tbuckley/cabot-search huggingface dataset:
NICE approves docetaxel for early breast cancer
Authors: Susan Mayor
Journal: BMJ (2006)

New guidance for the NHS published this week recommends docetaxel (Taxotere) to treat women with early, node positive breast cancer after surgery. Use of another taxane, paclitaxel (Taxol), is not recommended in the final guidance.

The guidance, issued by the National Institute for Health and Clinical Excellence (NICE), the body that advises on the use of treatments by the NHS in England and Wales, overturned draft guidance that had recommended against the use of docetaxel.

At the time the appraisal committee found that there was “too much uncertainty about the evidence to make a clear judgment on its clinical and cost effectiveness compared with current practice in England and Wales” (bmj.com, 6 May 2006, News Extra).

NICE asked for more information on the clinical and cost effectiveness of docetaxel in combination with doxorubicin and cyclophosphamide when compared with currently …
Glucose and Insulin Responses in Relation to Insulin Dose and Caloric Intake 12 h After Acute Physical Exercise in Men With IDDM
Authors: Barbara N Campaigne, Harriet Wallberg-Henriksson, Rolf Gunnarsson
Journal: Diabetes Care (1987)

Acute exercise in insulin-dependent diabetic patients may perturb glycemic control, and adjustments of insulin and diet might be required to avoid postexercise hypoglycemia. The aim of this study was to assess the role of alterations in insulin dose or caloric intake on blood glucose and free-insulin levels during 12 h after an evening bout of exercise. Nine insulin-dependent diabetic men (28–42 yr of age) receiving two daily injections with a combination of intermediate-acting and soluble insulin participated in the study. Patients were randomly assigned to four treatment protocols: A, 50% reduction in intermediate-acting insulin dose; B, 50% reduction in soluble insulin dose; C, extra caloric intake (1700 kj) 1 h after exercise; and D, no change. Exercise consisted of 45 min of cycling at 60% of maximal oxygen uptake at each occasion. Glucose and insulin responses were similar for the four protocols. There was a significant (P &amp;lt; .001) time effect found regardless of treatment, with lowest blood glucose values 75 min after exercise. Hypoglycemia occurred in six of the nine patients at some time during the study, with half of the occurrences on the control night (protocol D). Consistent individual plasma insulin and glucose patterns were observed independent of protocol used. In some patients, hypoglycemia was evident after reductions in insulin dose, and in others it was evident on the night increases in caloric intake were to occur; thus, none of the interventions were totally adequate in preventing exercise-induced hypoglycemia. In conclusion, general recommendations on how to adjust insulin or diet before exercise are difficult to give. Individualized recommendations for treatment modification appear most appropriate.
Lumbar Disk Disease: Laminectomy vs Chymopapain Chemonucleolysis
Authors: W. Robert Hudgins
Journal: JAMA (1975)

<h3>To the Editor.—</h3> The article by Leon L. Wiltse and co-workers, "Chymopapain Chemonucleolysis in Lumbar Disk Disease" (231:474,1975), evaluated relief of pain and disability by this new method of treatment. I have followed up 260 patients one year after laminectomy for lumbar disk disease and classified the results into categories almost identical to theirs. After chymopapain therapy, the results were as follows: excellent, 108 (34%); good, 111 (35%); fair, 38 (12%); and poor or failure, 60 (19%). Results after laminectomy were as follows: excellent, 78 (30%); good, 115 (44%); fair, 34 (13%); poor or failure, 33 (13%). I found no significant difference in the two groups by X<sup>2</sup>partition. This supports the authors' conclusion that "the overall incidence of symptomatic relief after chemonucleolysis is as good as that after laminectomy." However, there are several variables that must be controlled before this comparison is valid. The presence of compensation
Asialo von Willebrand factor interactions with platelets. Interdependence of glycoproteins Ib and IIb/IIIa for binding and aggregation.
Authors: H R Grainick, S B Williams, B S Coller
Journal: Journal of Clinical Investigation (1985)

Asialo von Willebrand factor (AS-vWf) binds to and aggregates normal human platelets in the absence of ristocetin. Maximal specific binding of AS-vWf is 1-2 micrograms vWf protein/10(8) platelets. Despite the specificity of the binding, only 60% of the bound AS-vWf can be dissociated after equilibrium has been reached. We investigated the site of binding and the mechanism of aggregation of platelets by AS-vWf by (a) pre-incubating platelets with either of two monoclonal antibodies, one against glycoprotein Ib (GPIb) or a second against the glycoprotein IIb/IIIa complex (GPIIb/IIIa), and (b) varying the concentration of fibrinogen in the medium. The results of our studies indicate that AS-vWf binds initially to GPIb. This binding then results in the exposure of receptors for AS-vWf on GPIIb/IIIa. In the presence of plasma fibrinogen, both AS-vWf and fibrinogen bind to GPIIb/IIIa. In the presence of plasma fibrinogen, 50% more AS-vWf binds to the platelet, and this additional AS-vWf binds almost exclusively to GPIIb/IIIa. Despite this enhanced binding of AS-vWf in the absence of fibrinogen, platelet aggregation is much less than that which occurs in the presence of plasma fibrinogen. Comparative studies of AS-vWf binding to normal platelets and the platelets of patients with Glanzmann's thrombasthenia reveal decreased binding to the thrombasthenic platelets and a marked decrease in the extent of platelet aggregation. These studies indicate that AS-vWf binding to, and ensuing aggregation of, platelets is different from that observed with intact vWf protein when platelets are stimulated with either ristocetin or thrombin. The AS-vWf binds to GPIb which, in turn, makes additional AS-vWf receptors available on GPIIb/IIIa. If plasma fibrinogen is present, it competes with the AS-vWf for binding to GPIIb/IIIa and causes aggregation of platelets. In the presence of plasma fibrinogen, more of the AS-vWf binds to GPIIb/IIIa, but this AS-vWf is much less effective than fibrinogen in supporting platelet aggregation.
The Rise of In-Store Clinics — Threat or Opportunity?
Authors: Richard Bohmer
Journal: New England Journal of Medicine (2007)

Interview with Richard Bohmer on the rise of in-store clinics. (07:13)Download The recent acquisition by the pharmacy chain CVS of MinuteClinic, a chain of in-store clinics founded in Minnesota, has put this model of primary care delivery back in the spotlight. Although still not widespread, the model is increasing in prevalence (see table) and appeals to several stakeholders: payers note that primary care is less expensive when delivered at in-store clinics than when provided in a doctor's office or emergency room, patients value the convenience and low price, entrepreneurs see a profitable business model, and proponents of consumer-driven health care see services that can be paid for out of health savings . . .
Surfactant Protein D Protects against Acute Hyperoxic Lung Injury
Authors: Deepika Jain, Elena N. Atochina-Vasserman, Yaniv Tomer, Helchem Kadire, Michael F. Beers
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Surfactant protein D (SP-D) is a member of the collectin family of soluble, innate, host defense molecules with demonstrated immunomodulatory properties in vitro. Constitutive absence of SP-D in mice is associated with lung inflammation, alteration in surfactant lipid homeostasis, and increased oxidative-nitrative stress.To test the hypothesis that SP-D would protect against acute lung injury from hyperoxia in vivo.Transgenic mice overexpressing rat SP-D constitutively (SP-D OE) or conditionally via regulation with doxycycline (SP-D Dox-on) were subjected to continuous hyperoxic challenge for up to 14 days.Compared with littermate control mice (wild-type [WT]), SP-D OE mice exposed to 80% O(2) demonstrated substantially increased survival accompanied by significant reductions in wet to dry lung ratios and bronchoalveolar lavage (BAL) protein. Although SP-D OE and WT mice exhibited a twofold increase in total BAL cells and neutrophilia in response to hyperoxia, the SP-D OE group had lower levels of BAL proinflammatory cytokines and chemokines, including IL-6, tumor necrosis factor-alpha, and monocyte chemotactic protein-1; increased mRNA levels of the transcription factor NF-E2 related factor-2 (NRF-2) and phase 2 antioxidants hemoxygenase-1 (HO-1), glutathione peroxidase-2 (GPx-2) and NAD(P)H quinone oxidoreductase-1 (Nqo-1); and decreases in lung tissue thiobarbituric acid-reactive substances. As proof of principle, the protective role of SP-D on hyperoxic injury was confirmed as SP-D Dox-on mice exposed to 85% O(2) demonstrated increased mortality upon withdrawal of doxycycline.Local expression of SP-D protects against hyperoxic lung injury through modulation of proinflammatory cytokines and antioxidant enzymatic scavenger systems.
Idiopathic Thrombocytopenic Purpura in a 101-Year-Old Woman
Authors: Kevin K. Chung, Louis R. Macareo, Teresa A. Coleman
Journal: Annals of Internal Medicine (2001)

Letters3 July 2001Idiopathic Thrombocytopenic Purpura in a 101-Year-Old WomanKevin K. Chung, MD, Louis R. Macareo, MD, and Teresa A. Coleman, MDKevin K. Chung, MDDwight D. Eisenhower Army Medical Center; Augusta, GA 30905 (Chung, Macareo, Coleman)Search for more papers by this author, Louis R. Macareo, MDDwight D. Eisenhower Army Medical Center; Augusta, GA 30905 (Chung, Macareo, Coleman)Search for more papers by this author, and Teresa A. Coleman, MDDwight D. Eisenhower Army Medical Center; Augusta, GA 30905 (Chung, Macareo, Coleman)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-1-200107030-00040 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 101-year-old woman, born on 25 December 1898, presented to our institution with a 2-day history of general weakness and presyncope. The platelet count was 0.0014 × 109 cells/L, hemoglobin and leukocyte counts were normal, and review of the peripheral smear revealed no clumping or schistocytes. Five months before admission, the patient had a normal platelet count. Her medical history was significant only for hypertension and glaucoma. She was taking calcium carbonate, hydrochlorothiazide, lisinopril, docusate, doxazosin, and acetaminophen and had not received any recent transfusions or intravenous fluids. Physical examination revealed several areas of ecchymoses and petechia ...References1. . Diagnosis and treatment of idiopathic thrombocytopenic purpura: recommendations of the American Society of Hematology. The American Society of Hematology ITP Practice Guideline Panel. Ann Intern Med. 1997;126:319-26. [PMID: 0009036806] LinkGoogle Scholar2. Mueller-Eckhardt C. Idiopathic thrombocytopenic purpura (ITP): clinical and immunologic considerations. Semin Thromb Hemost. 1977;3:125-59. [PMID: 0000322289] CrossrefMedlineGoogle Scholar3. Weiss GB, Klock JC, Richardson HB. Idiopathic thrombocytopenic purpura in the elderly [Letter]. Lancet. 1975;1:411-2. [PMID: 0000046576] CrossrefMedlineGoogle Scholar4. Frederiksen H, Schmidt K. The incidence of idiopathic thrombocytopenic purpura in adults increases with age. Blood. 1999;94:909-13. [PMID: 0010419881] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Dwight D. Eisenhower Army Medical Center; Augusta, GA 30905 (Chung, Macareo, Coleman) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 July 2001Volume 135, Issue 1Page: 70-71KeywordsComputed axial tomographyGlaucomaHemoglobinHepatosplenomegalyHypertensionIdiopathic thrombocytopenic purpuraIntravenous immunoglobulinObservational studiesPlateletsSyncope ePublished: 3 July 2001 Issue Published: 3 July 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Value of Doppler ultrasound in diagnosis of clinically suspected deep vein thrombosis.
Authors: J Meadway, A N Nicolaides, C J Walker, J D O'Connell
Journal: BMJ (1975)

Doppler ultrasound was used to study 120 legs of 106 patients with suspected deep vein thrombosis (DVT) or pulmonary embolism. Venography was subsequently performed in all. DVT was confirmed by venography in 44 legs and was confined to the calf in 10 of these. Ultrasound detected three calf thromboses and 29 out of 34 more extensive thromboses. Of five undetected thrombi that were proximal to the calf one was associated with partial occlusion and four with extensive collateral circulation. Of the 76 limbs without venographic evidence of thrombosis 21 were thought to have DVT by ultrasound; 18 of these false-positive results could be attributed to external compression of veins, two to excessive tenderness precluding adequate examination; and in one no explanation was found. This test gives more accurate results than judging by clinical signs alone, but users must be aware of its limitations and, particularly, the causes of false-positive and false-negative results.
Asterixis as a Manifestation of Salicylate Toxicity
Authors: RONALD J. ANDERSON
Journal: Annals of Internal Medicine (1981)

Brief Reports1 August 1981Asterixis as a Manifestation of Salicylate ToxicityRONALD J. ANDERSON, M.D.RONALD J. ANDERSON, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-2-188 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSalicylate intoxication rarely occurs as a result of chronic salicylate therapy in the adult. Only five of 327 patients with diagnoses of "salicylate ingestion" at the Mayo Clinic (1) were in this category. Case reports of these patients describe asterixis in an "obtunded" patient whose salicylate level was 48 mg/dL. Both the asterixis and the abnormal mental state disappeared with discontinuation of the salicylates. This is the only known description of asterixis in association with salicylate intoxication.Over the last 6 years, I have see asterixis in four patients receiving chronic salicylate therapy for rheumatoid arthritis. Their serum salicylate levels...References1. GREERWARDCORBIN HHK. Chronic salicylate intoxication in adults. JAMA. 1965;193:555-8. CrossrefMedlineGoogle Scholar2. LEAVITTTYLER SH. Studies in asterixis. Arch Neurol. 10:360-8. CrossrefMedlineGoogle Scholar3. ADAMSFOLEY RJ. Disorder of movement in more common varieties of liver disease. Electroenceph Clin Neurophysiol. 1951;5(suppl 3)51. Google Scholar4. AUSTENCARMICHAELADAMS FMR. Neurological manifestations of chronic pulmonary insufficiency. N Engl J Med. 1957;257:579-90. CrossrefMedlineGoogle Scholar5. MURPHYGOLDSTEIN MM. Diphenylhydantoin-induced asterixis. JAMA. 1974;229:538-40. CrossrefMedlineGoogle Scholar6. CONN H. Asterixis in non-hepatic disorders. Am J Med. 1960;29:647-61. CrossrefMedlineGoogle Scholar7. FORMANCHOULERMILNE MCF. Primidone-induced "uremic flap. " Lancet. 1979;2:1250-1. CrossrefMedlineGoogle Scholar8. TARSYLIEBERMANCHIRICO-POSTBENSON DBJP. Unilateral asterixis associated with mesencephalic syndrome. Arch Neurol. 1977;34:446-7. CrossrefMedlineGoogle Scholar9. MEYERSBERNSTEINFOSTIROPOULOUS EJG. Salicylate Ototoxicity. N Engl J Med. 1965;273:587-90. CrossrefMedlineGoogle Scholar10. MONGANKELLYNIESPORTERPAULUS EPKWH. Tinnitus as an indication of therapeutic serum salicylate levels. JAMA. 1973;226:142-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySalicylate ToxicityAsterixis: a study of 103 patientsSalicylate IntoxicationAntipyretic analgesics 1 August 1981Volume 95, Issue 2Page: 188-189KeywordsArthritisIngestionIntoxicationRheumatoid arthritisSalicylatesToxicity Issue Published: 1 August 1981 PDF downloadLoading ...
Emotional feelings originate below the neocortex: Toward a neurobiology of the soul
Authors: Jaak Panksepp
Journal: Behavioral and Brain Sciences (2007)

Disregard of primary-process consciousness is endemic in mind science. Most neuroscientists subscribe to ruthless reductionism whereby mental qualities are discarded in preference for neuronal functions. Such ideas often lead to envisioning other animals, and all too often other humans, as unfeeling zombies. Merker correctly highlights how the roots of consciousness exist in ancient neural territories we share, remarkably homologously, with all the other vertebrates.
Nitric Oxide and Hemodialysis-Induced Hypotension
Authors: Koji Yokokawa
Journal: Annals of Internal Medicine (1996)

Letters15 February 1996Nitric Oxide and Hemodialysis-Induced HypotensionKoji Yokokawa, MD, PhD, K. Anil Mandal, MD, and Mohammad G. Saklayen, MDKoji Yokokawa, MD, PhDOsaka City University Medical School; Osaka 545, JapanWright State University; Dayton, OH 45428Search for more papers by this author, K. Anil Mandal, MDOsaka City University Medical School; Osaka 545, JapanWright State University; Dayton, OH 45428Search for more papers by this author, and Mohammad G. Saklayen, MDOsaka City University Medical School; Osaka 545, JapanWright State University; Dayton, OH 45428Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-4-199602150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Perazella has raised an important question about a possible relation between hematocrit and plasma nitric oxide levels that may affect the lowering of blood pressure by heparin.We compared hematocrit values and plasma ferritin levels in patients who had a hypotensive episode during hemodialysis with those of patients who did not have a hypotensive episode. No significant difference was seen in hematocrit values or plasma ferritin levels (P > 0.2 for both comparisons) between the two groups, as shown by an unpaired t-test. Simple regression analysis showed no significant correlation between plasma nitric oxide levels after hemodialysis ... Author, Article, and Disclosure InformationAffiliations: Osaka City University Medical School; Osaka 545, JapanWright State University; Dayton, OH 45428 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByNitric Oxide: Biological and Clinical Perspectives 15 February 1996Volume 124, Issue 4Page: 454KeywordsBlood plasmaBlood pressureFerritinHematocritHeparinHypotensionHypotensive episodesNitric oxideRegression analysis Issue Published: 15 February 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Association of changes in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) with changes in cartilage thickness in the medial tibiofemoral compartment of the knee: a 2 year follow-up study using 3.0 T MRI
Authors: Michel D Crema, David J Hunter, Deborah Burstein, Frank W Roemer, Ling Li, Felix Eckstein, Nitya Krishnan, Marie-Pierre Hellio Le-Graverand, Ali Guermazi
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objective</h3> To determine the association between changes in the delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) index over 2 years as a measure of cartilage proteoglycan concentration, with changes in cartilage thickness in the medial tibiofemoral compartment of knees in middle-aged women. <h3>Methods</h3> One hundred and forty-eight women (one knee for each subject) aged ≥40 years were included. 3.0 T MR images of the knee were acquired at baseline, 1 year and 2 years. Three-dimensional (3D) spoiled gradient recalled echo (SPGR) sequences (for cartilage thickness) and 3D inversion recovery-prepared SPGR sequences after dGEMRIC were acquired. Segmentation was performed in the medial central (weight-bearing) femur and tibia to determine cartilage proteoglycan concentration and thickness. The association of change in the dGEMRIC indices between baseline and 1-year follow-up with (a) concomitant changes in cartilage thickness and (b) change in cartilage thickness between 1 and 2 years was assessed using linear regression. <h3>Results</h3> In the whole-sample model, a decrease in dGEMRIC indices over time at the central medial femur significantly predicted an increase in cartilage thickness at both the central medial femur (p=0.008) and the medial tibia (p=0.04). <h3>Conclusions</h3> A decrease in dGEMRIC indices was associated with an increase in cartilage thickness in the medial compartment. Our results suggest that an increase in cartilage thickness may also be related to a decrease in proteoglycan concentration, which may represent swelling of cartilage in early stages of degeneration.
Mechanisms of disease: are oxygen-derived free radicals involved in diaphragmatic dysfunction?
Authors: A Anzueto, G S Supinski, S M Levine, S G Jenkinson
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

"Mechanisms of disease: are oxygen-derived free radicals involved in diaphragmatic dysfunction?." American journal of respiratory and critical care medicine, 149(4), pp. 1048–1052
A NEW ADENOID CURETTE FORCEPS.
Authors: WILLIAM A. MARTIN
Journal: JAMA (1902)

The instrument here described is one on which I have been working at intervals for the past two years, and which has been remodeled a number of times. The present instrument is light and graceful and works almost perfectly. I can not say that it will displace all other instruments used for the same purpose, but it will do better work than any other single instrument. I assert that in the majority of instances it will remove the whole growth in one piece, that its use will be followed to a minimum hemorrhage and that no injury can be done to the septum, turbinates or pharyngeal walls when used with ordinary skill. There is little pain following its use compared to that which follows the repeated thrusts necessary in the use of the Gottstein curette and there will be no fragments left hanging to slough away and cause secondary hemorrhage.