tbuckley/cabot-search huggingface dataset:
Neutralization of low molecular weight heparin by polybrene prevents thromboxane release and severe pulmonary hypertension in awake sheep.
Authors: G Montalescot, W M Zapol, A Carvalho, D R Robinson, A Torres, E Lowenstein
Journal: Circulation (1990)

Protamine reversal of heparin anticoagulation in patients is occasionally associated with life-threatening acute pulmonary hypertension. In a sheep model, we evaluated the effect on this adverse cardiopulmonary reaction of modifying the type of heparin (low molecular weight heparin compared with unfractionated heparin) and the type of heparin antagonist (polybrene compared with protamine). Protamine reversal of low molecular weight heparin (LMWH) and polybrene reversal of unfractionated heparin induced more than a 10-fold increase of plasma thromboxane B2 levels, a threefold increase of pulmonary vascular resistance and pulmonary artery pressure, and a 25% decrease of PaO2. A similar adverse reaction followed protamine reversal of conventional unfractionated heparin. However, with polybrene (1 mg/kg) reversal of LMWH (1 mg/kg), we measured neither pulmonary hypertension (pulmonary artery pressure was 22.6 +/- 3.6 mm Hg at 1 minute after polybrene reversal of LMWH compared with 47.9 +/- 4.2 mm Hg after protamine reversal of unfractionated heparin, p less than 0.005 groups differ), hypoxemia (PaO2 was unchanged 2 minutes after polybrene compared with a decrease of 26 mm Hg 2 minutes after protamine, p less than 0.05), nor acute release of thromboxane into arterial plasma (thromboxane B2 was 0.2 +/- 0.1 at 1 minute after polybrene compared with 3.7 +/- 1.7 ng/ml at 1 minute after protamine, p less than 0.005). The hemodynamic effects and mediator release were also benign after neutralization of larger doses of LMWH (3 mg/kg) by polybrene (3 mg/kg). The increases of activated clotting time and activated partial thromboplastin time due to both types of heparin were completely reversed with polybrene. Anti-Xa activity increased to more than 3 IU/ml 4 minutes after LMWH anticoagulation (p less than 0.01) but was only partially neutralized by polybrene. Various polyanion-polycation complexes that are formed when heparin anticoagulation is reversed induce thromboxane release and acute pulmonary vasoconstriction in awake sheep. Reversal of LMWH anticoagulation with polybrene does not elicit this adverse reaction.
Report of a Previously Unrecognized Cause of Neonatal Asphyxia
Authors: William K. Stephan
Journal: JAMA (1961)

RARELY can practicing physicians perform a more worthwhile service than saving the life of a newborn infant. Nothing equals the personal satisfaction derived from a sucessful neonatal resuscitation. Nothing parallels the anguish of an expectant mother who emerges from an obstetric anesthesia to learn that her baby has just died. The following case report of a previously unrecognized cause of neonatal asphyxia is presented so that other physicians may recognize and promptly correct this reversible condition.  Report of a Case  A 16-year-old primigravida was admitted to the hospital in active labor 6 weeks prior to the calculated date of her confinement. Her family and personal medical histories were not remarkable with regard to this report. Occasional post-prandial nausea and vomiting had persisted throughout the gestation; she also had a chronic coryza and a nonproductive cough. Physical examinations, blood pressures, urinalyses, and weight gain had been consistently within normal limits.
House‐Dust Mites and Absolute Indoor Humidity
Authors: Jens Korsgaard
Journal: Allergy (1983)

The concentration of house‐dust mites ( Dermatophagoides spp.) was investigated for four seasons in three locations in each of 50 Danish apartments. Simultaneously the absolute humidity was recorded and the previously known correlation between mite counts and indoor humidity was confirmed. It appeared, however, that apartments which had a low absolute indoor humidity in the winter period (due to low household load of water vapour) did not contain noticeable concentrations of house‐dust mites in the summer and autumn despite the fact that the indoor absolute humidity in these apartments could be high enough to allow for a high peak‐population of mites. Because of this it is suggested that in a temperate climate avoidance measures against house‐dust mites should be supplemented at least by a drying out period in the winter, when this process is convenient to perform because of the low outdoor absolute humidity.
Gabapentin may cause reversible visual field constriction
Authors: Tom Eke
Journal: BMJ (2006)

Contraction and convergence: myth and realityEditor-The review of climate change issues in the BMJ of 10 June was comprehensive.On grounds of morality, the principle of contraction and convergence is unassailable. 1 In the real world, it is a pipe dream.It would work only by being enforcible, which implies an international policing authority with real teeth.Can we seriously believe that the United States, China, or Russia would submit to such an authority?Sadly there is no mileage in morality when affluent lifestyles are threatened.It is right to plead for changes in individual behaviour, but only the de-carbonising of energy at source will make a predictable and sustained impact on carbon dioxide emissions.The only long term route to this goal will be through the adoption of renewable energy technologies on two levels.Firstly, small scale to micro-generation systems are rapidly approaching market viability.Within five to 10 years, millions of homes could become cost effective mini-power stations linked to a local mini-grid under the umbrella of distributed generation.The Energy Saving Trust estimates that this sector could meet 40% of UK electricity demand. 2 Secondly, base load electricity could be provided by gigawatt scale technologies mostly drawing energy from wind, rivers, and seas.Tidal stream, tidal estuary, tidal impoundment, wave power, and offshore wind could more than match the output of today's nuclear power. 3 In the short term, "balancing power" to compensate for intermittency would be provided by combined cycle gas power plants.In the longer term, surplus electricity, which is an intrinsic problem with renewables, will be directed to producing hydrogen for grid connected gigawatt scale fuel cells in a symbiotic coupling with high energy density renewables installations.All this will, of course, depend on massive government investment, but so would nuclear energy.On the demand side, buildings are the biggest carbon culprits.The only effective answer, embracing both new and existing buildings, is the concept of the carbon budget, enforcible by law.This could also be adapted for transport.These have complex implications, perhaps for another time.
POSITIVE AND NEGATIVE RESULTS OF MEDICAL ACTION.
Authors: BEDFORD BROWN
Journal: JAMA (1892)

I have long been impressed with the importance of studying and clearly comprehending in the application of our therapeutic agents, the positive or negative, the certain or uncertain action of our remedies. It may be said now that this is a question duly considered by every intelligent physician. I think that I can demonstrate to you during the course of this paper that this question, even at the hands of intelligent, competent physicians, does not always receive the consideration that it merits. This question of the positive and negative results of medical action is eminently a practical one. The more closely one may calculate upon and approach certainty of results in medical action the better will be our results in the treatment of disease. On the contrary, the less attention we pay this important question, the less weight we attach to the character and action of our remedies, the more
EXPERIMENTAL HYPERGLOBULINEMIA
Authors: Goetz W. Richter
Journal: The Journal of Experimental Medicine (1952)

It was shown, by means of salt fractionation procedures and electrophoresis that a marked and sustained hyperglobulinemia regularly resulted when sodium ribonucleate was injected subcutaneously at frequent intervals into rabbits undergoing immunization with horse serum. The hyperglobulinemia was characterized by a large increase in the gamma globulin levels, and a slight increase in the alpha and beta globulin levels. In control experiments done concurrently, the immunization of rabbits with horse serum, accompanied by subcutaneous injections of saline instead of ribonucleate, resulted in only moderate elevations in gamma globulin levels, while injections of ribonucleate alone brought about slight elevations in all three globulin components in some of the animals. Precipitin tests showed that the rabbits immunized with horse serum and simultaneously treated with ribonucleate developed antibody titers against horse serum that were no higher than those of the immunized controls given saline instead of ribonucleate. Indeed, some of the animals treated with horse serum and ribonucleate had globulin levels that were much higher and had antibody titers that were significantly lower than were those of several rabbits receiving horse serum and saline. Injections of ribonucleate alone did not result in the formation of specific antibodies detectable by means of precipitin tests. The results made it plain that the hyperglobulinemia of the animals treated with horse serum and ribonucleate was not due to an excessive production of specific antibodies. The findings as a whole provide further evidence that nucleotides play an important role in the formation of proteins in animals, and they indicate that an abnormally increased utilization of ribonucleotides by cells capable of producing globulins may be a causative factor in the pathogenesis of hyperglobulinemia.
Predictive Value of Cardiac Troponin T in Pediatric Patients at Risk for Myocardial Injury
Authors: Steven E. Lipshultz, Nader Rifai, Stephen E. Sallan, Stuart R. Lipsitz, Virginia Dalton, David B. Sacks, Michael E. Ottlinger
Journal: Circulation (1997)

Background Biochemical markers have not been routinely used in children at risk for myocardial damage. Yet, because of somatic growth and the duration of survival, a low level of myocardial damage may ultimately be of more consequence in children than in adults. Methods and Results We investigated the utility of cardiac troponin T (cTnT) blood levels (CARDIAC T ELISA Troponin T, Boehringer Mannheim Corp) in 51 consecutively sampled patients from 1 day to 34 years of age (median=5.7 years) undergoing cardiovascular (n=19) or noncardiovascular (n=17) surgery or who received doxorubicin for acute lymphoblastic leukemia (ALL) (n=15). Minimum detectable cTnT elevations were 0.03 ng/mL. cTnT was measurable in children of all ages with myocyte damage. In patients who underwent cardiovascular surgery, a correlation was noted between a score of increasing surgical severity and the mean level of postoperative cTnT ( r =.79, P &lt;.0001). Postoperative cTnT levels were elevated in children who completed cardiovascular surgery with an open chest compared with those with a closed chest ( P =.0083). In addition, cTnT levels before cardiovascular surgery predicted postoperative survival ( P =.007). cTnT elevations were observed after initial doxorubicin therapy for ALL. The magnitude of elevation predicted left ventricular dilatation ( r =.80 when variables were treated as continuous, P =.003) and wall thinning ( r =.61, P =.044) 9 months later. Conclusions Elevations of blood cTnT in children relate to the severity of myocardial damage and predict subsequent subclinical and clinical cardiac morbidity and mortality.
558. cGMP Production of Plasmid DNA for Phase I Clinical Studies in an Academic Center
Authors: Mark Przybylowski, Shirley M. Bartido, Michel Sadelain, Isabelle Riviere
Journal: Molecular Therapy (2005)

Phase I clinical trials performed at Memorial Sloan Kettering Cancer Center utilize plasmid DNA for active immunization and require the production of large quantities of clinical grade material. Therefore, the Gene Transfer and Somatic Cell Engineering Facility developed a process whereby |[ge]|200 mg of plasmid DNA could be produced in a single production run in compliance with current Good Manufacturing Practice (cGMP). A dedicated cleanroom (Class 10,000 with Class 100 Biological Hood) is utilized for the production of the bacterial cell bank, the fermentation phase, the harvest and lysis of the biomass as well as the downstream processing (DP) steps to purify the plasmid DNA.
Beneficial effects of tri-lithium pyrroloquinoline quinonein on behaviors and pathology in a mouse model of Alzheimer’s disease
Authors: Lei Zhao, Neng Gong, Xiaojing Sun, Zhe Yu, Qi Fang, Na Zhao, Xiaoli Pan, Tianle Xu, Chunjiu Zhong
Journal: Molecular Neurodegeneration (2012)

Alzheimer’s disease (AD) is a complex disease with characteristic pathological hallmarks of senile plaques and neurofibrillary tangles, the occurrence and development of which are involved in multiple neurodegenerative processes. Conventional AD therapies target only at single disease-causing mechanisms. However, these have been mostly shown to be ineffective in recent clinical trials. Here we tested a novel strategy using a synthetic organic lithium salt, tri-lithium pyrroloquinoline quinonein (Li3PQQ), to modulate mulitple pathways involved in AD pathogenesis. The study of acute toxicity with mice showed Li3PQQ with a very low toxicity (Li3PQQ ID50 5g/kg weight vs. LiCl ID50 2.5g/kg weight). We showed that 8 weeks of daily Li3PQQ administration in the APP/PS1 mice significantly improved the learning and memory function in the Morris water maze test and facilitated long-term potentiation. Li3PQQ significantly reduced the area and numbers of amyloid plaque and phosphorylated tau levels in cortical areas and mechanistically, it increased activities of Aβ-binding alcohol dehydrogenase but decreased activities of glycogen synthase kinase-3 in the transgenic mice. Therefore, Li3PQQ exhibits profound beneficial effects on cognitive impairment and pathological alterations in the AD mouse model. Our study demonstrates the effectiveness of a novel therapeutic strategy for AD through targeting at multiple disease-causing mechanisms.
Termination of ventricular tachycardia by single extrastimulation during the ventricular effective refractory period.
Authors: R Ruffy, K J Friday, W F Southworth
Journal: Circulation (1983)

Termination of ventricular tachycardia by low-energy shocks delivered during the ventricular refractory period has been reported. We describe a case of reproducible termination of multiple episodes of sustained ventricular tachycardia by a low-current extrastimulus delivered during the effective refractory period of the right ventricle, from the distal bipole of a quadripolar electrode catheter.
New Directions in Cardiac Imaging
Authors: DAVID J. SKORTON
Journal: Annals of Internal Medicine (1985)

Cardiac imaging is among the most commonly used diagnostic techniques in cardiovascular medicine. Conventional imaging modes (chest roentgenography, echocardiography, radionuclide imaging, and angiography) allow delineation of cardiac morphology, coronary anatomy, ventricular and valvular function, and cardiac shunts, and permit qualitative evaluation of myocardial perfusion. Four new imaging procedures (digital subtraction angiography, rapid acquisition x-ray computed tomography, emission computed tomography, and magnetic resonance imaging) promise to expand diagnostic capabilities by permitting quantitative analysis of myocardial perfusion, evaluation of myocardial metabolism, and characterization of cardiac tissue composition. These techniques differ widely in cost, availability, and in the additional information they offer. Optimal use will be achieved only through carefully controlled comparative clinical trials directed at specific diagnostic questions.
MEDICAL PRACTICE IN SIBERIA.
Authors: G. B. HASSIN
Journal: JAMA (1905)

<h3>REQUIREMENTS FOR MEDICAL PRACTICE.</h3> The rules of medical practice in Siberia are the same as in European Russia; that is, for the whole Russian Empire, from the Baltic Sea and the German-Austrian frontier up to the Pacific Ocean—Vladivostok and Port Arthur—there is one medical law: For the right of practicing medicine one must be graduated from one of the ten imperial universities of Russia. The university can be attended only by those graduated from a classical high school (eight years' studies), the so-called gymnasium, while the time of study in the university is not less than five years. After graduation, each student is permitted to take the state examinations, always oral. If the student be successful in these "final" examinations, he gets his diploma, and the right to practice medicine throughout the Russian empire and to fill any medical position in the
Fumbling at Mumblety
Authors: E. L. Balter
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Mumblety-peg is the one game that I feel skillful enough to play for monetary stakes. Even at the age of 57,I sometimes take my penknife to a grassy place and hone my skill. I, therefore, believe that I know why the country boy in the painting<i>Mumble the Peg</i>on the cover of the Aug 21, 1987, issue of<i>JAMA</i><sup>1</sup>is raising a hand and smiling in anticipation. The throws done just before the one depicted are best done either sitting or kneeling. This particular throw is best done standing and the knife must stick in the ground pointwise for five consecutive throws. The boy in the picture will probably miss the throw.
Teaching medical students about alcohol.
Authors: E B Ritson
Journal: BMJ (1990)

of the family.9Specific skills are required from general practitioners, a variety of hospital specialists, nurses, social workers, school and hospital teachers, and staff in other disciplines.Inevitably there will be areas of overlap in what each group legitimately regards as its territory; without effective communication and coordination the family mem- bers may well find themselves overburdened by too many people interfering in some aspects of their lives while in other critical areas they are left unsupported.This is particularly true of school, a most important aspect of the lives of both patients and siblings that has received insufficient attention in the past.The prognosis for childhood malignancies has improved to a remarkable degree, but the impact of the diagnosis still resembles a sort of death sentence-death to life as it was for the affected family.The challenge to us as professionals remains, as before, to provide the sustenance that will help the family to survive this threat to its integrity.The psycho- dynamic theorists have done much to illuminate how we all have to learn to cope with necessary losses in our growth towards maturity,"0'3 but the ordinary props of family life may well prove insufficient when families are faced with such an extreme challenge.Skilled professional support can help to cushion the impact and to sustain and nurture family members through this crisis in their lives, enabling them to emerge tempered but not fractured by the fire of the experience.
Abstract 5752: Expression and biological significance of adiponectin receptors in papillary thyroid carcinoma
Authors: Shih-Ping Cheng, Chien-Liang Liu, Yi-Chiung Hsu, Yuan-Ching Chang, Shih-Yuan Huang, Jie-Jen Lee, Yu-Jen Chen
Journal: Cancer Research (2012)

Abstract Obesity is associated with a higher incidence of thyroid cancer. Adiponectin is one of the most abundant adipokines with pleiotropic roles in metabolism and in the development and progression of cancer. This study aimed to investigate the possible association between the expression of adiponectin receptors (AdipoR1 and AdipoR2) and clinicopathological variables in papillary thyroid cancer. We found that levels of AdipoR1 and AdipoR2 were commonly increased in thyroid cancer compared with adjacent normal thyroid tissues. Thyroid cancer cells expressed AdipoR1 and AdipoR2, which were attenuated by histone deacetylase inhibitor trichostatin A. We determined the expression of AdipoR1 and AdipoR2 by immunohistochemical staining in primary tumor samples and metastatic lymph nodes. AdipoR1 was expressed in 27% of primary tumors and AdipoR2 in 47%. AdipoR1 expression correlated with AdipoR2 expression in primary tumors and in metastatic lymph nodes. Tumor AdipoR1 expression was associated with larger tumor size, whereas negative AdipoR2 expression was significantly associated with extrathyroidal invasion and multicentricity. Patients in the high AMES risk group had negative tumor expression of AdipoR1 and AdipoR2. Collectively, altered expression of adiponectin receptors in thyroid cancer supports a potential role in the pathogenesis of thyroid cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5752. doi:1538-7445.AM2012-5752
Down and out in Italy
Authors: G Dunea
Journal: BMJ (1994)

Among the vacation packages available to tourists there is one that includes a six weeks' stay at a public hospital in Italy. A prerequisite for joining is severe jaundice from hepatitis A combined with the supreme confidence and unbounded insouciance of youth. This tour I took in 1959, soon after my internship. By the time I reached Milan I was ready for an educational experience at the other end of the needle in a large noisy medical ward. Here patients were being admitted at all hours and old men shuffled about all night with their parrot shaped “papagallo” urinals. In the next bed a man still confined to bed several weeks after a myocardial infarction was attached to a huge oxygen …
Campaigners seek legal assurance on safe water supplies worldwide
Authors: B. Roehr
Journal: BMJ (2009)

Campaigners and charities are seeking legislation in the US Congress to bring safe drinking water and sanitation to 100 million people in the developing world by 2015.

The representatives of various charities campaigning for better water supplies made their case at a Capitol Hill briefing on 29 July.

Congress made access to safe water and sanitation a policy objective for the US Agency for International Development when it passed the Water for the Poor Act in 2005. Last year the agency helped nearly two million people gain access to safe water and 1.5 million to improved sanitation for the first time.

But figures from the World Health Organization show that 1.1 billion people, nearly a fifth of the world’s population, …
Care of the Young Patient Who Is Dying
Authors: William M. Easson
Journal: JAMA (1968)

Death, a universal human experience and one of the commonest clinical syndromes, is rarely mentioned in medical teaching and is avoided in textbook discussions. The complete physician must be able to treat the dying so that his therapeutic management can be of maximum benefit. He should be able to cope understandingly with the normal, age-appropriate emotional reactions which will complicate his treatment procedures. In this brief presentation, I highlight some of the usual reactions to death in the child, the adolescent, and the young adult— reactions which the doctor should anticipate in his young patients, their families, his staff, and himself.