tbuckley/cabot-search huggingface dataset:
Some Factors in the Assessment of Gastric Antisecretory Drugs by a Sampling Technique
Authors: J. P. Bingle, J. E. Lennard-Jones
Journal: Gut (1960)

Samples of gastric contents from patients with duodenal ulcer were more often highly acid when they drank 120 ml. of milk-cream mixture every hour than when they ate a bland diet. The volume of the drinks and the timing of the samples determined this apparent difference. Long-acting propantheline bromide reduced gastric acidity a little when the patients ate the diet and more when they took the drinks of milk-cream alone. It is concluded that the clinical usefulness of gastric antisecretory drugs can only be assessed under the actual conditions of use.
Day and Night Home Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes: Three-Center Randomized Crossover Study
Authors: Lalantha Leelarathna, Sibylle Dellweg, Julia K. Mader, Janet M. Allen, Carsten Benesch, Werner Doll, Martin Ellmerer, Sara Hartnell, Lutz Heinemann, Harald Kojzar, Lucy Michalewski, Marianna Nodale, Hood Thabit, Malgorzata E. Wilinska, Thomas R. Pieber, Sabine Arnolds, Mark L. Evans, Roman Hovorka
Journal: Diabetes Care (2014)

OBJECTIVE To evaluate the feasibility of day and night closed-loop insulin delivery in adults with type 1 diabetes under free-living conditions. RESEARCH DESIGN AND METHODS Seventeen adults with type 1 diabetes on insulin pump therapy (means ± SD age 34 ± 9 years, HbA1c 7.6 ± 0.8%, and duration of diabetes 19 ± 9 years) participated in an open-label multinational three-center crossover study. In a random order, participants underwent two 8-day periods (first day at the clinical research facility followed by 7 days at home) of sensor-augmented insulin pump therapy (SAP) or automated closed-loop insulin delivery. The primary end point was the time when sensor glucose was in target range between 3.9 and 10.0 mmol/L during the 7-day home phase. RESULTS During the home phase, the percentage of time when glucose was in target range was significantly higher during closed-loop compared with SAP (median 75% [interquartile range 61–79] vs. 62% [53–70], P = 0.005). Mean glucose (8.1 vs. 8.8 mmol/L, P = 0.027) and time spent above target (P = 0.013) were lower during closed loop, while time spent below target was comparable (P = 0.339). Increased time in target was observed during both daytime (P = 0.017) and nighttime (P = 0.013). CONCLUSIONS Compared with SAP, 1 week of closed-loop insulin delivery at home reduces mean glucose and increases time in target without increasing the risk of hypoglycemia in adults with relatively well-controlled type 1 diabetes.
SPECT-CT of Meckel Diverticulum
Authors: Dimitri Papathanassiou, Jean-Claude Liehn, Benoît Menéroux, Jérôme Amans, Aude Domange-Testard, Mohammed Belouadah, Michel Abély
Journal: Clinical Nuclear Medicine (2007)

A 14-year-old male patient, with proctorrhagia and a clinical history suggesting a bleeding Meckel diverticulum, was referred for Tc-99m pertechnetate scintigraphy. Dynamic planar study showed an abdominal paramedian focus of uptake. A SPECT-CT (with a few CT slices) was performed to localize the abnormality and correlate it with the CT aspect; the uptake focus matched an abnormal area visible as part of the bowel on the CT. Surgery and histopathologic examination confirmed a Meckel diverticulum. The recent SPECT-CT hybrid modality is usable in such a case and is expected to potentially discriminate between Meckel diverticulum and possible artifacts.
New Serum Markers for Acute Myocardial Infarction
Authors: Christian W. Hamm
Journal: New England Journal of Medicine (1994)

A crucial step in confirming or ruling out the diagnosis of acute myocardial infarction is the measurement of myocardial enzymes in the serum. The levels of creatine kinase (CK) and especially of CK-MB (the myocardial-specific isoform) have served as essential components of decision making in emergency rooms for over 25 years. Common experience indicates, however, that this standard diagnostic test is far from perfect. The diagnostic specificity of elevations of CK-MB is reduced in the case of skeletal-muscle injury, such as may occur after chest compressions for resuscitation, electrical defibrillation, intramuscular injections, or extreme exercise. In the critical first six . . .
Study of medicine prescribing for elderly patients.
Authors: C B Freer
Journal: BMJ (1985)

An analysis of drug prescribing over six months in a random sample of 146 elderly patients showed that 42% were receiving one or more medicines long term. Diuretics, analgesics, and non-steroidal anti-inflammatory drugs were most often prescribed, and variations in prescribing by age, sex, and consultations with the general practitioner were examined. Only 17% of the group were taking three or more medicines on repeat prescriptions, and 42% received no prescriptions during the study. These results have implications for the workload of supervising prescriptions but also underline the need for a balanced view of drug prescribing and medicine taking in elderly people.
Cough Gastric Pressure and Maximum Expiratory Mouth Pressure in Humans
Authors: William D-C. Man, Dimitris Kyroussis, Tracey A. Fleming, Alfredo Chetta, Farzaneh Harraf, Naveed Mustfa, Gerrard F. Rafferty, Michael I. Polkey, John Moxham
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Maximal expiratory mouth pressure is a well established test that is used to assess expiratory muscle strength. However, low values are difficult to interpret, as they may result from technical difficulties in performing the test, particularly in patients with facial muscle weakness or bulbar dysfunction. We hypothesized that measuring the gastric pressure during a cough, a natural maneuver recruiting the expiratory muscles, might prove to be a useful additional test in the assessment of expiratory muscle function. Mouth expiratory and cough gastric pressures were measured in 99 healthy volunteers to obtain normal values and in 293 patients referred for respiratory muscle assessment to compare the two measurements. Between-occasion within-subject coefficient of variation, assessed in 24 healthy volunteers, was 10.3% for mouth pressure and 6.9% for cough. Mean +/- SD cough gastric pressure for normal males was 214.4 +/- 42.2 and 165.1 +/- 34.8 cm H2O for females. In 171 patients deemed weak by a low mouth expiratory pressure, 42% had a normal cough gastric pressure. In 105 patients deemed weak by a low cough gastric pressure, 5.7% had a normal expiratory mouth pressure. Low maximal expiratory mouth pressures do not always indicate expiratory muscle weakness. Cough gastric pressure provides a useful complementary test for the assessment of expiratory muscle strength.
Fluid Shear Stress Induces Lipocalin-Type Prostaglandin D <sub>2</sub> Synthase Expression in Vascular Endothelial Cells
Authors: Yoji Taba, Toshiyuki Sasaguri, Megumi Miyagi, Takeo Abumiya, Yoshikazu Miwa, Toshiko Ikeda, Masako Mitsumata
Journal: Circulation Research (2000)

Ligands for peroxisome proliferator-activated receptor gamma, such as the thiazolidinedione class of antidiabetic drugs and 15-deoxy-Delta(12,14)-prostaglandin J(2) (15d-PGJ(2)), modulate various processes in atherogenesis. In search of cells that generate prostaglandin D(2) (PGD(2)), the metabolic precursor of 15d-PGJ(2), we identified PGD(2) from culture medium of endothelial cells. To study how PGD(2) production is regulated in endothelial cells, we investigated the role of fluid shear stress in the metabolism of PGD(2). Endothelial cells expressed the mRNA for the lipocalin-type PGD(2) synthase (L-PGDS) both in vitro and in vivo. Loading laminar shear stress using a parallel-plate flow chamber markedly enhanced the gene expression of L-PGDS, with the maximal effect being obtained at 15 to 30 dyne/cm(2). The expression began to increase within 6 hours after loading shear stress and reached the maximal level at 18 to 24 hours. In contrast, shear stress did not alter the expression levels of PGI(2) synthase and thromboxane A(2) synthase. In parallel with the increase in the expression level of L-PGDS, endothelial cells released PGD(2) and 15d-PGJ(2) into culture medium. These results demonstrate that shear stress promotes PGD(2) production by stimulating L-PGDS expression and suggest the possibility that a peroxisome proliferator-activated receptor gamma ligand is produced in vascular wall in response to blood flow.
Normal Infant Born to a Mother With Phenylketonuria
Authors: Margaret S. Tenbrinck
Journal: JAMA (1982)

Following the introduction of artificial diets, a generation of women with phenylketonuria (PKU) has matured, and some of these women have reproduced. Offspring of these PKU mothers without PKU have multiple stigmata at birth, including mental retardation. To avoid harmful effects to the fetus, these mothers can be treated successfully by a low phenylalanine diet. This report of a case of the birth of a bright unaffected child includes specific diets for prepregnancy trial and maintenance during pregnancy.  ( JAMA 1982;247:2139-2140)
Governments need to invest more to deal with health risks of teenagers, says Unicef
Authors: J. Zarocostas
Journal: BMJ (2011)

The world needs to invest in the world’s 1.2 billion adolescents—88% of whom live in poor nations—to consolidate the gains of the last two decades for young children, and to help deal with the array of challenges, including health risks, faced by teenagers, a Unicef report says.

“Adolescence is a pivotal point—an opportunity to consolidate the gains made in early childhood or risk seeing those gains wiped out,” said Anthony Lake, Unicef executive director.

The paucity of attention and resources devoted to adolescents (aged 10-19), Unicef warns, is threatening to limit the impact that efforts devoted to improving children’s health have had.

“We need to focus more attention now on reaching adolescents—especially girls—investing …
Hepatitis C virus nonstructural protein 5A inhibitors: Novel target-Now for new trials and new treatment strategies
Authors: Alex J. Thompson, Paul J. Clark, John G. McHutchison
Journal: Hepatology (2010)

Abstract The worldwide prevalence of chronic hepatitis C virus (HCV) infection is estimated to be approaching 200 million people. Current therapy relies upon a combination of pegylated interferon-alpha and ribavirin, a poorly tolerated regimen typically associated with less than 50% sustained virological response rate in those infected with genotype 1 virus. The development of direct-acting antiviral agents to treat HCV has focused predominantly on inhibitors of the viral enzymes NS3 protease and the RNA-dependent RNA polymerase NS5B. Here we describe the profile of BMS-790052, a small molecule inhibitor of the HCV NS5A protein that exhibits picomolar half-maximum effective concentrations (EC50) towards replicons expressing a broad range of HCV genotypes and the JFH-1 genotype 2a infectious virus in cell culture. In a phase I clinical trial in patients chronically infected with HCV, administration of a single 100-mg dose of BMS-790052 was associated with a 3.3 log10 reduction in mean viral load measured 24 h post-dose that was sustained for an additional 120 h in two patients infected with genotype 1b virus. Genotypic analysis of samples taken at baseline, 24 and 144 h post-dose revealed that the major HCV variants observed had substitutions at amino-acid positions identified using the in vitro replicon system. These results provide the first clinical validation of an inhibitor of HCV NS5A, a protein with no known enzymatic function, as an approach to the suppression of virus replication that offers potential as part of a therapeutic regimen based on combinations of HCV inhibitors.
Book: The Evidence-Based Primary Care Handbook
Authors: D R Hannay
Journal: BMJ (2000)

Ed Mark Gabbay Royal Society of Medicine Press, £19.50 ISBN 1 85315 415 6 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> Evidence based medicine is fashionable and, at face value, a simple concept that should be self evidently desirable. In practice, it is a rapidly changing and complex field driven by information technology. This handbook attempts to bridge the gap between the sunny uplands of what is desirable and the realities of trying to provide evidence based primary care at the coal face of general practice. … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Reviews and Notes: Clinician's Handbook of Preventive Services: Put Prevention into Practice
Authors: Eddy A. Bresnitz
Journal: Annals of Internal Medicine (1996)

Literature of Medicine15 September 1996Reviews and Notes: Clinician's Handbook of Preventive Services: Put Prevention into PracticeEddy A. Bresnitz, MD, MSEddy A. Bresnitz, MD, MSAllegheny University of the Health Sciences, MCP ◆ Hahnemann School of Medicine, Philadelphia, PA 19129Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-6-199609150-00051 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail U.S. Department of Health and Human Services, Public Health Service, Office of Disease Prevention and Health Promotion. 420 pages. Washington, DC: US Gov Pr Office; 1994. $20.00. ISBN 0-16-043115-8. Order phone 202-512-1800.In 1989, the United States Preventive Services Task Force, with support from the Office of Disease Prevention and Health Promotion (ODPHP), published the Guide to Clinical Preventive Services, which was updated this year. Referred to as the “Blue Book” by practitioners of preventive medicine, the Guide summarizes the scientific evidence for a wide spectrum of preventive measures. On the basis of an analysis of that evidence, the Task ... Author, Article, and Disclosure InformationAffiliations: Allegheny University of the Health Sciences, MCP ◆ Hahnemann School of Medicine, Philadelphia, PA 19129 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1996Volume 125, Issue 6Page: 527KeywordsChildrenEnvironmental healthEpidemiologyHealth careHealth promotionInpatientsMedical servicesPrevention, policy, and public healthPreventive medicineProphylaxis ePublished: 15 August 2000 Issue Published: 15 September 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
CONGENITAL ATRESIA OF ESOPHAGUS ASSOCIATED WITH ATRESIA OF ANUS AND TRACHEA; ESOPHAGEAL FISTULA
Authors: Max Thorek
Journal: JAMA (1926)

Cases of congenital atresia of the esophagus, though not rare, are of interest. <h3>REPORT OF CASE</h3> G. S., a boy, born, Sept. 29, 1925, had no rectal opening. September 30, the infant was brought to the American Hospital for operation. No abnormalities were discovered in the eyes, ears, nose, throat, chest, lungs, heart, abdomen, genital organs or skin. After two attempts, owing to the child's failure to ingest the barium, roentgen-ray examination showed a distinct pouch formation of the esophagus at the sternal notch, the material failing to pass farther. Reexamination, after three hours, showed a small part of the unejected barium meal in the same pouch formation, no barium having passed beyond it. A soft rubber catheter passed into the esophagus reached the lower margin of the pouch, then reversed, the tip returning into the oral cavity. With the double malformation present the condition of the infant was deemed
Enzyme-Linked Immunosorbent Assay of Antibodies to Epstein-Barr Virus Nuclear and Early Antigens in Patients with Infectious Mononucleosis and Nasopharyngeal Carcinoma
Authors: Jessica Halprin, Alan L. Scott, Lisa Jacobson, Paul H. Levine, J. H. C. Ho, James C. Niederman, S. Diane Hayward, Gregory Milman
Journal: Annals of Internal Medicine (1986)

A sensitive enzyme-linked immunosorbent assay was used to measure titers of IgG antibodies against bacterially synthesized Epstein-Barr virus nuclear antigen and early antigen in sera from 100 healthy North Americans, 40 North American patients with infectious mononucleosis, and 48 Asian patients with nasopharyngeal carcinoma. All healthy persons previously infected with Epstein-Barr virus had antibodies to nuclear antigen, and 70% had very low but detectable antibody titers to early antigen. In contrast, patients with mononucleosis had nondetectable or very low levels of antibodies to nuclear antigen and high antibody levels to early antigen. High levels of antibody to early antigen also were seen in patients with nasopharyngeal carcinoma, and a decrease in this response during the first 12 months after diagnosis and treatment was a significant prognostic indicator of survival. The probability of survival was 75% for patients whose antibody concentration to early antigen remained constant or decreased, and near 0% for patients with increasing levels of antibody.
Funding respiratory research.
Authors: M Green
Journal: Thorax (1985)

Research is the life blood of medical advance.It varies from the rigor of experimentation in the basic sciences to observation of the natural history of dis- ease.Respiratory research encompasses many disci- plines, each contributing to our understanding of respiratory structure, function, and pathology, and the application of this knowledge to the relief and cure of patients, the goal of all clinicians.All research needs resources, which usually amount to time or money, or both.Time has to be given to the project by the investigator, although sometimes he may be able to do this as an extension of his normal activities without additional expense.Little useful research can proceed, however, without
Nonalcoholic steatohepatitis, insulin resistance, and metabolic syndrome: Further evidence for an etiologic association
Authors: Gianfranco Pagano, Giovanni Pacini, Giovanni Musso, Roberto Gambino, Fabio Mecca, Nadia Depetris, Maurizio Cassader, Ezio David, Paolo Cavallo-Perin, Mario Rizzetto
Journal: Hepatology (2002)

This study aims to determine the presence of the components of the metabolic syndrome in primary nonalcoholic steatohepatitis (NASH) and to assess the role of liver disease in the genesis of peripheral hyperinsulinemia. Nineteen patients (18 men and 1 woman; mean age, +/- SD, 38 +/- 10 years; body mass index [BMI], 26 +/- 2 kg/m(2)) with histologic evidence of NASH were enrolled; 19 age- and sex-matched normal subjects were investigated as controls. Plasma glucose, insulin, and C-peptide levels were measured during an oral glucose tolerance test, and a frequently sampled intravenous glucose tolerance test (FSIGT), analyzed by minimal modeling technique, was performed. Compared with controls, the NASH group had lower insulin sensitivity (3.84 +/- 2.44 vs. 7.48 +/- 3.01 10(-4) x min(-1)/microU/mL; P =.0003) and higher total insulin secretion (21 +/- 13 vs. 10 +/- 3 nmol/L in 240 minutes; P =.001). Hepatic insulin extraction was similar in both groups (69.8% +/- 16.1% vs. 70.2% +/- 18.3%; P =.854). According to the results of the oral glucose tolerance test, no patient was classified as diabetic, 5 were classified as glucose intolerant, and 1 was classified as having impaired fasting glycemia. Nine patients (47%) had at least the 2 minimum criteria required to define the metabolic syndrome according to the European Group for the Study of Insulin Resistance (EGIR). In conclusion, hyperinsulinemia and insulin resistance occur frequently in patients with NASH; these conditions do not stem from a reduced hepatic insulin extraction but from an enhanced pancreatic insulin secretion compensatory to reduced insulin sensitivity. The derangement of insulin regulation, often associated with the metabolic syndrome, may play a causal role in the pathogenesis of NASH.
781. The Effect of Overexpression of Lysyl Oxidase on Dermal Wound Healing
Authors: Ying-Ka I. Lau, Jennifer L. West
Journal: Molecular Therapy (2005)

Introduction: In this study, we aimed to increase crosslinking in extracellular matrix proteins through overexpression of lysyl oxidase (LO). Newly formed skin at a wound site never achieves the same mechanical strength as the original tissue and this condition is exacerbated in diabetic patients. It is therefore of interest to enhance mechanical strength of newly formed tissue in wounds. In this study, we have used a gene activated matrix (GAM) approach to locally deliver plasmid DNA complexed with polyethlyenimine (PEI) at the wound site. We demonstrated that PEI-DNA complexes were taken up and expressed by fibroblasts for at least 20 days. In vitro studies showed that fibroblast-seeded GAMs with LO transgene exhibited a 3-fold increase in mechanical strength as compared with a GFP-transgene control We applied this system to a wound healing model in vivo and showed that treatment with LO-producing GAMs led to significantly enhanced mechanical strength of newly formed skin at the wound site.
Insulinoma with Low Circulating Insulin Levels: The Diagnostic Value of Proinsulin Measurements
Authors: ROBERT N. ALSEVER
Journal: Annals of Internal Medicine (1975)

Hypoglycemia coexisting with very low plasma immunoreactive insulin concentrations was found in a 78-year-old woman with an insulinoma. However, the absolute proinsulin levels during hypoglycemia were elevated (0.9 to 1.4 ng/ml), accounting for 66.5% of the total circulating immunoreactive insulinlike material. The raised serum proinsulin concentrations together with an abnormal proinsulim:insulin ratio proved to be of critical importance in establishing the diagnosis of an islet-cell tumor in this patient.
Drug misuse in Lothian.
Authors: S Griffin, A Peters, M Reid
Journal: BMJ (1993)

years, which is worrying.There is a similar gap between the ages of 6 and 10 years.While a child's weight and therefore doses of drugs may vary considerably with age, the size of an endotracheal tube varies far less.The authors' chart should at least show a full range of endotracheal tube sizes.Before the meeting of the European Resuscitation Council in November last year the recommended endotracheal dose of adrenaline, atropine, and lignocaine was twice the intravenous or intraosseous dose.Since the meeting the American Heart Association has suggested that the initial endotracheal dose of adrenaline should in fact be 10 times the intravenous dose-that is, 100 pRg/kg.It is likely that this will soon be accepted by the European Resuscitation Council as the standard.Thus Burke and Bowden's chart has at best a twofold and at worst a tenfold dosage error.I understand that Oakley is currently revising his chart in accordance with the European Resuscitation Council's guidelines and is taking account of all these points.I look forward to seeing his new chart.In conclusion, Burke and Bowden's chart has serious flaws and may even be dangerous.It should not replace the existing or updated Oakley chart.
The Routine Use of Quinidine in Acute Myocardial Infarction
Authors: Frank B. Cutts, Bernard Rapoport
Journal: New England Journal of Medicine (1952)

DURING the course of a study on the use of Dicumarol in acute myocardial infarction, the value of the routine use of quinidine in this condition was also investigated. In particular, the investigation was directed toward ascertaining whether or not the incidence of arrhythmias and sudden unexpected death could be altered. The first 55 patients in the Dicumarol study had received no quinidine and were therefore designated as a control group. The remaining 66 patients received 0.2 gm. of quinidine sulfate by mouth four times a day, at 8 a.m., 12 noon, 4 p.m. and 8 p.m. This dosage schedule . . .