tbuckley/cabot-search huggingface dataset:
Autonomic and cardiovascular effects of pentobarbital anesthesia during trigeminal stimulation in cats
Authors: Hiroshi Hanamoto, Hitoshi Niwa, Mitsutaka Sugimura, Yoshinari Morimoto
Journal: International Journal of Oral Science (2012)

Stimulation of the trigeminal nerve can elicit various cardiovascular and autonomic responses; however, the effects of anesthesia with pentobarbital sodium on these responses are unclear. Pentobarbital sodium was infused intravenously at a nominal rate and the lingual nerve was electrically stimulated at each infusion rate. Increases in systolic blood pressure (SBP) and heart rate (HR) were evoked by lingual nerve stimulation at an infusion rate between 5 and 7 mg·kg−1·h−1. This response was associated with an increase in the low-frequency band of SBP variability (SBP-LF). As the infusion rate increased to 10 mg·kg−1·h−1 or more, decreases in SBP and HR were observed. This response was associated with the reduction of SBP-LF. In conclusion, lingual nerve stimulation has both sympathomimetic and sympathoinhibitory effects, depending on the depth of pentobarbital anesthesia. The reaction pattern seems to be closely related to the autonomic balance produced by pentobarbital anesthesia. Anesthetized patients can experience potentially serious physiological responses to physical stimuli. For example, animal studies have revealed a 'trigeminal depressor response' (TDR), wherein stimulation of facial nerves under anesthesia triggers a marked decrease in blood pressure and heart rate. Since these studies have not considered the impact of depth of anesthesia, Hiroshi Hanamoto and colleagues at Japan's Osaka University Graduate School of Dentistry examined the importance of this factor. They found that in lightly anesthetized cats, electrical stimulation of the lingual nerve actually led to increased heart rate and blood pressure; only under heavier anesthesia did such stimuli trigger TDR. This suggests that dental patients who faint during procedures could do so in response to pain, or fear of pain, rather than physiological changes induced by TDR, as was previously speculated.
Cost effectiveness of combination therapy for hepatitis C: a decision analytic model
Authors: K Stein
Journal: Gut (2002)

Objective: To estimate the cost utility of treatment with combination therapy (ribavirin and interferon α) for hepatitis C compared with no treatment or monotherapy (interferon α) based on UK costs and clinical management. Design: Decision analysis model using a Markov approach to simulate disease progression. Setting: UK secondary care. Participants: Hypothetical cohort of patients with hepatitis C. Main outcome measures: Cost per quality adjusted life year (QALY) gained. Results: Discounted cost per QALY for combination therapy over no treatment was £3791. Cost per QALY varied between £1646 and £9170 according to subgroup, with the lowest ratios being for genotype 2 or 3, women, those aged less than 40 years, and those with moderate hepatitis. The discounted cost per QALY of the combination over monotherapy was £3485. Similar findings were shown for subgroups as for the comparison with no treatment. One way sensitivity analysis showed that while drug costs were more important in the analysis than assumptions about disease progression or costs of treating hepatitis C disease, the results were robust to large changes in underlying assumptions. Conclusions: Combination therapy for hepatitis C is a cost effective treatment option and is superior to monotherapy. Considerable uncertainties remain over the appropriate management strategies in the populations excluded from randomised controlled trials and in whom treatment is currently being considered in the UK.
Histology for Pathologists
Authors: Walter F. Coulson
Journal: JAMA (1992)

Several years ago, as editor-in-chief of the<i>American Journal of Surgical Pathology</i>, Dr Sternberg inaugurated a series of articles under the same heading as his book's title,<i>Histology for Pathologists</i>. These articles have now been considerably augmented and incorporated into this large, almost 1000-page, comprehensive text, whose 80 authors comprise an international cast of experts. Inevitably, the chapters vary in their quality, to an extent that reflects either inadequate editorial surveillance or adherence to a very tight deadline. I would assume that the instruction to contributors was to write on pure and applied histology, with the level of detail required by a practicing pathologist. As Dr Sternberg mentions in his preface, there are many histology books in existence, but none contains the detail and variations from normal that form a baseline for estimating the presence of disease. The papers originally published in the<i>American Journal of Surgical Pathology</i>are strictly
Autosomal monosomies among 24,262 consecutive cytogenetic studies: Prevalence, chromosomal distribution and clinicopathologic correlates of sole abnormalities
Authors: Sania Raza, Fareeda TaherNazerHussain, Mrinal Patnaik, Ryan Knudson, Daniel Van Dyke, Ayalew Tefferi
Journal: American Journal of Hematology (2011)

Monosomal karyotype (MK) has recently been associated with poor prognosis in acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and primary myelofibrosis (PMF). The objectives of the current study were to describe the prevalence and spectrum of autosomal monosomies in an unselected cohort of patients with known or suspected hematologic malignancies. Bone marrow cytogenetic studies (24,262) were performed at our institution between 1989 and 2009. An abnormal karyotype was demonstrated in 6,565 cases (~27%); of these, 1,365 (~21%) included autosomal monosomies that occurred as sole (n = 133; ~10%), part of two (n = 82; ~6%) or more (n = 1,150; ~84%) anomalies. All 22 autosomes were involved, but monosomy 7 was by far the most frequent, constituting ~80% of all isolated monosomies and the highest fraction of those with two or more abnormalities. Other recurrent sole monosomies included chromosomes 20 (~11%) and 21 (~4%). Monosomy 13 (~10%), 20 (~8%), 18 (~7%), 17 (~6%), 21 (~5%), 5 (~5%), and 12 (~4%) were also recurrent in the setting of ≥2 abnormalities. Bone marrow histology and clinical information were reviewed in all cases with isolated monosomy; associated clinical phenotypes were MDS (n = 60; 52 were -7), AML (n = 32; 31 were -7), myeloproliferative neoplasms (n = 16; 10 were -7), chronic myelomonocytic leukemia (CMML; n = 10; 9 were -7) and other nonmyeloid malignancies (n = 15; 4 were -7). Sole monosomy 20 (n = 14; six MDS, five MPN, and three nonmyeloid) was not seen in AML or CMML. Sole monosomy 21 was more frequent in nonmyeloid as opposed to myeloid cases.
The antibody response to methyl isocyanate: experimental and clinical findings.
Authors: M H Karol, S Taskar, S Gangal, B F Rubanoff, S R Kamat
Journal: Environmental Health Perspectives (1987)

As a result of the industrial accident in Bhopal, India (December 1984) in which thousands of people were exposed to methyl isocyanate (MIC), concern was raised for possible long-term health effects. The well-recognized immunologic consequences of exposure to other industrial isocyanates prompted investigation of an antibody response to MIC. Using procedures which had been developed in this laboratory to evaluate isocyanate immunotoxicity, animal studies were undertaken to develop and test reagents which could be used to detect antibodies to MIC in the exposed population. Guinea pigs were injected with MIC in its reactive isocyanate form. Three weeks later, blood was drawn and serum evaluated using ELISA. To detect antibodies, an antigen was prepared by reaction of MIC with guinea pig serum albumin. Antibodies were detected in each of the four animals injected with MIC. Titers achieved were 1:5120 to 1:10,240. Inhibition assays revealed antibody specificity directed toward the MIC hapten. Analogous antigens prepared by reaction of MIC with human serum albumin were used to evaluate sera from individuals exposed in Bhopal to MIC. Antibodies were detected in 12 of 144 exposed persons. Antibodies were specific for MIC, as evidenced by inhibition assays, and belonged to the IgG, IgM and IgE classes. However, titers were generally low and transient and were found in persons having had the highest MIC exposures. Total IgE values of sera were not significantly different from those of control sera obtained from Bombay residents. The results indicate that exposure to methyl isocyanate resulted in production of specific antibodies. However, the low titers observed and the transient nature of the response suggest little health consequence should result form the antibody response.
Beyond the Scalpel
Authors: Richard T. Caleel
Journal: JAMA (1992)

In<i>Beyond the Scalpel</i>Dr Costanzo reports his first year of surgical residency in a daily journal format. The majority of the book deals with his experiences in the emergency department and operating room. It is difficult to develop a feel for the personalities of his patients, since they are only briefly encountered. The material appears to be somewhat disjointed, and even Dr Costanzo's persona does not fully emerge for the reader. There are a considerable number of spelling errors, which can be quite confusing, eg, "carotid" for "parotid." It would appear from his comments that the majority of the attending surgeons are extremely difficult and unpleasant personalities. He consistently refers to the women in his book as "chicks," despite their position or relationship to the story. In summary, I feel that this book offers little to experienced medical personnel and would probably be somewhat confusing to the lay public.
Discordant Tc-99m Sulfur Colloid and ln-113m Chloride Blood Pool Images in Patients with Acute Amebic Liver Abscess
Authors: WEI-JEN SHIH, RICHARD C. REBA, YEN-CHANG TU, SHIN-HWA YEH
Journal: Clinical Nuclear Medicine (1983)

Using combined Tc-99m sulfur colloid and ln-113m chloride eluate imaging, studies from 32 patients with proven amebic liver abscess were analyzed. The results revealed good perfusion of the amebic lesion in three, poor perfusion in 11, and absent perfusion in 18. These results appear to depend on abscess size and age. Images with ln-113m seem to be better than those with Tc-99m sulfur colloid in depicting amebic liver abscess during antiamebic therapy. Overall, the In-113m images provide more precise information concerning abscess size and shape.
Asialoglycoprotein receptor targeted gene delivery using galactosylated polyethylenimine-graft-poly(ethylene glycol): In vitro and in vivo studies
Authors: Eun-Mi Kim, Hwan-Jeong Jeong, In-Kyu Park, Chong-Su Cho, Hyung-Bae Moon, Dae-Yeul Yu, Hee-Seung Bom, Myung-Hee Sohn, In-Joon Oh
Journal: Journal of Controlled Release (2005)
Blunted natriuretic response and low blood pressure after atrial natriuretic factor in early cirrhosis
Authors: Jaap J. Beutler, Hein A. Koomans, Ton J. Rabelink, Carlo A. Gaillard, Jan van Hattum, Peter Boer, Evert J. Dorhout Mees
Journal: Hepatology (1989)

We compared the natriuretic response to a standard dose of atrial natriuretic factor in nine patients with early cirrhosis (no ascites or edema) with the response in normal subjects displaying a range of baseline sodium excretions due to different sodium intakes (20 mmoles per day, n = 9; 100 mmoles per day, n = 9, and 200 mmoles per day, n = 9). In these normal subjects, sodium output rose, in the same order, from 49 +/- 12 to 177 +/- 26, from 116 +/- 21 to 365 +/- 106 and from 228 +/- 29 to 901 +/- 85 mumoles per min in the first 20 min after 100 micrograms atrial natriuretic factor (human atrial natriuretic factor 99-126). Thus, irrespective of basal excretion, natriuresis rose by at least 2-fold. In the cirrhotic patients, natriuresis rose from 173 +/- 42 to 305 +/- 77 mumoles per min, that is by hardly 1-fold, significantly less than in the normal subjects (p less than 0.01). Renal function studies indicated that atrial natriuretic factor caused less rise in glomerular filtration rate and in fractional sodium excretion. Atrial natriuretic factor induced a fall in blood pressure only in the cirrhotic group, from 130 +/- 4/81 +/- 2 to 108 +/- 4/68 +/- 3 mmHg (p less than 0.001). Plasma atrial natriuretic factor was not low in the cirrhotic patients. Although these data are compatible with a primary disturbance of sodium excretion in early cirrhosis without ascites, such an explanation is complicated by the concomitant drop in blood pressure after atrial natriuretic factor.(ABSTRACT TRUNCATED AT 250 WORDS)
Leukocyte Activation in the Peripheral Blood of Patients With Cirrhosis of the Liver and SIRS
Authors: Alan J. Rosenbloom
Journal: JAMA (1995)

<h3>Objective.</h3> —Leukocyte adhesion plays an important role in inflammation. Adhesion molecules such as CD11b on polymorphonuclear neutrophil leukocytes (PMNs) up-regulate in response to tumor necrosis factor—α, interleukin-8 (IL-8), and other mediators that are involved in systemic inflammatory response syndrome (SIRS). This study examined the behavior of CD11b and other membrane molecules in SIRS in relation to serum cytokines and the severity of illness. <h3>Design.</h3> —Survey study. <h3>Setting.</h3> —Liver transplantation intensive care unit at a tertiary care center. <h3>Patients.</h3> —A consecutive sample of 22 patients admitted to the liver transplantation intensive care unit for complications related to cirrhosis of the liver in the absence of other disease. Sixteen of the patients developed SIRS and multiple organ dysfunction syndrome with suspected bacterial infections. Seven control subjects were also studied. <h3>Main Outcome Measures.</h3> —Modified Goris organ failure score and Acute Physiology and Chronic Health Evaluation II score. <h3>Results.</h3> —Mean serum IL-6 levels, but not IL-1 β or tumor necrosis factor—α levels, correlated with organ failure (<i>r</i>=0.79,<i>P</i>&lt;.001). Leukocyte cell-surface markers fluctuated from day to day. The mean of several values was more stable. Mean CD11b and CD35 on PMNs correlated with serum IL-6 level (<i>r</i>=0.75,<i>P</i>&lt;.001, and<i>r</i>=0.77,<i>P</i>&lt;.005, respectively). Up-regulation of both CD11b and CD35 display on PMNs correlated with organ failure (<i>r</i>=0.74,<i>P</i>&lt;.001, and<i>r</i>=0.71,<i>P</i>&lt;.01, respectively). Polymorphonuclear neutrophil leukocyte L-selectin, CD31, and CD16 were simultaneously decreased, consistent with PMN activation. Monocytes appeared to be activated, but the pattern of surface molecule display was different. <h3>Conclusions.</h3> —In human SIRS, the circulating monocyte and PMN pools undergo alterations suggestive of leukocyte activation, including up-regulation of PMN CD11b in correlation with the serum IL-6 level and severity of organ dysfunction. (<i>JAMA</i>. 1995;274:58-65)
Differential screening of a human chromosome 3 library identifies hepatocyte growth factor-like/macrophage-stimulating protein and its receptor in injured lung. Possible implications for neuroendocrine cell survival.
Authors: C G Willett, D I Smith, V Shridhar, M H Wang, R L Emanuel, K Patidar, S A Graham, F Zhang, V Hatch, D J Sugarbaker, M E Sunday
Journal: Journal of Clinical Investigation (1997)

Transient pulmonary neuroendocrine cell hyperplasia and non-neuroendocrine lung tumors develop in nitrosaminetreated hamsters, which we hypothesized might modulate epithelial cell phenotype by expressing gene(s) homologous to human chromosome 3p gene(s) deleted in small cell carcinoma of the lung (SCLC). We differentially screened a chromosome 3 library using nitrosamine-treated versus normal hamster lung cDNAs and identified hepatocyte growth factor-like/macrophage-stimulating protein (HGFL/MSP) in injured lung. HGFL/MSP mRNA is low to undetectable in human SCLC and carcinoid tumors, but the HGFL/MSP tyrosine kinase receptor, RON, is present and functional on many of these neuroendocrine tumors. In H835, a pulmonary carcinoid cell line, and H187, a SCLC cell line, HGFL/ MSP induced adhesion/flattening and apoptosis. Using viable cell counts to assess proliferation after 14 d of treatment with HGFL/MSP, there is growth inhibition of H835 but not H187. Nitrosamine-treated hamsters also demonstrate pulmonary neuroendocrine cell apoptosis in situ during the same time period as expression of the endogenous HGFL/ MSP gene, immediately preceding the spontaneous regression of neuroendocrine cell hyperplasia. These observations suggest that HGFL/MSP might regulate neuroendocrine cell survival during preneoplastic lung injury, which could influence the ultimate tumor cell phenotype.
Depression of Cell-Mediated Immunity during Acute Infectious Mononucleosis
Authors: Richard J. Mangi, James C. Niederman, Joseph E. Kelleher, John M. Dwyer, Alfred S. Evans, Fred S. Kantor
Journal: New England Journal of Medicine (1974)

To elucidate mechanisms responsible for depression of cell-mediated immunity associated with viral infections, we studied 41 patients with infectious mononucleosis. Intradermal tests, lymphocyte stimulation in vitro and enumeration of peripheral blood T and B cells were performed. There was significant anergy and diminished lymphocyte responsiveness in vitro to mitogens and antigens during the first weeks of illness. This depression of cell-mediated immunity was accompanied by increased numbers of peripheral blood T and B cells. The numbers of atypical lymphocytes in the peripheral blood of several patients were too great to be classified as entirely T or B cells in type, and probably represent both types of lymphocytes. On the basis of these data, we hypothesize that T-cell response to viral infections results in antigenic competition, which is the major mechanism responsible for depression of cell-mediated immunity during infectious mononucleosis. (N Engl J Med 291:1149–1153, 1974)
Oncogenic tyrosine kinase NPM-ALK induces expression of the growth-promoting receptor ICOS
Authors: Qian Zhang, HongYi Wang, Kanchan Kantekure, Jennifer C. Paterson, Xiaobin Liu, Andras Schaffer, Chrystal Paulos, Michael C. Milone, Niels Odum, Suzanne Turner, Teresa Marafioti, Mariusz A. Wasik
Journal: Blood (2011)
Projections to achieve minimum surgical rate threshold: an observational study
Authors: Tarsicio Uribe-Leitz, Micaela M Esquivel, George Molina, Stuart R Lipsitz, Stéphane Verguet, John Rose, Stephen W Bickler, Atul A Gawande, Alex B Haynes, Thomas G Weiser
Journal: The Lancet (2015)
Frequent interruptions linked to drug errors
Authors: Lisa Hitchen
Journal: BMJ (2008)

Interruptions and distractions were the main reasons given for drug errors, in a study at one acute hospital trust.

These were mentioned 14 times as contributing to drug errors in a three month pilot study of an enhanced reporting scheme carried out at Bradford Teaching Hospitals Foundation Trust. Heavy workload and labelling errors were both mentioned 10 times in the 49 reports included in the study.

Although the numbers are too small to be statistically significant, research by Gerry Armitage, a senior research fellow at Bradford Institute for Health Research, confirms interruptions is a factor that needs to be dealt with.

“We live in a time pressured environment and interruptions and distractions are contributing,” …
On first name terms
Authors: Oliver Ellis
Journal: BMJ (2013)

My first proper job was as a computer salesman at a big chain of electrical shops. During my induction the general manager introduced himself as John Clark.

I had just left school, and my only retail experience was from watching reruns of the 1970s British sitcoms Are You Being Served and Open All Hours , so I had no idea whether I should call him John or Mr Clark. I spent the next week addressing him as “Excuse me” and desperately listening out for cues from my colleagues.

Seven months into my first job …
Essentials of Gastroenterology
Authors: Howard M. Spiro
Journal: JAMA (1969)

Dr. J. Ned Smith, Jr., has written a delightful handbook for quick reference, one particularly aimed at medical students, so that there is little in it to arouse controversy. At first I hesitated to review this text, as I too have recently completed a textbook on clinical gastroenterology, but I hope my experience has made me a better judge. After reading Dr. Smith's book, I find the subjects covered to be pleasantly treated, and I would be happy to have my students acquire their first knowledge of digestive disorders from this volume. No one will agree with all that Dr. Smith says, but little details are unimportant. He gives space to subjects in proportion to their general frequency in real life, so that ulcerative colitis and duodenal ulcer receive their due. Because it is intended for medical students, however, the book has some omissions, an example of which is the
NHS will be left with high risk, low profit services under private finance initiative
Authors: D N Bennett-Jones
Journal: BMJ (1996)

EDITOR,—Chris Ham's editorial highlights genuine concerns about the government's private finance initiative in the NHS.1 In Carlisle, where a single consortium has tendered to build and manage a major development of the hospital, we already have experience of private finance in the form of a contracted dialysis service. Under the terms of the contract (which is usually described as a “partnership” by the company), equipment, disposables, and nursing cover are provided for a …
Hypoglycemic Activity of Glyburide (Glibenclamide) Metabolites in Humans
Authors: Tony Rydberg, Anders Jönsson, Michael Røder, Arne Melander
Journal: Diabetes Care (1994)

OBJECTIVE To assess the hypoglycemie effect and the insulin-releasing effect of the main glyburide (glibenclamide) metabolites 4-trans-hydroxy-glibenclamide (Ml) and 3-cis-hydroxy-glibenclamide (M2) in humans. RESEARCH DESIGN AND METHODS Eight healthy subjects participated in a placebo-controlled, randomized, single-blind crossover study with five single-dose tests, 3 months apart: 3.5 mg glibenclamide (Gb) orally, 3.5 mg Gb intravenously, 3.5 mg Ml intravenously, 3.5 mg M2 intravenously, and placebo intravenously, each in the fasting state. Standardized meals were given 0.5 and 5.5 h after each medication. Blood glucose levels were measured by a glucose oxidase method, and serum insulin concentrations were analyzed by a specific immunoassay. RESULTS Blood glucose levels during the first 5 h were significantly lowered not only by Gb but also by Ml and M2. The mean ± SE blood glucose reductions (versus placebo) expressed as percent of area under the curve (AUC) (0-5 h) were 18.2 ± 3.3% for Ml, 12.5 ± 2.3% forM2,19.9 ± 2.1% for intravenous Gb, and 23.8 ± 1.2% for Gb orally. Serum insulin levels were significantly increased by Gb as well as by Ml and M2. CONCLUSIONS The two main metabolites of glyburide (glibenclamide) have a hypoglycémie effect in humans, which is due to increased insulin secretion.
Inflammation, Epithelial to Mesenchymal Transition, and Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Resistance
Authors: Kostyantyn Krysan, Jay M. Lee, Mariam Dohadwala, Brian K. Gardner, Karen L. Reckamp, Edward Garon, Maie St. John, Sherven Sharma, Steven M. Dubinett
Journal: Journal of Thoracic Oncology (2008)
A link between protein translation and body weight
Authors: Liangyou Rui
Journal: Journal of Clinical Investigation (2007)

Nutrient overload induces obesity, a primary risk factor for type 2 diabetes. Ribosomal biogenesis and protein synthesis, which are controlled by the mammalian target of rapamycin (mTOR), are primary energy-consuming processes in cells. mTOR phosphorylates and inactivates members of the eukaryotic translation initiation factor 4E–binding (eIF4E-binding) protein (4E-BP) family, which are translational repressors of 5′ cap–dependent protein synthesis. In this issue of the JCI, Le Bacquer et al. report that simultaneous deletion of both 4E-BP1 and 4E-BP2 in mice results in insulin resistance, decreased energy expenditure, and increased adipogenesis (see the related article beginning on page 387). These findings link protein synthesis, insulin sensitivity, and body weight.