tbuckley/cabot-search huggingface dataset:
The Diagnosis and Treatment of Acute Poisoning
Authors: Thomasina Blissard
Journal: JAMA (1962)

The large number of toxic agents accessible today to the general public manifestly complicates the physician's task of treating patients who present as victims of poisoning. The agents run the gamut from poisonous plants and "venomous creatures" through the familiar carbon monoxide, sedatives, and ethyl alcohol, to the increasingly occurring radiation effects. Though this book is not a toxicology text, it includes clinical information on hundreds of nonmedicinal products and over 1,000 proprietary preparations of drugs containing a toxic component. The author regards poisoning as a preventable medical problem, the incidence of which has nevertheless risen in recent years (though mortality from this cause has declined in the United States). Particularly noteworthy is the increased incidence of attempted suicide. Barbiturates, salicylates, carbon monoxide, and ethyl alcohol surpass all other agents by which either accidental or suicidal poisoning occurs: therefore, highly detailed discussions of these materials are presented. The medical emergencies
EFFECT OF ORAL VS. PATCH CONTRACEPTION ON INFLAMMATORY MARKERS, OXIDATIVE STRESS, AND VASCULAR REACTIVITY IN HEALTHY PRE-MENOPAUSAL WOMEN
Authors: Pathmaja Paramsothy, Eric V. Kreiger, Elizabeth Chan, Eve Preus, Irina Rusanu, Sarah Prager, Brian Fish, Robert H. Knopp
Journal: Journal of the American College of Cardiology (2010)
Experts warn of drug rationing by GPs under new pricing scheme
Authors: Z. Kmietowicz
Journal: BMJ (2010)

Experts have warned that the new GP consortiums in England will be left with the responsibility of rationing which drugs their patients get when a new system of drug pricing is introduced in 2014.

England’s health secretary, Andrew Lansley, has repeatedly stated his preference for switching to a value based pricing scheme because he believes that it will better reflect the benefit of drugs to patients and reduce the drug bill.

He plans to introduce the scheme, in which the government will negotiate the prices that the NHS pays for drugs according to the therapeutic benefits they bring to patients, in the next three years.

The scheme effectively means that the role of the National Institute for Health and Clinical Excellence (NICE) in ruling on whether drugs should be available to patients on …
Where Are the Children of the 'Dirty War'? Science Seeks Answers for Their Relatives
Authors: Chris Raymond
Journal: JAMA (1989)

HOW LONG does it take for the bones of a 6-month-old child to dissolve?  With a voice periodically quavering with emotion, geneticist Mary-Claire King, PhD, recalled the grisly question posed to her one day in 1984. She replied that bones don't dissolve. Tears came to his eyes, and he said, 'Then Matilda is still alive,' King said in a speech in San Francisco at the annual meeting of the American Association for the Advancement of Science (AAAS).  The man's question was less a scientific query than an emotional plea. He wanted to know why a grave containing the remains of his daughter, son-in-law, and two of their children lacked any evidence of Matilda but for her pajamas.  Nevertheless, science is providing some solace to him and many other bereft grandparents in his troubled nation. King and a team of fellow geneticists and molecular biologists have been helping a group of
Tobacco use and urinary excretion of thromboxane A2 and prostacyclin metabolites in women stratified by age.
Authors: C Rångemark, G Benthin, E F Granström, L Persson, S Winell, A Wennmalm
Journal: Circulation (1992)

Activated platelets have been implicated in both acute thrombus formation and atherogenesis. Because smoking is a risk factor for cardiovascular disease in men and women and male smokers have biochemical evidence of increased platelet activation, we found it of interest to study whether smoking augments platelet activity in women as well.Data on smoking habits and a urinary sample were obtained from 125 healthy female nonsmokers and an equal number of smokers, stratified by age in five groups from 18 to 59 years old. Urinary samples were analyzed with gas chromatography/mass spectrometry for the 2,3-dinormetabolites of thromboxane A2 (Tx-M), reflecting platelet activity, and prostacyclin (PGI-M), representing platelet/vessel wall interaction. Urinary Tx-M in smokers was higher than in nonsmokers (p < 0.001), increasing with the number of cigarettes smoked per day and with age. In nonsmokers, there was no difference in Tx-M between the age groups. Urinary PGI-M in smokers was higher than that in nonsmokers (p < 0.001) and decreased with age in nonsmokers but not in smokers. There was no difference in Tx-M between previous smokers and lifelong nonsmokers.The elevated Tx-M in women who smoke cigarettes indicates an increased platelet activity that is dependent on smoking intensity. In parallel, PGI-M is augmented, suggesting that platelet/vessel wall interaction is stimulated. Quitting smoking is an effective means to restore platelet function. We propose that the observed increase in platelet activity in women who smoke cigarettes may be related to subsequent development of cardiovascular disease and that quitting smoking should be considered a high-priority medical target also in this sex.
Treatment of canine embolic pulmonary hypertension with recombinant tissue plasminogen activator. Efficacy of dosing regimes.
Authors: F Shiffman, J Ducas, P Hollett, E Israels, D Greenberg, R Cook, R M Prewitt
Journal: Circulation (1988)

We investigated effects of two dosing regimes of recombinant tissue plasminogen activator (rt-PA) and sodium heparin on pulmonary thrombolysis in a canine model of pulmonary hypertension, induced by injection of radioactive blood clots. By continuously counting over both lung fields with a mobile gamma camera, we correlated rate and extent of pulmonary thrombolysis with corresponding pulmonary hemodynamics. Treatment with heparin, over a 3-hour interval, did not result in significant thrombolysis or in a decrease in mean pulmonary artery pressure (PAP). In contrast, rt-PA caused marked pulmonary thrombolysis. While total clot lysis was similar when 1 mg/kg rt-PA was infused over 15 (rt-PA15) or 90 (rt-PA90) minutes (47% and 42%, respectively), rate of lysis during infusion was markedly increased with rt-PA15 (56% vs. 27%/hr, p less than 0.001). Corresponding to the increased rate of thrombolysis with rt-PA15, relative PAP decrease was greater at 15 and 30 minutes. At 4 hours, PAP decreased most with rt-PA90. However, two of the six dogs given rt-PA15 had an increase in PAP and lung radioactivity 1 hour after rt-PA. This was associated with dislodgment of a previously trapped clot. These results suggest that rt-PA may be appropriate therapy for pulmonary embolism and support further studies designed to optimize dosing regimes.
Medical Innovation and Institutional Interdependence
Authors: Annetine C. Gelijns, Samuel O. Thier
Journal: JAMA (2002)

University-industry research collaborations have been key to a continued high degree of technological innovation in medicine. Recently, however, critical questions have been posed about the potential negative aspects of highly productive means of encouraging innovation. Concerns center on blurring roles between academic research and the commercial world and the implications of universities' newfound readiness to benefit financially from their intellectual property. The roles of both parties are often inadequately captured by considering members of university faculties as single-mindedly devoted to the advancement of fundamental knowledge and industrial firms as mere developers of university research. Rather, medical innovation depends on extensive interactions between universities and industry, with knowledge and technology transfer flowing in both directions. These interactions have had important public health and economic benefits. Yet, there is a risk to the university-industry relationship if the cultural and ethical principles of one partner overwhelm those of the other. Therefore, universities and industry need to maximize the upsides of collaboration and minimize the downsides by means of internal organizational change as well as formation of new models of collaboration, such as intellectual partnerships or virtual research organizations. This article reviews the numerous institutional patterns of innovation and draws implications for organizational and public policies.
The Supply of Primary Care Physicians
Authors: Fred Matthies
Journal: JAMA (1991)

<h3>To the Editor.</h3> —The article by Politzer et al<sup>1</sup>makes a number of excellent points regarding increased output of primary care physicians by US medical schools. In particular, the recommendation to increase funding for training research and initiatives deserves careful analysis. Two related phenomena that were not mentioned warrant examination. They illustrate how perverse incentives within the funding mechanisms for medical schools can lead to the shortage of primary care physicians. First, students are actively dissuaded from primary care careers during medical school.<sup>2</sup>Second, medical schools in this country have become very expensive enterprises. Deans and department chairpersons have come to depend heavily on overhead from research grants to operate the institutions.<sup>3,4</sup> The 8% overhead allowed for training and faculty development grants is not likely to capture the attention of deans to the same extent as the near 50% overhead for basic research. Unless the benefit to
Fluoride and Bone — Quantity versus Quality
Authors: Robert Lindsay
Journal: New England Journal of Medicine (1990)

Postmenopausal osteoporosis is a major public health problem, whose impact is expected to reach epidemic proportions during the early part of the next century as the population ages. Consequently, whereas the prevention of bone loss will probably remain the most effective approach to therapy, efficacious treatment of patients who have already had fractures is sorely needed. The ideal therapy would eliminate the risk of future fractures by restoring bone mass and repairing the alterations in architecture that had already occurred. Current treatments such as those using estrogen and calcitonin are antiresorptive — that is, they act by preventing further loss . . .
Reexamining the role of the humoral immune response in control of hepatitis C virus infection
Authors: Lynn B. Dustin
Journal: Hepatology (2004)

Immunoglobulin GM and KM allotypes—genetic markers of γ and κ chains, respectively—are associated with immune responsiveness to several infectious pathogens and with survival in certain viral epidemics. We hypothesized that GM and KM allotypes affect the outcome of hepatitis C virus (HCV) infection. To test this hypothesis, we serologically allotyped 100 persons with well-documented clearance of HCV infection and 198 matched persistently infected persons. None of the GM or KM phenotypes by itself was associated with the clearance or persistence of HCV infection. Particular combinations of these phenotypes, however, were significantly associated with the outcome of HCV infection. Subjects with GM 1,17 5,13 and KM 1,3 phenotypes were over three times (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.44–8.87) as likely to clear the infection as the subjects who lacked these phenotypes. This GM phenotype had a similar association with clearance in the absence of KM 3 (OR, 2.75; 95% CI, 1.21–6.23). The presence of GM 1,3,17 23 5,13 phenotype (in the absence of KM 3) was associated with persistence (OR, 0.21; 95% CI, 0.06–0.77), while its absence (in the presence of KM 1,3) was associated with the clearance of infection (OR, 2.03; 95% CI, 1.16–3.54). These results show epistatic interactions of genes on chromosomes 14 (GM) and 2 (KM) in influencing the outcome of an HCV infection. Further investigations involving candidate genes (GM, KM, HLA, and Fcγ receptors) and cellular and humoral immune responses to HCV epitopes are needed to understand the mechanisms underlying these associations.
Clinical Observations on the Rectal and Oral Use of Various Ergot Derivatives in Headache
Authors: Arnold Henry Kadish
Journal: New England Journal of Medicine (1950)

CLINICAL observations have recently been reported on the use of Cafergone, a new anticephalalgic agent for oral use consisting of 1 mg. of ergotamine tartrate and 100 mg. caffeine alkaloid. Several observers1 2 3 4 5 6 reported excellent results with Cafergone orally in vascular headache, and it was the consensus of most that Cafergone is effective in the treatment of migraine, especially when taken early and in adequate dosage, and that it is also of value in combating psychogenic headache. The results were especially encouraging in headache caused by overindulgence, as well as in that associated with fever and photophobia.In patients in whom . . .
Activated <i>Rho</i> A Stimulates c- <i>fos</i> Gene Expression in Myocardial Cells
Authors: Tomomi Ueyama, Tsuyoshi Sakoda, Seinosuke Kawashima, Eiji Hiraoka, Ken-ichi Hirata, Hozuka Akita, Mitsuhiro Yokoyama
Journal: Circulation Research (1997)

Abstract Rho regulates various cell functions, including cell morphology and motility. However, the functional role of Rho on the signaling pathway in myocardial cells (MCs) is unknown. In the present study, we attempted to explore the mode of Rho action for c- fos gene expression in MCs. Expression of the c- fos promoter/enhancer linked to the luciferase reporter gene (c- fos luciferase) was stimulated by the wild type of Rho A and the point-mutated active form of Rho A ( Rho A Val14) but not the biologically inactive effector domain mutant of Rho A. Rho GDP dissociation inhibitor inhibited the action of Rho A on c- fos luciferase expression. The deletion analysis revealed that the c- fos serum response element (SRE) and the 12- O -tetradecanoylphorbol-13-acetate response element (TRE) mainly account for c- fos luciferase expression by Rho A Val14. The c- fos SRE mutant, which contains an intact binding site for the serum response factor but lacks the ternary complex factor binding site, was activated by Rho A Val14. The action of Rho A Val14 on c- fos luciferase expression was not inhibited by downregulation of protein kinase C, protein kinase C inhibitors, or tyrosine kinase inhibitors. These results indicate that activated Rho A stimulates c- fos gene expression through the c- fos SRE and TRE and that the signaling pathway from activated Rho A to the c- fos promoter/enhancer is independent of these inhibitor-sensitive pathways in MCs.
ADDRESS OF THE CHAIRMAN OF THE SECTION ON PRACTICE OF MEDICINE, MATERIA MEDICA AND PHYSIOLOGY.
Authors: J. H. Hollister
Journal: JAMA (1883)

Delivered to the American Medical Association, June 6, 1883. Gentlemen of the Association— In the development of medical science, men have been compelled to grapple with some of the most intricate and difficult problems which can challenge investigation. In studying those higher relations which lie in part beyond the limits of finite conception, reason may properly defer to faith, and, seeking the guiding hand of revelation, walk with a wisdom other than its own. But in medicine it is not so. Forces, mental and material, interchangeable, inter-dependent, and inseperable, manifest themselves in ways so manifold, and with so many essential facts undiscovered, that reason is compelled to thread her way with steps slow and uncertain, sometimes, in truth, oft times in error, ever painfully conscious of her weakness, and of the mysteries that confront her on every side. Thus only may we account for the seemingly meagre fruitage which represents
mtDNA Tandem Repeats in Domestic Dogs and Wolves: Mutation Mechanism Studied by Analysis of the Sequence of Imperfect Repeats
Authors: Peter Savolainen, Lars Arvestad, Joakim Lundeberg
Journal: Molecular Biology and Evolution (2000)

The mitochondrial (mt) DNA control region (CR) of dogs and wolves contains an array of imperfect 10 bp tandem repeats. This region was studied for 14 domestic dogs representing the four major phylogenetic groups of nonrepetitive CR and for 5 wolves. Three repeat types were found among these individuals, distributed so that different sequences of the repeat types were formed in different molecules. This enabled a detailed study of the arrays and of the mutation events that they undergo. Extensive heteroplasmy was observed in all individuals; 85 different array types were found in one individual, and the total number of types was estimated at 384. Among unrelated individuals, no identical molecules were found, indicating a high rate of evolution of the region. By performing a pedigree analysis, array types which had been inherited from mother to offspring and array types which were the result of somatic mutations, respectively, could be identified, showing that about 20% of the molecules within an individual had somatic mutations. By direct pairwise comparison of the mutated and the original array types, the physiognomy of the inserted or deleted elements (indels) and the approximate positions of the mutations could be determined. All mutations could be explained by replication slippage or point mutations. The majority of the indels were 1–5 repeats long, but deletions of up to 17 repeats were found. Mutations were found in all parts of the arrays, but at a higher frequency in the 5′ end. Furthermore, the inherited array types within the mother-offspring pair were aligned and compared so that germ line mutations could be studied. The pattern of the germ line mutations was approximately the same as that of the somatic mutations.
Associations of CFHR1–CFHR3 deletion and a CFH SNP to age-related macular degeneration are not independent
Authors: Soumya Raychaudhuri, Stephan Ripke, Mingyao Li, Benjamin M Neale, Jesen Fagerness, Robyn Reynolds, Lucia Sobrin, Anand Swaroop, Gonçalo Abecasis, Johanna M Seddon, Mark J Daly
Journal: Nature Genetics (2010)
High-Dose Desferoxamine and Diamond-Blackfan Anemia
Authors: L. KANZ
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 April 1986High-Dose Desferoxamine and Diamond-Blackfan AnemiaL. KANZ, M.D., H. ARNOLD, M.D., G.W. LÖHR, M.D.L. KANZ, M.D.Search for more papers by this author, H. ARNOLD, M.D.Search for more papers by this author, G.W. LÖHR, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-4-585 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The principal cause of death in patients with thalassemia major who receive transfusions is iron-induced cardiac toxicity. Although some data provide evidence that long-term subcutaneous desferoxamine therapy may protect patients from cardiac disease (1), the efficiency of iron-chelation therapy in the reversal of overt iron-induced cardiomyopathy remains uncertain (2-4). We write to report the reversal of iron-induced symptomatic cardiac toxicity by desferoxamine therapy in a patient with Diamond-Blackfan anemia.Anemia was diagnosed in the patient in 1958, 6 weeks after birth. Transfusion of about 2 U of packed erythrocytes was needed every 3 to 4 weeks to...References1. WOLFEOLIVIERISALLAN LND. Prevention of cardiac disease by subcutaneous desferoxamine in patients with thalassemia major. N Engl J Med. 1985;312:1600-3. CrossrefMedlineGoogle Scholar2. FREEMANGILESBERDOUKASWALSHCHOYMURRAY ARVWDP. Early left ventricular dysfunction and chelation therapy in thalassemia major. Ann Intern Med. 1983;99:450-4. LinkGoogle Scholar3. HENRY W. Echocardiography evaluation of the heart in thalassemia major, pp 892-4. In: NIENHUIS AW, moderator. Thalassemia major: molecular and clinical aspects. Ann Intern Med. 1979;91:883-97. MedlineGoogle Scholar4. MARCUSDAVIESBANTOCKUNDERWOODWALTONHUEHNS RSHSSE. Desferoxamine to improve cardiac function in iron-overloaded patients with thalassemia major. Lancet. 1984;1:392-3. CrossrefMedlineGoogle Scholar5. ARNOLDWEHINGERDEUSLÖHR HHBG. Kontrollierte Desferrioxamin-Therapie bei kongenitaler Anämie und Transfusionssiderose. Dtsch Med Wochenschr. 1978;103:1240-4. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEvaluation of the Oral Iron Chelator 1,2-Dimethyl-3-hydroxypyrid-4-one (L1) in Iron-Loaded PatientsManagement of Iron Overload in the Pediatric Patient 1 April 1986Volume 104, Issue 4Page: 585-586KeywordsAnemiaBeta-thalassemiaBirthCardiomyopathiesHeart diseasesToxicity Issue Published: 1 April 1986 PDF downloadLoading ...
Myocardial Scintigraphy with Tc-99m TBI in a 6-Month-old Infant with Myocardial Infarction after Mustard Operation
Authors: DIRK SANDROCK, UTA-CLAUDIA FRANKE, GUIDO HERBORN, DIETER L. MUNZ
Journal: Clinical Nuclear Medicine (1989)

Myocardial scintigraphy was performed in a 6-monthold infant with congenital dextro-transposition of the great arteries. Three days post partum balloon atrioseptostomy was done. He developed signs of myocardial infarction (elevated ST in ECG, arrhythmias, enhanced CPK, SGOT, LDH) two days after a successful Mustard operation. No coagulation or other metabolic abnormalities were present. Within four weeks there was nearly complete normalization of ECG changes and enzyme patterns. Imaging was done two hours after injection of 75 MBq (2 mCi) Tc-99m hexakis (t-butylisonitrile) technetium (I) (Tc-99m TBI) and showed an area of decreased activity (inferoapical/posterior) confirming the suspicions of the myocardial infarction as an unusual early complication after Mustard operation.
Peripheral Vascular Volumes and Whole Body Hematocrit During Human Heart Lung Bypass
Authors: STANLEY GIANNELLI, STEPHEN M. AYRES, PETER FLEMING, WILLIAM CONRAD, MELVIN S. SCHWARTZ, HOWARD GOULD
Journal: Circulation (1970)

Indicator-dilution curves were obtained across the peripheral vascular bed in 15 patients soon after the beginning of heart lung bypass, and in eight of these persons they were repeated just prior to the conclusion of bypass. A bolus containing labelled red cells and albumin was injected into the arterial inflow line just proximal to the aorta. Serial blood samples were obtained at intervals of 1 second from the venous return line, just distal to the right atrium, and the radioactivity was measured. The interposed volume of blood in the pump oxygenator delayed recirculation, allowing extrapolation of the exponential downslope and calculation of flow rates and indicator distribution volumes by the Hamilton-Stewart equations. The distribution volume of albumin (average, 56.3 ml/kg) was always greater than that of red cells (average, 44.8 ml/kg). The average ratio of whole body hematocrit to perfusate hematocrit was 0.873. The absence of significant differences between data obtained at the beginning and just prior to the end of bypass suggests that there were no alterations in venous tone or the volume relationships of large vessels to the microcirculation.
Recruitment of circulating NK cells through decidual tissues: a possible mechanism controlling NK cell accumulation in the uterus during early pregnancy
Authors: Claudia Carlino, Helena Stabile, Stefania Morrone, Roberta Bulla, Alessandra Soriani, Chiara Agostinis, Fleur Bossi, Carlo Mocci, Filippo Sarazani, Francesco Tedesco, Angela Santoni, Angela Gismondi
Journal: Blood (2008)
REAL-TIME DECISION SUPPORT TOOL INCREASED OUTPATIENT MEDICATION USE FOR MINORITY AND LOW-INCOME POPULATIONS WITH CORONARY HEART DISEASE/DIABETES: THE OFFICE-GUIDELINE APPLIED IN PRACTICE PROGRAM (OFFICE-GAP)
Authors: Venu Gourineni, Adesuwa Olomu, Steven Pierce, Nirzari Pandya, Kamesh Parashar, Kim Eagle
Journal: Journal of the American College of Cardiology (2012)
Adverse Effects of Vitamin D Deficiency on Outcomes of Patients With Chronic Hepatitis B
Authors: Grace Lai-Hung Wong, Henry Lik-Yuen Chan, Hoi-Yun Chan, Chi-Hang Tse, Angel Mei-Ling Chim, Angeline Oi-Shan Lo, Vincent Wai-Sun Wong
Journal: Clinical Gastroenterology and Hepatology (2014)