tbuckley/cabot-search huggingface dataset:
Low-Density Lipoprotein Cholesterol Concentrations and Death Due to Intraparenchymal Hemorrhage
Authors: Hiroyuki Noda, Hiroyasu Iso, Fujiko Irie, Toshimi Sairenchi, Emiko Ohtaka, Mikio Doi, Yoko Izumi, Hitoshi Ohta
Journal: Circulation (2009)

Background— Few studies have examined the association between low levels of low-density lipoprotein (LDL) cholesterol and risk of intraparenchymal hemorrhage. Methods and Results— A total of 30 802 men and 60 417 women, 40 to 79 years of age with no history of stroke or coronary heart disease, completed a baseline risk factor survey in 1993 under the auspices of the Ibaraki Prefectural Health Study. Systematic mortality surveillance was performed through 2003, and 264 intraparenchymal hemorrhage deaths were identified. LDL cholesterol levels were calculated with the Friedewald formula. Persons with LDL cholesterol ≥140 mg/dL had half the sex- and age-adjusted risk of death due to intraparenchymal hemorrhage of those with LDL cholesterol &lt;80 mg/dL. After adjustment for cardiovascular risk factors, the multivariable hazard ratio compared with persons with LDL cholesterol &lt;80 mg/dL was 0.65 (95% CI 0.44 to 0.96) for those with LDL cholesterol 80 to 99 mg/dL, 0.48 (0.32 to 0.71) for 100 to 119 mg/dL, 0.50 (0.33 to 0.75) for 120 to 139 mg/dL, and 0.45 (0.30 to 0.69) for ≥140 mg/dL. These inverse associations were not altered substantially after the exclusion of persons with hypertriglyceridemia, after analysis with a Cox proportional hazard model with time-dependent covariates, or in sensitivity analysis for the potential effect of competing risks. Conclusions— Low LDL cholesterol levels are associated with elevated risk of death due to intraparenchymal hemorrhage.
Anti-tuberculosis medication and the liver: dangers and recommendations in management
Authors: NP Thompson, ME Caplin, MI Hamilton, SH Gillespie, SW Clarke, AK Burroughs, N McIntyre
Journal: European Respiratory Journal (1995)

In the light of three deaths due to liver failure secondary to anti-tuberculosis therapy at the Royal Free Hospital, we have reviewed the current literature, and asked--How common is liver dysfunction with anti-tuberculosis medications and how might it be prevented? Anti-tuberculosis chemotherapy is associated with abnormalities in liver function tests in 10-25% of patients. Clinical hepatitis develops in about 3%, though estimates vary, and in these patients there is likely to be significant morbidity and mortality. On the basis of reported cases of tuberculosis, 160 patients in England and Wales can be expected to develop drug-induced hepatitis due to anti-tuberculosis therapy each year. There are published guidelines from the British and American Thoracic Societies regarding the choice of drug therapy for tuberculosis. Current recommendations with regard to monitoring liver function, and what to do when these tests become abnormal, vary considerably. We suggest a protocol for using liver function tests to monitor for liver damage, and give recommendations on what action to take when these become abnormal.
Glucagon and Insulin Binding to Liver Membranes in a Partially Nephrectomized Uremic Rat Model
Authors: Vijay Soman, Philip Felig
Journal: Journal of Clinical Investigation (1977)

To investigate the role of glucagon and insulin receptor binding in the glucagon hypersensitivity and insulin resistance which characterize the glucose intolerance of uremia, liver plasma membranes were prepared from control rats (blood urea nitrogen [BUN] 15±1 mg/100 ml, creatinine 0.7±0.2 mg/100 ml), and from 70% nephrectomized rats (BUN 30±2 mg/100 ml, creatinine 2.2±0.2 mg/100 ml), and from 90% nephrectomized rats (BUN 46±3 mg/100 ml, creatinine 4.20±0.7 mg/100 ml), 4 wk after surgery. As compared to controls, the 90% nephrectomized rats had significantly higher levels of plasma glucose (95±4 vs. 125±11 mg/100 ml), plasma insulin (28±9 vs. 52±11 μU/ml), and plasma glucagon (28±5 vs. 215±18 pg/ml). Similar, but less marked, elevations were observed in the 70% nephrectomized animals.
What Does It Mean To Be Identifiable?
Authors: Sara Chandros Hull, Benjamin S. Wilfond
Journal: The American Journal of Bioethics (2008)

"What Does It Mean To Be Identifiable?." The American Journal of Bioethics, 8(10), pp. W7–W8 The views expressed in this article are those of the authors and do not necessarily reflect those of the National Institutes of Health.
Biological Variation of Glycated Hemoglobin: Implications for diabetes screening and monitoring
Authors: Eric S Kilpatrick, Paul W Maylor, Brian G Keevil
Journal: Diabetes Care (1998)

To assess the inherent potential of glycated hemoglobin as a screening test for type 2 diabetes by determining the biological variation in nondiabetic subjects.HbA1c values were measured by high-performance liquid chromatography (HPLC) in 12 nondiabetic subjects (7 men and 5 women; median age, 40 years [range, 21-55 years]) on 10 fortnightly occasions. The nondiabetic index of individuality (IOI) for HbA1c (i.e., the square root of the ratio of intra- to interindividual variance) was determined. Any test with an IOI of 1.4 has the most potential in disease screening, while one of 0.6 will be of little value.The analytical variance contributed to 9% of the total test variance, intraindividual variance, 6%; and interindividual variance, 85%. The IOI was, therefore, only 0.27. Thus, nondiabetic HbA1c values vary markedly between subjects, while values in the same individual change little with time. As such, to lie outside the assay reference range, the HbA1c values of some nondiabetic subjects must exceed 12 SD from their usual mean value, while in others a change of only 2 SD would be sufficient.This fundamental characteristic of HbA1c means that even if analytical methods improve, glycated hemoglobin measurements will always be of limited value when screening for type 2 diabetes. If similar interindividual differences also exist in diabetic subjects, then patients with the same glycemic control may vary by at least 1-2%, which has implications in setting glycated hemoglobin targets.
Epigallocatechin gallate affects human dendritic cell differentiation and maturation
Authors: Satomi Yoneyama, Kazushige Kawai, Nelson H. Tsuno, Yurai Okaji, Masahiro Asakage, Takeshi Tsuchiya, Jun Yamada, Eiji Sunami, Takuya Osada, Joji Kitayama, Koki Takahashi, Hirokazu Nagawa
Journal: Journal of Allergy and Clinical Immunology (2007)
931 EXPRESSION OF PERILIPIN AND ADIPOPHILIN IN HUMAN NONALCOHOLIC FATTY LIVER DISEASE AND THEIR RELATION TO OXIDATIVE DAMAGE
Authors: H. Fujii, Y. Ikura, J.C. Iezzoni, S. Park, H. Itabe, N. Kawada, M. Ueda, S.H. Caldwell
Journal: Journal of Hepatology (2008)
Development of a high performance jockey helmet
Authors: D Patton, A McIntosh, K Thai
Journal: British Journal of Sports Medicine (2011)

Background A high performance European equestrian helmet standard (EN 14572) was created to promote a higher level of protection for jockeys than existing equestrian helmet standards. Currently no equestrian helmet has been manufactured that meets this standard with the main challenge being the requirement to meet high and low impact energy attenuation criteria while passing tests against hazard and hemispherical anvils. Objective To develop and assess helmet prototypes to meet the energy attenuation requirements of EN 14572. Design Materials and helmet prototypes were assessed using impact tests. Polymer honeycomb and foams of selected densities and thicknesses (expanded polystyrene, expanded polypropylene, and polyurethane) were sourced as possible energy attenuating liner materials. These materials were impact tested both as single material samples and combination samples consisting of relative high and low density materials. Impact tests were performed using a rigid headform with test heights ranging from 1.2 m to 2.5 m. A series of prototype helmets were constructed with a high performing material combination as the energy attenuating liner in a typical thermoplastic shell. The prototypes were impact tested and compared to existing models. Setting Jockeys and equestrian sportspeople. Intervention Helmet design. Main outcome measurements Linear headform acceleration measured during impact tests. Results Increasing the liner thickness increased the energy attenuation performance of all materials and allowed lower density materials to perform better during higher velocity impacts. Combination samples of polymer honeycomb and low density foam performed better than single material samples over the range of impact velocities. The prototype helmets had higher energy attenuation performance when compared to unmodified helmets with the same shell, especially for lower severity impacts, but were larger and heavier. Conclusion There is potential to increase the energy attenuation capabilities of current equestrian helmets through utilisation of novel materials and dimensional changes. The impact of these changes on helmet ergonomics needs consideration.
Invasive Candida Infections
Authors: John E. Edwards
Journal: New England Journal of Medicine (1991)

THE evolution of fungi of the genus candida from infrequent pathogens to among the most common agents of nosocomial infection has been both dynamic and interesting. The story of their emergence began in the early 1960s with events remarkably similar to those (recently recounted in the Journal by Klein1) involving the transformation of coagulase-negative staphylococci from a harmless commensal to an invasive pathogen. The severity of the problem is illustrated by the data collected by the National Nosocomial Infections Surveillance System during the past decade. Jarvis and colleagues2 reported studying 344,610 nosocomial pathogens reported to the surveillance system between . . .
Changing Age of the Menopause
Authors: D. J. Frommer
Journal: BMJ (1964)

ResultsOf the 443 women 52 were single and 391 were married or single with children.The average number of childre.-a per woman was 2.02.The various complaints for which these women attended hospital are given in Table I.The numbers of menopausal women at the various ages are shown in Table II.The 50% point on the regression line (integrated frequency distribution curve) for 45.75-54.75years is 50.10 years (Fig. 1)
Digitalis-Induced Increase in Aortic Regurgitation and the Contrasting Effects of Glucagon in the Sedated Dog
Authors: Barry E. Hopkins, Roger R. Taylor
Journal: Journal of Clinical Investigation (1974)

The hemodynamic and phasic ascending aortic flow changes induced by acetylstrophanthidin and glucagon were studied in closed-chest sedated dogs with aortic regurgitation. While the positive inotropic effect of both agents was reflected in an increase in peak rate of rise of left ventricular pressure, acetylstrophanthidin increased aortic regurgitation, while glucagon decreased it. With the former, left ventricular end-diastolic pressure rose from 20±6 to 27±6 mm Hg (P < 0.005), but fell from 18±4 to 11±3 mm Hg (P < 0.001) with glucagon. Acetylstrophanthidin increased systemic vascular resistance, aortic diastolic pressure, and diastolic regurgitant flow rate, and, heart rate and the duration of regurgitation per beat and per minute being unchanged, regurgitant flow per beat increased 32±15% (P < 0.001). Glucagon decreased regurgitant flow per beat 27±14% (P < 0.001) because of abbreviation of diastole associated with tachycardia, and because of reduction in regurgitant flow rate. Despite tachycardia, the duration of regurgitation per minute was unchanged, and the small fall in regurgitant blood flow per minute was not significant, but this pertained in the face of 47% increase in effective cardiac output (P < 0.001). In contrast, acetylstrophanthidin increased regurgitant flow per minute 28±14% (P < 0.001) without change in effective cardiac output. The increase in cardiac contractility, tachycardia, and systemic vasodilatation induced by glucagon preferentially enhanced forward blood flow, which led to reduction in left ventricular volume overload, while it increased cardiac output. Contrarily, acetylstrophanthidin increased aortic regurgitation and, despite its inotropic effect, increased left ventricular volume overload without an increase in cardiac output.
Localization and Mechanisms of Airway Responses
Authors: Howard L. Bleich, Emily S. Boro, Roland H. Ingram, E. R. McFadden
Journal: New England Journal of Medicine (1977)

The air passages of the lung are not rigid tubes; they can reduce their caliber in response to chemicals, such as sulfur dioxide, drugs, such as histamine, and antigenic agents, such as ragweed pollen. The effects of these substances may be direct and local, or they may be reflexly mediated by the vagus nerve. The body's reactions can consist of smooth muscle constriction, mucosal edema with or without inflammatory-cell infiltration, increased secretions, altered clearance and changes in parenchymal elasticity, which depend on the nature of the agent, the dosage and the duration of exposure and subsequent response. These reactions appear . . .
Diabetes Mellitus Following Acute Pancreatic Necrosis
Authors: Renwick K. Caldwell
Journal: New England Journal of Medicine (1954)

ACUTE pancreatic necrosis is a rare cause of diabetes mellitus. Detailed clinical and post-mortem studies of a patient who survived such a necrosis for a month are the basis for the following report.Case ReportJ.A., a 38-year-old single Army private was admitted to the hospital on September 10, 1943, for continued treatment of a schizophrenic reaction, paranoid type.Routine physical examinations were within normal limits until November 6, 1950, when prostatic hypertrophy and urinary retention were found.A transurethral resection was done on December 12. When the diagnosis of adenocarcinoma of the prostate was made diethylstilbestrol administration was begun. . . .
Dermal-epidermal deposition of complement components and properdin in systemic lupus erythematosus
Authors: ROBERT E. JORDON, ARNOLD L. SCHROETER, R.K. WINKELMANN
Journal: British Journal of Dermatology (1975)

Skin lesions and clinically normal skin of thirteen patients with systemic lupus erythematosus (SLE) were examined, by the use of immunofluorescent techniques, to determine the presence of Ciq, C3, C3 proactivator (C3PA), properdin, immunoglobulins (IgG, IgA, and IgM), and fibrin. IgM deposition was present in all thirteen skin lesions and in all eleven normal areas tested, whereas IgG deposition occurred in eleven of the lesions but in only six normal areas. IgA was the least frequently encountered immunoglobulin. C1q deposition occurred in all thirteen skin lesions, and C3 deposition was present in twelve. Seven of nine and eight of eleven clinically normal areas demonstrated C1q and C3 deposition, respectively. Although less intense than C1q and C3 deposition, properdin deposition occurred in eight of the thirteen skin lesions tested but in only two of nine normal areas. C3PA deposition was of greater intensity than was properdin, but was seen in only five lesions and three clinically normal areas. Seven skin lesions and two normal areas also demonstrated fibrin deposition. Although alternate pathway activation is. apparent, our findings suggest that the classical pathway (C1 to C9) is the primary complement pathway involved in slli skin.
The feeling of pain and the emotion of distress
Authors: Eric A. Salzen
Journal: Behavioral and Brain Sciences (2002)

An ethological analysis suggests that effort and protection actions, which are expressions of distress, are comparable with pain expressions. Distress occurs with uncontrollable pain, and the expressions are ritualized pain responses with exaggerated features and lower thresholds. Pain is a sensory-motor feeling state with aversive motivational (hedonic) value. Distress is an emotional state of failure of pain responses to control the pain.
Analysts in India call for urgent expansion of essential medicines list
Authors: A. Jain
Journal: BMJ (2014)

Public health policy analysts have called for an urgent revision of the Drug (Prices Control) Order 2013 to expand the list of “essential” medicines, whose prices are fixed, beyond the current 348.1

An independent evaluation of the policy by the Public Health Foundation of India and the Institute for Studies in Industrial Development found that this price regulation was limited to 17% of the drugs prescribed in India.2 This left most of the market untouched and provided only marginal financial relief to patients, the authors said. 

The report was released at a conference on pharmaceutical policies in India, held in New Delhi from 3 to 7 March. The authors recommended increasing the scope and coverage of the price control order, as well as abandoning the current market based formula for drug pricing in favour of a cost based formula.

The current policy restricts drug pricing control to formulations that are included in the National List of Essential Medicines (NLEM). 

Anurag Bhargava, of the Himalayan Institute of Medical Sciences, told the conference, “This is a matter of concern given that the NLEM was not drafted as an instrument for price regulation. It is a representative rather than a comprehensive list of medicines utilised in actual practice. To serve as a reference for rational prescribing, the NLEM includes only a …
Radiation-inducible Immunotherapy for Cancer: Senescent Tumor Cells as a Cancer Vaccine
Authors: Yuru Meng, Elena V Efimova, Khaled W Hamzeh, Thomas E Darga, Helena J. Mauceri, Yang-Xin Fu, Stephen J Kron, Ralph R Weichselbaum
Journal: Molecular Therapy (2012)

Radiotherapy offers an effective treatment for advanced cancer but local and distant failures remain a significant challenge. Here, we treated melanoma and pancreatic carcinoma in syngeneic mice with ionizing radiation (IR) combined with the poly(ADP-ribose) polymerase inhibitor (PARPi) veliparib to inhibit DNA repair and promote accelerated senescence. Based on prior work implicating cytotoxic T lymphocytes (CTLs) as key mediators of radiation effects, we discovered that senescent tumor cells induced by radiation and veliparib express immunostimulatory cytokines to activate CTLs that mediate an effective antitumor response. When these senescent tumor cells were injected into tumor-bearing mice, an antitumor CTL response was induced which potentiated the effects of radiation, resulting in elimination of established tumors. Applied to human cancers, radiation-inducible immunotherapy may enhance radiotherapy responses to prevent local recurrence and distant metastasis. Radiotherapy offers an effective treatment for advanced cancer but local and distant failures remain a significant challenge. Here, we treated melanoma and pancreatic carcinoma in syngeneic mice with ionizing radiation (IR) combined with the poly(ADP-ribose) polymerase inhibitor (PARPi) veliparib to inhibit DNA repair and promote accelerated senescence. Based on prior work implicating cytotoxic T lymphocytes (CTLs) as key mediators of radiation effects, we discovered that senescent tumor cells induced by radiation and veliparib express immunostimulatory cytokines to activate CTLs that mediate an effective antitumor response. When these senescent tumor cells were injected into tumor-bearing mice, an antitumor CTL response was induced which potentiated the effects of radiation, resulting in elimination of established tumors. Applied to human cancers, radiation-inducible immunotherapy may enhance radiotherapy responses to prevent local recurrence and distant metastasis.
Mutation in<i>CPT1C</i>Associated With Pure Autosomal Dominant Spastic Paraplegia
Authors: Carlo Rinaldi, Thomas Schmidt, Alan J. Situ, Janel O. Johnson, Philip R. Lee, Ke-lian Chen, Laura C. Bott, Rut Fadó, George H. Harmison, Sara Parodi, Christopher Grunseich, Benoît Renvoisé, Leslie G. Biesecker, Giuseppe De Michele, Filippo M. Santorelli, Alessandro Filla, Giovanni Stevanin, Alexandra Dürr, Alexis Brice, Núria Casals, Bryan J. Traynor, Craig Blackstone, Tobias S. Ulmer, Kenneth H. Fischbeck
Journal: JAMA Neurology (2015)

The family of genes implicated in hereditary spastic paraplegias (HSPs) is quickly expanding, mostly owing to the widespread availability of next-generation DNA sequencing methods. Nevertheless, a genetic diagnosis remains unavailable for many patients.
Doctors' complicity with torture
Authors: S. H Miles
Journal: BMJ (2008)

It is time for sanctions

It is an arresting thought. More doctors abet torture than treat the millions of victims. More than 100 countries condone the use of torture. A third to a half of torture survivors report that a doctor oversaw the abuse.1 Many prisoners never see the doctors who refined the techniques to minimise evidential scars, prolong pain, or cause psychological destruction.2 Estimates of the numbers of torture victims do not include people whose murders disappear when a doctor writes “natural causes” on a death certificate.

The medical profession ought to dissociate itself from torture—a practice that destroys institutions of civil society; that is used against colleagues of conscience, and that has far reaching adverse mental, physical, and social consequences. Instead, medical societies and licensing boards offer lofty condemnation, which is most ardently aimed at offenders abroad rather than accomplices at home.

Doctors who abet torture rarely face professional risks. Governments will not punish a doctor for helping them carry out their crimes. Few medical societies or licensing boards have the courage and constancy of …
Labial Stenotrophomonas Presenting as Lip Nodules in an Immunocompromised Host
Authors: Rebecca I. Hartman, Xiaowei Xu, Mindy Schuster, Joseph Sobanko, Carmela C. Vittorio, Misha A. Rosenbach, Karolyn A. Wanat
Journal: JAMA Dermatology (2013)

We present an unusual case of Stenotrophomonas maltophilia infection manifest as lip nodule in a patient with aplastic anemia. While S maltophilia may colonize the skin and mucosa, bacteremia indicates true infection and requires targeted therapy.
Clinical Significance of Hyperuricemia in Routinely Screened Hospitalized Men
Authors: Harold E. Paulus
Journal: JAMA (1970)

When 16 automated blood chemistry examinations were routinely performed at the time of admission to a large Veterans Administration hospital, serum urate values greater than 7 mg/100 ml were found in 13.2% of 4,148 male patients. When 200 patients with hyperuricemia were studied in detail, the most common causes of urate elevation were azotemia (20%), acidosis (20%), and ingestion of diuretics (20%). Only 12% had a history of gout. Eighty percent (160 patients) did not require specific therapy; the remaining 20% either had gout or had sustained hyperuricemia (values above 9 mg/100 ml) which warranted drug treatment. These findings suggest that abnormal data generated by a routine laboratory screening program do not confirm a diagnosis or justify therapy, but merely represent a different type of "chief complaint" which must be carefully investigated before a diagnosis is made or therapy considered.