tbuckley/cabot-search huggingface dataset:
THE ETIOLOGY OF THE EXCESSIVE VOMITING OF PREGNANCY
Authors: J. H. Martin
Journal: BMJ (1912)

EXCESSIVE VOMITING OF PREGNANCY.[MAy 18j 1I92.sixth month, in 2 cases -it began during the fourth, and in 5 rases during the flfth month.In 6 cases the presence of constipation was noted.In B others it was stated that the bowels had been opened regularly.In 8 cases the trouble was right-sided, in 8 cises the
Serum Micronutrient Concentrations and Decline in Physical Function Among Older Persons
Authors: Benedetta Bartali, Edward A. Frongillo, Jack M. Guralnik, Martha H. Stipanuk, Heather G. Allore, Antonio Cherubini, Stefania Bandinelli, Luigi Ferrucci, Thomas M. Gill
Journal: JAMA (2008)

ContextMaintaining independence of older persons is a public health priority, and identifying the factors that contribute to decline in physical function is needed to prevent or postpone the disablement process. The potential deleterious effect of poor nutrition on decline in physical function in older persons is unclear.ObjectiveTo determine whether a low serum concentration of micronutrients is associated with subsequent decline in physical function among older men and women living in the community.Design, Setting, and ParticipantsLongitudinal study of 698 community-living persons 65 years or older who were randomly selected from a population registry in Tuscany, Italy. Participants completed the baseline examination from November 1, 1998, through May 28, 2000, and the 3-year follow-up assessments from November 1, 2001, through March 30, 2003.Main Outcome MeasureDecline in physical function was defined as a loss of at least 1 point in the Short Physical Performance Battery during the 3-year follow-up. Odds ratios (ORs) were calculated for the lowest quartile of each nutrient using the other 3 quartiles combined as the reference group. Two additional and complementary analytical approaches were used to confirm the validity of the results.Results The mean decline in the Short Physical Performance Battery score was 1.1 point. In a logistic regression analysis that was adjusted for potential confounders, only a low concentration of vitamin E (&lt;1.1 μg/mL [&lt;24.9 μmol/L]) was significantly associated with subsequent decline in physical function (OR, 1.62; 95% confidence interval, 1.11-2.36; P = .01 for association of lowest α-tocopherol quartile with at least a 1-point decline in physical function). In a general linear model, the concentration of vitamin E at baseline, when analyzed as a continuous measure, was significantly associated with the Short Physical Performance Battery score at follow-up after adjustment for potential confounders and Short Physical Performance Battery score at baseline (β = .023; P = .01). In a classification and regression tree analysis, age older than 81 years and vitamin E (in participants aged 70-80 years) were identified as the strongest determinants of decline in physical function (physical decline in 84% and 60%, respectively; misclassification error rate, 0.33). ConclusionsThese results provide empirical evidence that a low serum concentration of vitamin E is associated with subsequent decline in physical function among community-living older adults. Clinical trials may be warranted to determine whether an optimal concentration of vitamin E reduces functional decline and the onset of disability in older persons.
The National Practitioner Data Bank: Bane or Benefit?
Authors: Michael Dube
Journal: JAMA (1992)

<h3>To the Editor.</h3> —I was pleased initially to see the recent article on the NPDB<sup>1</sup>in<i>JAMA</i>. I thought I might finally be informed of the details of the function and operation of what many physicians consider a "Big Brother" approach to monitoring the practice of medicine. While it is certainly a laudable goal to improve the identification of "bad doctors," I am very concerned about the methods used and the extreme potential for abuse. The article states that the main reason to create the NPDB was to prevent incompetent doctors from moving around (ie, from state to state) to avoid sanctions. It is also clearly stated that another body does this, the Federation of State Medical Boards. This is as pertains to licensure actions, which is certainly the foremost concern. So it would appear that the NPDB was formed for other reasons. The authors go on to state
Possible cytokine mechanism of increased megakaryocytic proliferation in 5q- syndrome
Authors: Yücel Üstünda??, Ibrahim C. Haznedaro??lu, Osman Özcebe, Semra Dündar, ŞErafettin Kirazli
Journal: American Journal of Hematology (1996)

blood cell count increased from 0.4 X 10yL to 1.0 X 109/L in the first 10 days, only to exhibit an accelerated rise afterwards, the count reaching 36.5 X 109L on the 14th day.G-CSF was therefore discontinued (Fig. I).The peripheal smear revealed 2% blasts, 3% promyelocytes, 5% metamyelocytes, 14% bands, S8% polymorphonuclear leukocytes, 12% lymphocytes, and 6% normohlasts.Bone marrow aspirate exhibited hypercellularity and marked myeloid hyperplasia (myeloid/erythroid ratio, 8: I), with 1.0% blasts.The white blood cell count declined to 4.6 X 109/L in a period of 8 days.Daily peripheral blood smear examinations revealed the gradual resolution of leukoerythroblastosis.Subsequent bone marrow aspiration was unremarkable except for mild erythroid hyperplasia, with a blast count ofO.S%.On the confirmation of remission, the patient was discharged and was followed as an outpatient on a monthly basis.The patient is well and free of any evidence of relapse after 6 months of follow-up.The exclusion of other possible causes of leukoerythroblastosis such as invasion of the bone marrow with the leukemic clone or infections and the absence of acute hemolysjs or sepsis together with resolution of the condition after the discontinuation of treatment have defined G-CSF as the responsible factor for this unexpected finding.After 6 months of follow-up, the patient remains in remission, which can be taken as evidence that leukoerythroblastosis associated with G-CSF administration is a transient and benign condition.We agree with Reykdal et al. [I] that the appearance of blasts may not always indicate relapse, such unexpected effects of G-CSF should always be kept in mind.
Prevention of further bone mass loss by nasal calcitonin in patients on long term glucocorticoid therapy for asthma: a two year follow up study.
Authors: M Luengo, F Pons, M J Martinez de Osaba, C Picado
Journal: Thorax (1994)

BACKGROUND--Injectable calcitonin is effective in reducing spinal bone loss in steroid-dependent asthma but side effects are frequent. In contrast, a nasal spray presentation has been shown to be effective and well tolerated in involutional osteoporosis. To test the efficacy of nasal calcitonin a two year prospective trial was conducted in 44 steroid-dependent asthmatic patients. METHODS--All patients received a calcium supplement of 1000 mg and were allocated randomly into two groups treated with either salmon calcitonin nasal spray (200 IU every other day, n = 22) or calcium alone (n = 22) for two years. All patients completed the first year of the study. Five patients in each group dropped out during the second year. In the calcitonin group one patient developed generalised pruritus and four lost steroid dependence, and in the calcium alone group five were no longer dependent on steroids. The efficacy of treatment was evaluated as follows: bone turnover assessed by biochemical markers, bone loss assessed by serial measurement of lumbar spine density, and rates of bone fractures. RESULTS--The bone mass in the calcitonin group increased by 2.7% in the first year while in the group receiving calcium alone it decreased by 2.8%; this difference was significant. Calcitonin prevented more bone loss during the second year while the calcium alone group continued losing bone mass (-7.8%). The difference between means was 0.1077 (95% CI 0.0381 to 0.1773). Three new fractures occurred in both groups. No changes in biochemical parameters were detected in either group. CONCLUSIONS--Calcitonin given intranasally increased spinal bone mass during the first year of treatment and maintained bone mass in a steady state during the second year. These results suggest that calcitonin may be a useful agent to prevent steroid-induced osteoporosis. However, the lack of effect of calcitonin on the rate of vertebral fractures does not permit its recommendation for routine use in preventing steroid-induced osteoporosis.
Abstract B48: Inflammation-mediated genetic and epigenetic alterations drive cancer development in the neighboring epithelium upon stromal abrogation of TGF-β signaling
Authors: B.R Achyut, David Bader, Ana Robles, Wanga Darawarlee, Curtis Harris, Thomas Ried, Li Yang
Journal: Cancer Research (2015)

Abstract Deletion of tumor suppressor genes in stromal fibroblasts induces epithelial cancer development, suggesting an important role of stroma in epithelial homoeostasis. However, the underlying mechanisms remain to be elucidated. Here we report that deletion of the gene encoding TGF-ß receptor 2 (Tgfbr2) in the stromal fibroblasts (Tgfbr2fspKO) induces inflammation and significant DNA damage in the neighboring epithelia of the forestomach. This results in loss or down-regulation of cyclin-dependent kinase inhibitors p15, p16, and p21, which contribute to the development of invasive squamous cell carcinoma (SCC). Anti-inflammation treatment restored p21 expression, delayed tumorigenesis, and increased survival of Tgfbr2fspKO mice. Our data demonstrate for the first time that inflammation is a critical player in the epigenetic silencing of p21 in tumor progression. Examination of human esophageal SCC showed a down-regulation of TGFß receptor 2 (TßRII) in the stromal fibroblasts, as well as increased inflammation, DNA damage, and loss or decreased p15/p16 expression. Our study suggests anti-inflammation may be a new therapeutic option in treating human SCCs with down-regulation of TßRII in the stroma. Citation Format: B.R Achyut, David Bader, Ana Robles, Wanga Darawarlee, Curtis Harris, Thomas Ried, Li Yang. Inflammation-mediated genetic and epigenetic alterations drive cancer development in the neighboring epithelium upon stromal abrogation of TGF-β signaling. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr B48. doi:10.1158/1538-7445.CHTME14-B48
Post-viral Fatigue Syndrome
Authors: Michael F. Loudon
Journal: JAMA (1992)

When a man is tired of London he is tired of life, said Samuel Johnson, and one might say that the physician who is tired of books like this is tired of medicine. The quest for an explanation of chronic fatigue is that most fascinating of subjects, an exploration of the nature of disease. No bad can come of it, whatever the final conclusions, but along the way there are many methodological and philosophical pitfalls. Even the most outstanding physicians cannot always resist the temptation to simplify notions of cause and effect when constructing theories of disease. Auenbrugger, for instance, in his wonderful treatise on the percussion of the chest (1760), wrote, "Of these affections of the mind, I have observed none more powerful in rendering obscure the natural resonance of the chest than the destruction of the cherished hopes. And... among this class of diseases, nostalgia (commonly called Heimwehe—home-ail)
P15.08 * NEUROPSYCHOLOGICAL OUTCOMES AFTER MICROSURGICAL RESECTION OF BRAIN TUMORS: THE PREDICTIVE VALUE OF COGNITIVE BACKGROUND, AGE AND EDUCATION
Authors: C. Sindorio, R. V. Abbritti, R. Otera, M. C. Quattropani, A. Germano
Journal: Neuro-Oncology (2014)

INTRODUCTION: Neuropsychological assessment of patients suffering from brain tumors provides a functional map of cognitive impairment regarding memory, attention, visuospatial and visuo-constructive abilities related to the tumor's location. Several studies reported the clinical and prognostic value of pre and post-operative cognitive and behavioral assessment in neuroncology. Some authors demonstrated that age, education and gender may influence the cognitive functions, while others argued that neuropsychological deficits are independent from these factors. Despite controversies, cognitive outcome remains an unpredictable aspect after neurosurgical treatment of brain tumors. The aim of this study is evaluate the validity of the association between neuropsychological scores at base-line and variables like age, gender, and education's level, as predictors of good postoperative neuropsychological performance. In our experience, high education's level, younger age, and slight preoperative cognitive impairment are predictive of postoperative cognitive improvement, while, on the contrary, a low education's level and a significant preoperative cognitive impairment, seemed to be associated to a worsened post-op cognitive outcome. MATERIALS AND METHODS: We conducted a cognitive assessment of patients harboring a brain tumoron admission, by using the Mini Mental State Examination and the Repeatable Battery for the Assessment of Neuropsychological Status. This is a brief, fast and simple neuropsychological battery, useful to preoperatively assess delicate patients, which assesses 5 different domains: immediate memory, visuospatial and visuo-constructive abilities, attention, language comprehension and delayed memory, minimizing the effect of cognitive strain. Results have been compared with post-operative short and long-term assessment of the same functions. RESULTS AND DISCUSSIONS: We observed a significant postoperative cognitive improvement in patients with higher education's level, younger age and better pre-op cognitive performance compared to patients with lower education's level and pre-op cognitive performance, which was independent from the type of lesion or surgical results. A more detailed analysis of data is, however, necessary to find out the role of cognitive and socio-demographic variables as predictive factors of better or worse outcome after surgical removal.
OBSERVATIONS ON THE EFFECT OF FREEZING ON DIPHTHERIA TOXIN-ANTITOXIN MIXTURES
Authors: MARY B. KIRKBRIDE
Journal: JAMA (1924)

Such widespread publicity has been given to a recent report of serious reactions following the injection of a diphtheria toxin-antitoxin mixture which had been exposed to an extremely low temperature that it is feared the general use of this most valuable prophylactic agent may be affected. It has been assumed that, as a result of freezing, the toxin and antitoxin became dissociated, thereby increasing the toxicity of the mixture. It is well known that diphtheria toxin is extremely labile and subject to deterioration. Hence, any evidence of increased toxicity in a mixture of toxin and antitoxin would very naturally suggest some form of dissociation. It is therefore important to record without delay the results of a careful experimental study of the effect of freezing on the toxicity of such preparations. The original toxin-antitoxin mixture that was used in prophylaxis against diphtheria contained undiluted toxin, the number of L +<sup>1</sup>doses
A CASE OF TYPHLITIS, WITH AUTOPSY.
Authors: R. D. BARKER
Journal: JAMA (1883)

Luella A., American, aged twenty-one years. Was called to see her first at 2P. M., July 5, 1883. Learned the following history of the case: Had been for some time of a costive habit—bowels frequently not moving for three or four days. Although not feeling very well, she went on an excursion to Spirit Lake, twenty miles distant by rail July 4. The forenoon of the day was damp and rainy, and upon arriving at the lake she was too ill to join her companions in the grove, but lay on the sofa in the sitting-room of the hotel most of the day. She complained to her friends of pain “across her,” and vomited once or twice during the day. On returning home in the evening, not having had movement of her bowels for two or three days, and the pain across her continuing, her mother gave her a
Thiazolidinediones and Heart Failure
Authors: Sonal Singh, Yoon K. Loke, Curt D. Furberg
Journal: Diabetes Care (2007)

OBJECTIVE—Thiazolidinediones (TZDs) are known to increase the risk of heart failure in patients with type 2 diabetes. We aimed to evaluate the magnitude of the risk of heart failure with TZDs and classify this adverse effect under the novel dose-time-susceptibility system. RESEARCH DESIGN AND METHODS—Evidence from randomized trials, controlled observational studies, anecdotal case reports, case series, and spontaneous reports in the Canadian Drug Reaction Monitoring Program (CADRMP) was analyzed in a teleo-analysis. RESULTS—A random-effects meta-analysis of three randomized controlled trials showed an odds ratio (OR) of 2.1 (95% CI 1.08–4.08; P = 0.03) for the risk of heart failure in patients randomized to TZDs compared with placebo. Four observational studies revealed an OR of 1.55 (1.33–1.80; P &amp;lt; 0.00001) for heart failure with TZDs. A dose-time-susceptibility analysis of 28 published reports and 214 spontaneous reports from the CADRMP database showed that heart failure was more likely to occur after several months (with median treatment duration of 24 weeks after initiation of therapy). Heart failure equally occurred at high and low doses. The adverse reaction was not limited to the elderly, with 42 of 162 (26%) of the reported cases occurring in patients aged &amp;lt;60 years. CONCLUSIONS—Our teleo-analysis confirms the increased magnitude of the risk of heart failure with TZDs. We estimate the number needed to harm with TZDs to be ∼50 over 2.2 years. Existing guidelines and package inserts may have to be revised to incorporate these risk characteristics of TZDs.
Late results of antrectomy and vagotomy.
Authors: A C Dean, H C Edwards, A I Munro
Journal: Gut (1966)

Endothelial nitric oxide synthase (eNOS) deficiency may contribute to the pathogenesis of diabetic nephropathy in both experimental models and humans, but the underlying mechanism is not fully understood. Here, we studied two common sequelae of endothelial dysfunction in diabetes: glomerular capillary growth and effects on neighboring podocytes. Streptozotocin-induced diabetes increased glomerular capillary volume in both C57BL/6 and eNOS<sup>−/−</sup> mice. Inhibiting the vascular endothelial growth factor receptor attenuated albuminuria in diabetic C57BL/6 mice but not in diabetic eNOS<sup>−/−</sup> mice, even though it inhibited glomerular capillary enlargement in both. In eNOS<sup>−/−</sup> mice, an acute podocytopathy and heavy albuminuria occurred as early as 2 weeks after inducing diabetes, but treatment with either captopril or losartan prevented these effects. <i>In vitro</i>, serum derived from diabetic eNOS<sup>−/−</sup> mice augmented actin filament rearrangement in cultured podocytes. Furthermore, conditioned medium derived from eNOS<sup>−/−</sup> glomerular endothelial cells exposed to both high glucose and angiotensin II activated podocyte RhoA. Taken together, these results suggest that the combined effects of eNOS deficiency and hyperglycemia contribute to podocyte injury, highlighting the importance of communication between endothelial cells and podocytes in diabetes. Identifying mediators of this communication may lead to the future development of therapies targeting endothelial dysfunction in albuminuric individuals with diabetes.
A GOITRE SURVEY IN ALBINO RATS
Authors: R. McCarrison
Journal: BMJ (1930)

patienit commencedtreatmen t is in itsef probably of little importance when allowance is miiade for the age at first onset of the disease and for the length of time it hlas been in existence.Relation to.Etioloyical Factors.Here(lity.-Tlhe.occurrence of astlhma in.onie or.mi1or-e of the niear relatives of the patients has been taken for our purpose as evidence of a positive inheritanlce.Such an
Academics join forces in training fight as junior doctors face uncertainty over their future
Authors: Lynn Eaton
Journal: BMJ (2007)

UK NEWS Scientists plead for right to create interspecies embryos, p1238 World NEWS US gro�p highlights symptoms of early o�arian cancer, p 12�� US gro�p highlights symptoms of early o�arian cancer, p 12�� bmj.com �itamin d from s�n e�pos�re may protect against solid cancers �itamin d from s�n e�pos�re may protect against solid cancers
Trauma Center: Three Days in the Life of an Emergency Room Doctor
Authors: Gary M. Sollars
Journal: JAMA (1985)

In 1982, Dr Randall Sword completed<i>Emergency Room</i>, a short book of tales from the front that was insightful, generally upbeat, and reflected well the feelings of an individual who believed in what he was doing and was doing it well (reviewed in<i>JAMA</i>1983;249:653). He has now written, with Ms Janet Keller, a new, somewhat similar book—<i>Trauma Center</i>—which explores the "Dark Side of the Force": the pervading aura of death, hopelessness, and the Sisyphean tasks of day-to-day emergency medical care. This is a book about burnout; not a dry objective statistical study, but a personalized purgation of emotions, told in a style that makes the reader empathize—all the more so if one has experienced some of it. Things have changed for Sword. Now the director of an emergency room in Los Angeles, he is dealing with a clientele seemingly more callous and hopeless, the down-and-out, for whom
Brain Imaging Changes Associated With Risk Factors for Cardiovascular and Cerebrovascular Disease in Asymptomatic Patients
Authors: Joseph I. Friedman, Cheuk Y. Tang, Hans J. de Haas, Lisa Changchien, Georg Goliasch, Puneet Dabas, Victoria Wang, Zahi A. Fayad, Valentin Fuster, Jagat Narula
Journal: JACC. Cardiovascular imaging (2014)
Prognostic Importance of Exercise-Induced Changes in Mitral Regurgitation in Patients With Chronic Ischemic Left Ventricular Dysfunction
Authors: Patrizio Lancellotti, Pierre Troisfontaines, Anne-Christine Toussaint, Luc A. Pierard
Journal: Circulation (2003)

Background— In the post–myocardial infarction phase, mortality risk is related to the severity of mitral regurgitation (MR). Ischemic MR is a dynamic condition that can be studied during exercise. Whether the assessment of exercise-induced changes in the degree of MR provides prognostic information is unknown. Methods and Results— Ninety-eight consecutive patients with chronic ischemic left ventricular dysfunction and at least mild MR who prospectively underwent quantitative measurement of the regurgitant volume and the effective regurgitant orifice (ERO) of MR at rest and during semisupine exercise test were followed up for 19±8 months. The 16 patients who underwent surgery were censored at the time of operation. Of the 82 patients who were medically treated, 9 (11%) died. No clinical data demonstrated a distinction between survivors and nonsurvivors. By multivariate Cox regression analysis, independent predictors of cardiac death were an increase in ERO by ≥13 mm 2 ( P =0.0045) during exercise, an ERO &gt;20 mm 2 at rest ( P =0.01), and a shorter mitral deceleration time ( P =0.044). Half of the patients with exercise-induced significant increases in MR who died had moderate MR at rest. In contrast, none of the 14 patients with a decrease in MR at exercise displayed cardiac death. Conclusions— In patients with ischemic MR and left ventricular dysfunction, quantitative assessment of exercise-induced changes in the degree of MR provides independent prognostic information. Significant exercise-induced increases in MR unmask patients at high risk of poor outcome.
IgG subclass composition of rheumatoid arthritic sera and joint fluids.
Authors: F Shakib, D R Stanworth
Journal: Annals of the Rheumatic Diseases (1976)

The IgG subclass composition of 24 matched pairs of synovial fluids and sera, from 24 patients with rheumatoid arthritis, was determined. The subclass composition of rheumatoid synovial fluid IgG was found to be qualitatively the same as that of the corresponding serum, differing only in certain quantitative aspects. A 7-8% increase in IgG1 level found in the sera of rheumatoid arthritis patients relative to that in the sera of normal individuals was accompanied by 6-8, 0-7, and 0-3% decreases in IgG2, IgG3, and IgG4, respectively.