activities of the 3 NO synthase (NOS) isoforms. In arterial smooth muscle cells, acute hypoxia induces increased vascular tone, which is attenuated if hypoxia persists. In this issue of the JCI, Ward et al. demonstrate that changes in O2 concentration have effects on neuronal NOS enzymatic activity and gene expression that contribute to vascular homeostasis under conditions of acute and chronic hypoxia.
Report highlights “catastrophic” personal payments for health care in Asia
Authors: Ganapati Mudur
Journal: BMJ (2007)

Bangladesh, China, and India have the highest incidence in Asia of “catastrophic” payments from individuals' own finances to cover healthcare costs—those payments that are so crippling financially that they throw a household into catastrophe.

Such payments severely disrupt household living standards, a new study has said. The report, published online ahead of print publication on 21 February in Health Economics (www3.interscience.wiley.com, doi: 10.1002/hec.1209), says that patients' own out of pocket payments account for 80% of spending on health care in India and Vietnam and more than 60% in Bangladesh and China. The World Health Organization said in a 2005 report on catastrophic health costs that any spending that was above 40% of non-subsistence income should …
M-CSF mediates TNF-induced inflammatory osteolysis
Authors: H. Kitaura
Journal: Journal of Clinical Investigation (2005)

TNF-alpha is the dominant cytokine in inflammatory osteolysis. Using mice whose BM stromal cells and osteoclast precursors are chimeric for the presence of TNF receptors, we found that both cell types mediated the cytokine's osteoclastogenic properties. The greater contribution was made, however, by stromal cells that express the osteoclastogenic cytokine M-CSF. TNF-alpha stimulated M-CSF gene expression, in vivo, only in the presence of TNF-responsive stromal cells. M-CSF, in turn, induced the key osteoclastogenic cytokine receptor, receptor activator of NF-kappaB (RANK), in osteoclast precursors. In keeping with the proproliferative and survival properties of M-CSF, TNF-alpha enhanced osteoclast precursor number only in the presence of stromal cells bearing TNF receptors. To determine the clinical relevance of these observations, we induced inflammatory arthritis in wild-type mice and treated them with a mAb directed against the M-CSF receptor, c-Fms. Anti-c-Fms mAb selectively and completely arrested the profound pathological osteoclastogenesis attending this condition, the significance of which is reflected by similar blunting of the in vivo bone resorption marker tartrate-resistant acid phosphatase 5b (TRACP 5b). Confirming that inhibition of the M-CSF signaling pathway targets TNF-alpha, anti-c-Fms also completely arrested osteolysis in TNF-injected mice with nominal effect on macrophage number. M-CSF and its receptor, c-Fms, therefore present as candidate therapeutic targets in states of inflammatory bone erosion.
Assessment of Subclinical Left and Right Ventricular Dysfunction by Using Isovolumic Acceleration in Patients with Dipper and Non-dipper Hypertensives
Authors: Mehmet Ertürk, Ali Buturak, Hamdi Pusuroglu, Ali Kemal Kalkan, Muhammet Gurdogan, Fatih Uzun, Ozgur Akgul, Hale Unal Aksu, Faruk Akturk, Nevzat Uslu
Journal: Journal of the American College of Cardiology (2013)
CARDIOLOGY PRACTICE IMPROVEMENT PATHWAY: HOW DO WE MEASURE QUALITY IN CARDIOVASCULAR CARE?
Authors: Andrea M. Russo, Eileen Hagan, Cathleen Biga, Joseph G. Cacchione, Joseph Drozda, Peter L. Duffy, Linda Gillam, Paul A. Heidenreich, Kathy Jenkins, Jerry D. Kennett, Ann Loth, Michael Mirro, Chelsea Newhall, William Oetgen, Sid Smith, Bonnie H. Weiner, John Windle, Janet Wright
Journal: Journal of the American College of Cardiology (2011)
A Sense of Humor
Authors: Charles D. Aring
Journal: JAMA (1971)

To do the exacting work of medicine devoid of a sense of humor adds immeasurably to the effort. Humor often saves the day when dealing with man's foibles, with his genius and idiocies, his joys and sorrows, pleasure and pains, loves and hates, generosities and meannesses, grace and clumsiness, gentility and crudeness, in short, with his inconsistencies. A sense of humor is a precious possession and those so endowed find it difficult to conceive of life without it. Humor cannot be invoked as can theorems or the law. Humor is natural or it is nothing; if it does not come gracefully it is better unessayed. Not that it cannot be practiced as one strives to know oneself, which as the record has it is one of the most difficult jobs in the world. Humor is a basic trait appearing to develop in formative years. Perhaps it is akin to learning
Hepatic steatosis in HIV/hepatitis C coinfection: Prevalence and significance compared with hepatitis C monoinfection
Authors: Alexander Monto, Lorna M. Dove, Alan Bostrom, Sanjay Kakar, Phyllis C. Tien, Teresa L. Wright
Journal: Hepatology (2005)

Liver disease in patients coinfected with HIV and hepatitis C virus (HCV) has received increasing attention in recent years. Steatosis is accepted as an important contributor to liver disease in patients with HCV, but despite coinfected patients having several reasons to have steatosis, the prevalence and significance of such changes has received scant attention. We examined steatosis in an unselected cohort of coinfected patients and compared its prevalence and predictors with findings in monoinfected patients, where these relationships have been established. We studied 92 coinfected and 372 monoinfected patients undergoing staging liver biopsy. Baseline characteristics of the two groups differed significantly, pointing at different contributors to steatosis in each. Histological inflammation and fibrosis were very similar in the two groups, but steatosis was less in coinfected patients. Steatosis had a univariate association with fibrosis in both groups, but retained a multivariate association only in monoinfected patients. Other multivariate predictors of steatosis in monoinfected patients were the accepted variables of elevated body mass index, male sex, and genotype 3a infection, as well as age. In coinfected patients, however, age was the only multivariate predictor. Undetectable HIV viral load was associated with steatosis in coinfected patients in univariate analysis, but highly active antiretroviral therapy or its individual components could not be initially linked to steatosis. In conclusion, steatosis is less common in HIV/HCV coinfected patients than similar HCV monoinfected patients, and predictors of steatosis differ between the two groups. (HEPATOLOGY 2005;42:310–316.)
Oxygen-dependent tension in vascular smooth muscle. Does the endothelium play a role?
Authors: R F Coburn, R Eppinger, D P Scott
Journal: Circulation Research (1986)

We investigated a hypothesis that an oxygen sensor involved in hypoxia-induced relaxation of vascular smooth muscle may reside in endothelial cells. We also determined the oxygen dependence of hypoxia-induced decreases in cyclic guanosine 3',5'-monophosphate concentrations in vascular smooth muscle rings. Rings of canine femoral artery, rabbit thoracic aorta, and lamb ductus arteriosus, either with an intact endothelium or with damaged or absent endothelium, were studied using organ baths that allowed changes in PO2 without a change in pH. Hypoxia-induced relaxations of rabbit thoracic aorta, lamb ductus arteriosus, and canine femoral artery were not dependent on an intact endothelium. The magnitude of hypoxia-induced relaxations was unchanged in rings of canine femoral artery without intact endothelium compared to rings with endothelium. Quasi-steady state organ bath PO2-mechanical tension relationships were unchanged in rings of canine femoral artery without endothelium over an organ PO2 range of 200-20 mm Hg. With rabbit thoracic aorta, magnitudes of hypoxia-induced relaxations were significantly smaller in rings without endothelium. Quasi-steady state plots, where mechanical tension was given as percentage of maximal relaxation, were similar in rings either with or without intact endothelium. Cyclic guanosine 3',5'-monophosphate concentrations were shown to be oxygen-sensitive, decreasing during hypoxia-induced relaxations with a threshold PO2 of 80-100 mm Hg with canine femoral artery, and 60-80 mm Hg with rabbit thoracic aorta rings, but this finding seems unrelated to the mechanism of hypoxia-induced relaxation.
Competence, professional self regulation, and the public interest
Authors: R. Klein
Journal: BMJ (1998)

Editorial by Treasure News by Dyer 

The case of the three doctors in Bristol represents a landmark in the history of the self regulation of the medical profession in the United Kingdom in terms of its length, its salience in the eyes of the public, and the issues it has raised. It has stretched over eight months and involved more than 60 days of hearings before the General Medical Council—probably the most extended and expensive case in the history of the GMC. It is the stuff of which headlines are made; it is highly charged emotionally since it concerns the deaths of children after heart operations. And it has provided a test case for the GMC's policy of seeking to ensure that all members of the profession accept their collective responsibility for maintaining standards and practising within the limits of their competence.1

Until the GMC has determined its verdict, in the light of their findings of the facts, it would be improper to comment on the actions of the individuals being investigated. However, the case raises some wider questions, both for the medical profession and for the NHS. This paper explores some of these questions from the perspective of a lay observer, drawing on an analysis of the transcripts of the proceedings.

#### Summary points

There seems to be some confusion about how doctors should interpret their responsibility for protecting patients from harm from other doctors

Doctors seem to need training in communicating with each other

There may be a need for more explicit and stringent training requirements before surgeons are permitted to operate independently

There may be a need for more explicit requirements for retraining when results are poor

The proceedings have been long and drawn out because they have involved the detailed examination of the circumstances of every death in …
The Successful Treatment of Gonorrhea.
Authors: William Warren Townsend
Journal: JAMA (1902)

Rutland, Vt., Oct. 22, 1902. <h3>To the Editor:</h3> —I note inThe Journal, Oct. 11, 1902, an article from the pen of S. T. Rucker, M.D., of Tennessee, "The Successful Treatment of Gonorrhea and All Inflammatory Diseases of the Urethra by Packing It with an Antiseptic Oiled Dressing." The author states that he wishes "to announce to the profession a new method of treating this intractable malady by packing the urethra with an antiseptic oiled dressing." This "new method" is not a new method, unless the important part of it is the oily medicant. For in a paper published in the<i>Medical News</i>, Sept. 27, 1893, Pitts describes a treatment used by him, namely, tamponing the urethra with pledgets of cotton soaked in a mercurial solution, and introduced into the urethra by the aid of an ordinary endoscopic tube. Pitts, if I remember correctly, did not treat his cases as
Quality of life measures in health care. II: Design, analysis, and interpretation.
Authors: A. Fletcher, S. Gore, D. Jones, R. Fitzpatrick, D. Spiegelhalter, D. Cox
Journal: BMJ (1992)

The design, analysis, and interpretation of studies using measures of quality of life vary according to the context of use.In this paper we are primarily con- cerned with quality of life measures in clinical trials but our comments are relevant in other contexts. DesignApart from the usual considerations of good study design, particular issues in studies measuring quality of life are the choice of dimensions and the selection of instruments to measure these dimensions.There are also several practical considerations.
Familial Idiopathic Thrombocytopenic Purpura
Authors: E. J. S. Woolley
Journal: BMJ (1956)

Closer examination of the inside of the tube, however, revealed the remains of the original large blister and two smaller blisters.Another section of the tube was half cut across at one of the light patches.Two layers of the tube were clearly discernible, one on each side of the metal reinforcement (see 'Fig.).These layers could be separated quite readily, and it was found that the inner layer would swell very con- siderably if trichlorethylene were applied to it.The swelling continued until the entire lumen of the tube was obstructed.When fresh air was blown through the tube the process was shown to be reversible and the swelling almost entirely disappeared.
FOXP1, a gene highly expressed in a subset of diffuse large B-cell lymphoma, is recurrently targeted by genomic aberrations
Authors: I Wlodarska, E Veyt, P De Paepe, P Vandenberghe, P Nooijen, I Theate, L Michaux, X Sagaert, P Marynen, A Hagemeijer, C De Wolf-Peeters
Journal: Leukemia (2005)
Maternal-Fetal Calcium and Bone Metabolism During Pregnancy, Puerperium, and Lactation*
Authors: Christopher S. Kovacs, Henry M. Kronenberg
Journal: Endocrine Reviews (1997)

I. Introduction II. Maternal Physiology and Pathophysiology During Pregnancy A. Maternal adaptive goals during pregnancy B. Mineral ions and calcitropic hormones C. Intestinal absorption of calcium D. Renal handling of calcium E. Skeletal calcium metabolism F. Primary hyperparathyroidism G. Hypoparathyroidism and pseudohypopara- thyroidism H. Summary III. Fetal-Placental Physiology and Pathophysiology A. Fetal adaptive goals B. Mineral ions and calcitropic hormones C. Fetal-placental calcium transport D. Renal handling of calcium and the amniotic fluid E. Skeletal calcium metabolism F. Fetal response to maternal hyper- or hypoparathy-roidism G. Integrated fetal calcium homeostasis H. Summary IV. Maternal Physiology and Pathophysiology During Lactation A. Maternal adaptive goals during lactation B. Mineral ions and calcitropic hormones C. Intestinal absorption of calcium D. Renal handling of calcium E. Skeletal calcium metabolism F. Hypoparathyroidism and pseudohypoparathy- roidism G. Summary V. Neonatal P...