tbuckley/cabot-search huggingface dataset:
Effect of aspirin and ifetroban on skeletal muscle blood flow in patients with congestive heart failure treated with enalapril
Authors: Stuart D Katz, Michael Radin, Thomas Graves, Cynthia Hauck, Alan Block, Thierry H LeJemtel
Journal: Journal of the American College of Cardiology (1999)

OBJECTIVES The purpose of this study was to determine the acute and chronic effects of cyclooxygenase inhibition with aspirin and thromboxane A2receptor blockade with ifetroban on the chronic vasodilating effects of enalapril in the skeletal muscle circulation of patients with heart failure. BACKGROUND Angiotensin-converting enzyme inhibition and antiplatelet therapy with aspirin independently reduce the risk for subsequent nonfatal coronary events in survivors of myocardial infarction. The safety of the combined administration of angiotensin-converting enzyme inhibitors and aspirin has been questioned due to their divergent effects on the vascular synthesis of vasodilating prostaglandins. METHODS Forearm blood flow (ml/min/100 ml) at rest and during rhythmic handgrip exercise and after transient arterial occlusion was determined by strain gauge plethysmography before and 4 h and six weeks after combined administration of enalapril with either aspirin, ifetroban or placebo in a multicenter, double-blind, randomized trial of 62 patients with mild to moderate heart failure. RESULTS Before randomization, forearm hemodynamics were similar in the three treatment groups except for increased resting forearm blood flow and decreased resting forearm vascular resistance in the aspirin group when compared with the placebo group. After combined administration of enalapril and study drug for 4 h and six weeks, changes from prerandomization values of mean arterial pressure, forearm blood flow and forearm vascular resistance at rest, during handgrip exercise and after transient arterial occlusion did not differ among the three treatment groups. CONCLUSIONS These findings demonstrate that the vasodilating effects of enalapril in the skeletal muscle circulation of patients with heart failure are not critically dependent on prostaglandin pathways.
THYROIDECTOMY: A FURTHER MODIFICATION IN TECHNIC
Authors: C. A. ROEDER
Journal: JAMA (1924)

To a careful observer, the appearance of the neck, following a good percentage of thyroidectomies, is far from satisfactory. The Kocher flap, which separates the platysma muscle from the underlying deep fascia, is followed by a deposit of scar tissue between these two layers, frequently resulting in a wrinkled skin over a more or less brawny induration. The reunion of the sternohyoid and sternothyroid muscles, when cut across for additional exposure, adds to a local deposit of scar tissue beneath this flap, and quite often leaves, in addition, a more or less conspicuous nodule, which patients frequently complain of. The almost constant and most undesirable postoperative deformity, however, is the adhesion between the skin and the trachea, due to the muscles being separated over the trachea for exposure of the gland and to the previous path of the drainage tube, which was brought out through the midline. This adhesion also
HOW TO TREAT MUSCULAR AND JOINT SPRAINS OF RAILWAY EMPLOYEES.
Authors: H. SNEVE
Journal: JAMA (1901)

Joint and muscular sprains differ, so far as I know, not the slightest from the same affections in other occupations, but the same justification that obtains in calling railway surgery a special branch of surgery will allow of the use of the title of this paper. Sprain of some sort or another is a very common accident among railway employees. This is perhaps due to the fact that so many of them, in the discharge of their duties, are forced to run backward and forward, work on machinery in constrained positions, do heavy lifting, and are exposed to falls from heights. In order to form an idea of how frequently such accidents affect railway employees, I have prepared a table of the sprains and strains of all kinds, reported as such to my office, occurring on the lines of the Chicago Great Western for the year 1899: It will be
INVOLVEMENT OF THE ORBIT IN DISEASE OF THE NASAL ACCESSORY SINUSES
Authors: R. E. Wright
Journal: BMJ (1921)

The evidence demonstrating excessive proteinase activity in states of shock is reviewed. The capacity of extrinsic inhibitors to control such activity is indicated and the literature showing the value of inhibitors in treating shock is summarized. Three principles to be observed in the use of exogenous inhibitors are proposed.
Evolving therapies for liver fibrosis
Authors: Detlef Schuppan, Yong Ook Kim
Journal: Journal of Clinical Investigation (2013)

Fibrosis is an intrinsic response to chronic injury, maintaining organ integrity when extensive necrosis or apoptosis occurs. With protracted damage, fibrosis can progress toward excessive scarring and organ failure, as in liver cirrhosis. To date, antifibrotic treatment of fibrosis represents an unconquered area for drug development, with enormous potential but also high risks. Preclinical research has yielded numerous targets for antifibrotic agents, some of which have entered early-phase clinical studies, but progress has been hampered due to the relative lack of sensitive and specific biomarkers to measure fibrosis progression or reversal. Here we focus on antifibrotic approaches for liver that address specific cell types and functional units that orchestrate fibrotic wound healing responses and have a sound preclinical database or antifibrotic activity in early clinical trials. We also touch upon relevant clinical study endpoints, optimal study design, and developments in fibrosis imaging and biomarkers.
Responses from pharmaceutical companies to doctors' requests for more drug information in Pakistan: postal survey
Authors: A. Hafeez, Z. Mirza
Journal: BMJ (1999)

What health professionals know about medicines resembles the information provided in the advertisements of pharmaceutical companies rather than the scientific literature. 1 Drug companies spend 15-20% of their income on promotion. 2They are responsible for providing adequate information about drugs, and the wording and illustrations should be consistent with the scientific data sheet for the drug concerned. 3 Inadequate and biased information has been reported in developing countries and this results in incorrect use of drugs. 4 5 We assessed how seriously pharmaceutical companies take their responsibility to provide information on request by recording the promptness, nature, and adequacy of their replies to doctors.
The Risks of Surgery in Obese Patients
Authors: PATRICK S. PASULKA
Journal: Annals of Internal Medicine (1986)

Obesity is commonly considered a surgical risk factor, but the degree of risk has been imprecisely quantified. There is little evidence that excessive body weight in itself should contraindicate general surgery. However, obesity is often associated with abnormal cardiorespiratory function, metabolic function, and hemostasis, which may predispose to morbidity and mortality after surgery. We review pertinent data and offer guidelines to minimize the risks of surgery in obese patients.
Downregulation of smooth muscle α-actin expression by bacterial lipopolysaccharide
Authors: N SANDBO, S TAURIN, D YAU, S KREGEL, R MITCHELL, N DULIN
Journal: Cardiovascular Research (2007)

Smooth muscle alpha-actin (SMA) is a cytoskeletal protein characteristic to vascular smooth muscle cells (VSMC), and it serves to facilitate cell contraction and migration. Bacterial lipopolysaccharide (LPS), a major mediator of septic shock secondary to infection, is known to directly affect VSMC. The objective of this study was to investigate the effect of LPS on the expression levels of SMA in VSMC.This study was performed on cultured VSMC derived from human aorta, human coronary artery, or rat aorta.We show that SMA expression in VSMC, induced by endothelin-1 (ET1) or transforming growth factor-beta (TGF-beta), is potently inhibited by a LPS. This parallels a decreased migration of VSMC after LPS treatment. Downregulation of SMA by LPS is not a result of altered signaling of ET1 or TGF-beta receptors, and it is not mediated by canonical (for LPS) mechanisms, such as production of prostaglandins or nitric oxide, or secretion of other endocrine factors. On a molecular level, downregulation of SMA expression by LPS occurs at the level of transcription, as both SMA mRNA levels and SMA promoter activity are inhibited by LPS. The SMA promoter is controlled largely by two major regulatory elements-CArG boxes activated by serum response factor (SRF), and TGF-beta control elements (TCE). LPS does not affect the activity of SRF, but it potently inhibits both basal and inducible TCE activation.We show for the first time that LPS attenuates SMA transcription and protein expression in VSMC likely through inhibition of a TCE element on the SMA promoter.
Effect of nonprotective vaccination on antibody response to subsequent human immunodeficiency virus infection.
Authors: S H Pincus, K G Messer, S L Hu
Journal: Journal of Clinical Investigation (1994)

We have investigated the systemic anti-HIV antibody response in chimpanzees who were immunized with live vaccinia containing either the HIV envelope glycoprotein (gp160IIIB) or a control antigen (herpes simplex virus glycoprotein D) and then challenged with either a high dose (300,000 TCID50) or low dose (100 TCID50) of HIVIIIB. HIV was subsequently isolated from all animals, indicating failure of the vaccination to protect against HIV infection. Serum antibody responses were evaluated before immunization, at the time of challenge with HIV, and at multiple time points in the 9 mo after challenge. Immunization resulted in a more rapid rise of antibody to gp160 in both high and low dose animals. Antibodies to the V3 loop induced upon infection were unaffected by immunization. In low dose animals, neutralizing antibody rose more rapidly and to higher levels in the immunized animals as compared with the control. There was no difference in neutralizing antibodies between immunized and control chimpanzees in the high dose group. Epitope mapping of the anti-gp 160 response indicated that immunization with gp160 vaccinia induced a postinfection antibody response to a region of gp41 (amino acids 718-743) that was not immunogenic in control-vaccinated animals. These data indicate that failed vaccination with the HIV envelope can alter both the timing and epitope specificity of the subsequent anti-HIV antibody response. These studies also define the evolution and fine specificity of the antibody response during the critical period immediately postinfection.
1053 ROLE OF ACOUSTIC RADIATION FORCE IMPULSE (ARFI) SONOELASTOGRAPHY FOR NONINVASIVE DIAGNOSIS OF NONALCOHOLIC FATTY LIVER DISEASE
Authors: C. Fierbinteanu-Braticevici, R. Usvat, G. Oprea, E. Sarbu, A. Petrisor, E. Panaitescu
Journal: Journal of Hepatology (2012)
Caring for the Poor and Professional Liability
Authors: John Glasson
Journal: JAMA (1993)

Over the years, our understanding of medical malpractice has been plagued by a number of myths, many of which have been exposed by a remarkable series of reports from two groups.<sup>1-3</sup>As a result of these reports, and contrary to popular belief, we know that adverse events due to negligent practice rarely result in a lawsuit (only 2% of such events lead to malpractice claims),<sup>1</sup>juries are not systematically biased against physicians (malpractice defendants win more than two thirds of cases, a better record than defendants in other kinds of personal injury cases),<sup>2,4</sup>and juries decide cases on the basis of the physician's quality of care rather than the patient's severity of injury.<sup>2</sup> See also p 1697. In this issue, Burstin et al<sup>3</sup>expose another persistent myth about medical malpractice. It is commonly believed that poor patients are more likely than wealthier patients to bring
Antioxidant Vitamins, Cancer, and Cardiovascular Disease
Authors: E R Greenberg, M B Sporn
Journal: New England Journal of Medicine (1996)

In 1850, an article on the origin of epidemic yellow fever and malaria appeared in the Boston Medical and Surgical Journal. 1 The anonymous author referred to earlier reports that “those who slept under musquito [sic] netting escaped the disease” and that “a gauze screen in a window adds much to the security of . . . the occupant of a chamber, in even the most unsound places.” These observations, which now seem prescient, were used to support the theory that epidemics result from infective spores carried by the wind from decaying organic matter; the netting and screens were believed to . . .
Compulsory Powers over Mental Patients
Authors: I. Atkin
Journal: BMJ (1957)

<h3>Aim</h3> We hypothesised that short-term application of bi-level nasal continuous positive airway pressure CPAP (SiPAP) compared with conventional nasal CPAP (nCPAP) at the same mean airway pressure in infants with persistent oxygen need recovering from respiratory distress syndrome would improve CO<sub>2</sub> removal with no change in oxygen requirement. <h3>Design</h3> Non-blinded, randomised, observational four-period crossover study. <h3>Setting/population</h3> Level III NICU; low-birthweight infants requiring CPAP and oxygen while recovering from respiratory distress syndrome. <h3>Methods</h3> Infants requiring nasal CPAP for &gt;24 h prior to study enrolment, and fraction of inspired oxygen requirement (FiO<sub>2</sub>) of 0.25–0.5, were randomised to either nCPAP or SiPAP. A crossover design with four 1 h treatment periods was used such that each infant received both treatments twice. Oxygen saturations (SaO<sub>2</sub>), transcutaneous CO<sub>2</sub> (tcCO<sub>2</sub>) and vital signs were monitored continuously. Polysomnographic recordings were analysed for apnoea, bradycardia and oxygen desaturation. <h3>Results</h3> Twenty low-birthweight infants receiving 0.3±0.04% supplemental oxygen on CPAP of 6 cm H<sub>2</sub>O were studied at an average of 33 days of age (±23 days, SD). There were no differences in tcCO<sub>2</sub> or other physiological parameters except mean blood pressure, which was lower during nCPAP (52.3±8.3 vs 54.4±9.1 mm Hg; ±SD; p&lt;0.01). No differences in short or prolonged apnoea, bradycardia or significant desaturation events were observed. <h3>Conclusions</h3> At similar mean airway pressures, SiPAP does not improve CO<sub>2</sub> removal, oxygenation or other studied physiological parameters with the exception of mean blood pressure, which was not clinically significant. <h3>Trial registration number</h3> NCT01053455.
Oral Lichen Planus as a Clinical Sign of Graft-versus-Host Disease
Authors: Mordechai Findler, Adi A Garfunkel
Journal: New England Journal of Medicine (2003)

A 19-year-old woman had acute lymphocytic leukemia. While she was in her first remission, she underwent bone marrow transplantation. Three months later, she had an oral eruption consistent with lichen planus–like hyperkeratotic striae of the tongue, which is an indication of chronic graft-versus-host disease. The white coating on the tongue could not be rubbed off. Culture and microscopical examination of the scraped material did not show active candidiasis. As the graft-versus-host disease worsened, the skin, liver, and gastrointestinal system became involved. In conjunction with acute lichen planus, there were erythema and pseudomembranous ulcerations in the oral cavity, as well as . . .
Production of intracellular and extracellular interleukin-1 alpha and interleukin-1 beta by peripheral blood monocytes from patients with connective tissue diseases.
Authors: S Aotsuka, K Nakamura, T Nakano, M Kawakami, M Goto, M Okawa-Takatsuji, M Kinoshita, R Yokohari
Journal: Annals of the Rheumatic Diseases (1991)

An enzyme linked immunosorbent assay (ELISA) was used to estimate the production of intracellular and extracellular interleukin-1 (IL-1) alpha and beta by peripheral blood monocytes from 26 patients with various connective tissue diseases (CTD), including 19 with systemic lupus erythematosus, four with progressive systemic sclerosis, two with mixed connective tissue disease, and one with Sjögren9s syndrome. Monocytes obtained from patients with CTD with serum antibodies to nuclear ribonucleoprotein (nRNP) released significantly higher concentrations of extracellular IL-1 alpha and IL-1 beta, whereas intracellular IL-1 alpha and IL-1 beta production was similar to that by monocytes from patients with CTD without antibodies to nRNP. Furthermore, the concentrations of extracellular IL-1 alpha correlated significantly with those of extracellular IL-1 beta. There was no significant correlation between the concentrations of extracellular and intracellular IL-1 alpha, and those of extracellular and intracellular IL-1 beta, indicating that synthesis and secretion of IL-1 by human monocytes may be two distinct biological events. It seems that enhanced extracellular release of both IL-1 alpha and IL-1 beta contributes to the excessive anti-nRNP production in CTD.
Secondhand effects of alcohol use among university students: computerised survey
Authors: J. D Langley
Journal: BMJ (2003)

<h3>ABSTRACT</h3> Environmental impact assessments often rely on best available information, which may include models that were not designed for purpose and are not accompanied by an assessment of limitations. We reproduced available models of boreal woodland caribou resource selection and demography and evaluated their suitability for projecting impacts of development in the Ring of Fire on boreal caribou in the Missisa range (Ontario, Canada). The specificity of the resource selection model limited usefulness for predicting impacts, and high variability in model coefficients among ranges suggests responses vary with habitat availability. The aspatial demographic model projects decreasing survival and recruitment with increasing disturbance, but high variability among populations implies the importance of these impacts depends on population status, and there is no current status estimate. New models that are designed for forecasting, informed by more current herd status information and information from neighbouring ranges, are required to better inform decisions. To demonstrate how open-source tools and reproducible workflows can improve the transparency and reusability of models we developed an R package for data preparation, resource selection, and demographic calculations. Open-source tools, reproducible workflows, and reuseable forecasting models can improve our collective ability to inform wildlife management decisions in a timely manner.
The NO cascade, eNOS location, and microvascular permeability
Authors: W. N. Duran, J. W. Breslin, F. A. Sanchez
Journal: Cardiovascular Research (2010)

The nitric oxide (NO) cascade and endothelial NO synthase (eNOS) are best known for their role in endothelium-mediated relaxation of vascular smooth muscle. Activation of eNOS by certain inflammatory stimuli and enhanced NO release have also been shown to promote increased microvascular permeability. However, it is not entirely clear why activation of eNOS by certain vasodilatory agents, like acetylcholine, does not affect microvascular permeability, whereas activation of eNOS by other inflammatory agents that increase permeability, like platelet-activating factor, does not cause vasodilation. In this review, we discuss the evidence demonstrating the role of eNOS in the elevation of microvascular permeability. We also examine the relative importance of eNOS phosphorylation and localization in its function to promote elevated microvascular permeability as well as emerging topics with regard to eNOS and microvascular permeability regulation.
Risk of Chlamydial PID and Oral Contraceptives
Authors: A. E. Washington, N. S. Padian, N. Hearst, J. Schachter
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Our colleagues Wølner-Hanssen et al<sup>1</sup>conclude that oral contraceptive use is associated with decreased risk of pelvic inflammatory disease (PID) among women infected with<i>Chlamydia trachomatis</i>but not among those infected with<i>Neisseria gonorrhoeae</i>. We have two questions about their methods and would like to caution against overinterpretation of their principal findings. First, why were all variables showing significant differences between the case and control groups<sup>1(Table1)</sup>not considered in the multivariate analysis? The variables "ever pregnant" (<i>P</i>&lt;.001), "unemployed" (<i>P</i>&lt;.001), "drinking" (<i>P</i>=.002), and "mean number of lifetime sexual partners" (<i>P</i>=.004) should also be included. Would inclusion of these variables affect the odds ratio and level of significance? Second, how is oralcontraceptive use measured? In particular, how is duration or intermittent use taken into account? The data on the overall relationship observed between oral contraceptive use and PID<sup>1(Table3)</sup>do not demonstrate
Unclassified Mycobacteria
Authors: Edwin L. Kendig
Journal: New England Journal of Medicine (1963)

IN two previous reports1 , 2 results suggested that infection with one of the so-called anonymous, atypical or unclassified mycobacteria might be the causative agent of a positive tuberculin reaction. One of these studies suggested the frequent occurrence of such infection in children. Both studies were conducted among patients of low socioeconomic status, primarily Negroes.The present study was undertaken among patients of a middle or upper socioeconomic stratum, and all the patients were white. In contrast to the previous groups, all of whom were tuberculin positive, patients in the present group were those encountered in routine pediatric practice, in which each . . .
The fish gill: site of action and model for toxic effects of environmental pollutants.
Authors: D H Evans
Journal: Environmental Health Perspectives (1987)

The gill epithelium is the site of gas exchange, ionic regulation, acid-base balance, and nitrogenous waste excretion by fishes. The last three processes are controlled by passive and active transport of various solutes across the epithelium. Various environmental pollutants (e.g., heavy metals, acid rain, and organic xenobiotics) have been found to affect the morphology of the gill epithelium. Associated with these morphological pathologies, one finds alterations in blood ionic levels, as well as gill Na,K-activated ATPase activity and ionic fluxes. Such physiological disturbances may underly the toxicities of these pollutants. In addition, the epithelial transport steps which are affected in the fish gill model resemble those described in the human gut and kidney, sites of action of a variety of environmental toxins.
MID-TERM ANGIOGRAPHIC AND CLINICAL OUTCOMES FROM ANTEGRADE VERSUS RETROGRADE RECANALIZATION FOR CHRONIC TOTAL OCCLUSIONS
Authors: Hiroyuki Tanaka, Kazushige Kadota, Shingo Hosogi, Yasushi Fuku, Tsuyoshi Goto, Kazuaki Mitsudo
Journal: Journal of the American College of Cardiology (2011)
Immediate Post–Transurethral Resection of Bladder Tumor Intravesical Chemotherapy Prevents Non–Muscle-invasive Bladder Cancer Recurrences: An Updated Meta-analysis on 2548 Patients and Quality-of-Evidence Review
Authors: Nathan Perlis, Alexandre R. Zlotta, Joseph Beyene, Antonio Finelli, Neil E. Fleshner, Girish S. Kulkarni
Journal: European Urology (2013)