tbuckley/cabot-search huggingface dataset:
Abnormal cardiac function in the streptozotocin-diabetic rat. Changes in active and passive properties of the left ventricle.
Authors: S E Litwin, T E Raya, P G Anderson, S Daugherty, S Goldman
Journal: Journal of Clinical Investigation (1990)

To provide an integrated assessment of changes in systolic and diastolic function in diabetic rats, we measured conscious hemodynamics and performed ex vivo analysis of left ventricular passive-elastic properties. Rats given streptozotocin (STZ) 65 mg/kg i.v. (n = 14) were compared with untreated age-matched controls (n = 15) and rats treated with insulin after administration of STZ (n = 11). After 7 d, diabetic rats exhibited decreases in heart rate and peak developed left ventricular (LV) pressure during aortic occlusion. After 26 d of diabetes there were significant decreases in resting LV systolic pressure, developed pressure, and maximal +dP/dt, whereas LV end-diastolic pressure increased and the time constant of LV relaxation was prolonged. The passive LV pressure-volume relationship was progressively shifted away from the pressure axis, and the overall chamber stiffness constant was decreased. However, "operating chamber stiffness" calculated at end-diastolic pressure was increased at 7 d, and unchanged at 26 d. LV cavity/wall volume and end-diastolic volume were increased after 26 d of diabetes. Myocardial stiffness was unchanged at both time intervals. All of the above abnormalities were reversed by the administration of insulin. We conclude that the hemodynamic and passive-elastic changes that occur in diabetic rats represent an early dilated cardiomyopathy which is reversible with insulin.
Is psychiatry thinking adequately about behaviour?
Authors: I. McClure
Journal: BMJ (2010)

Spence’s cogent summary of concerns about child behaviour problems contains a fundamental confusion about behaviour and thinking disorders.1 To a psychiatrist, mental disorder is a conscious difference in thinking, pathological compared with the norm. Thought difference leads to behaviour problems that can threaten the patient’s or others’ safety.

Over the past century psychiatry explored such presentations in children, and their …
P11 Assessment of malignancy in patients with idiopathic pulmonary embolus: an audit
Authors: R. Som
Journal: Thorax (2011)

<h3>Background</h3> There are 65 000 cases of pulmonary embolus (PE) in hospital per year in England and Wales. There is a significant association between idiopathic venous thrombosis and cancer and an increase in risk of diagnosis of cancer within a year of idiopathic venous thrombosis. The British Thoracic Society (BTS) guidelines suggests that all patients who do not have a major risk factor for PE should receive “a combination of careful clinical assessment, routine blood tests and chest radiography” and only when these indicate possibility of malignancy, should further imaging or invasive investigations for malignancy be considered. Our aim was to evaluate these guidelines in a large teaching hospital in England. <h3>Method</h3> A retrospective patient-chart review of all patients admitted with pulmonary embolus over 12 months was performed. A patient was excluded if they had a clear major risk factor for developing PE for example, recent pelvic surgery, known malignancy etc. If a patient had no clear risk factor, the documentation during the admission was reviewed to see whether clinicians were complying with BTS guidelines and assessing for malignancy appropriately. A pro-forma was designed to check this, with 1 point being given for every aspect of history/investigation performed in regards to assessing for cancer for example, 1 point awarded if the patient was asked about recent change in bowel habit; 1 point if the patient9s serum calcium was checked. An overall score was given for each clinical assessment for malignancy for each patient (out of 14 for men; out of 15 for women). <h3>Results</h3> 202 patients with confirmed PE were admitted over 12 months. 39 patients were included in the study. In summary, compliance with BTS guidelines calling for thorough clinical assessment was poor in a number of parameters—patients were not asked if they were suffering from systemic symptoms of malignancy, or assessed for symptoms and signs of common malignancies associated with PE. Conversely, a number of patients were inappropriately referred for further investigation—particularly imaging—for possible malignancy without a documented history or examination pertaining to a specific malignancy. <h3>Conclusion</h3> Compliance with the guidelines from the BTS is poor. Adequate histories and examinations for malignancy are not being performed. This suggests that either the guidelines or the clinical practice needs re-evaluation.
Dietary Management in the Coronary Care Unit-Reply
Authors: Richard J. Jones
Journal: JAMA (1977)

I also noticed (too late) that the 40%:20%:30% calorie ratio did not add up to 100% and regret that this was not caught before final publication. In truth, the additional 10% could be all relegated to carbohydrate or divided, as Ms Stegemann suggests, between carbohydrate and fat or, for that matter, between carbohydrate and protein. The only objection to making the carbohydrate 50% of the calories is the possible effect this may have in stimulating very low density lipoprotein overproduction in patients susceptible to carbohydrate induction. Thus, I would accept the correction of Ms Stegemann with the provision that the type 2 hyperproteinemic patients should have 50%:20%:30% as their ratio, whereas type 4 hyperproteinemic patients might use the ratio 40%:20%:40% to better advantage. The point raised by Ms Stegemann with regard to the division of carbohydrates is a good one. Simple sugars, particularly fructose, are thought to be
Raised plasma concentrations of 3-methoxy-4-hydroxyphenylethyleneglycol in cirrhotic patients with or without hepatic encephalopathy.
Authors: H Echizen, A Minegishi, S Hayashi, N Umeda, T Oda, T Ishizaki
Journal: Gut (1989)

We measured the plasma concentration of a centrally derived noradrenaline (NA) metabolite, 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), in 20 cirrhotic patients (eight with (group A) and 12 without (group B) hepatic encephalopathy (HE] and in 14 age matched healthy subjects to study if the central NA metabolism would be altered in liver cirrhosis patients, particularly in those with HE. The mean (SEM) plasma MHPG concentrations in the patient groups, group A (74.9 (8.6) pmol/l) and B (54.8 (7.2) pmol/l), were significantly (p less than 0.01) greater than in the control group (22.3 (2.0) pmol/l), and that in group A was significantly (p less than 0.05) greater than in group B. The plasma concentration of MHPG observed in these study subjects (n = 34) correlated (rs = 0.77, p less than 0.01) more strongly with the ratio of plasma catecholamine precursor amino acids (tyrosine and phenylalanine) to other neutral amino acids (tryptophan, leucine, isoleucine, and valine) known to compete with catecholamine precursor amino acids for uptake into the brain than with plasma concentration of tyrosine plus phenylalanine alone (rs = 0.63, p less than 0.01). In addition, the mean plasma MHPG concentrations measured in another group of eight cirrhotic patients (group C) during HE (79.3 (10.6) pmol/l) was significantly (p less than 0.01) greater than that measured after the recovery from HE (47.2 (5.2) pmol/l). The results suggest that the central NA metabolism may be altered in patients with liver cirrhosis, particularly in those with HE, and that the derangement in the central NA metabolism may be associated not only with an increase in plasma catecholamine precursor amino acids but also with a decrease in branched chain amino acids.
Monitoring effects of deprivation on health
Authors: M. Ryan, G. Barrett, L. Lessof
Journal: BMJ (1995)

Living close to industryEDrrOR,-Ian Harvey describes some of the diffi- culties of determining whether living close to industry harms people's health.'Scottish studies that colleagues and I carried out during the 1970s and 1980s used several techniques for sharpening the focus on this type of epidemiology of small areas.2 3
Treatment of bronchopulmonary aspergillosis with observations on the use of natamycin
Authors: A. H. Henderson, J. E. G. Pearson
Journal: Thorax (1968)

The problems of treatment in bronchopulmonary aspergillosis are discussed and illustrated by 11 case reports—four with aspergilloma, six with allergic aspergillosis, and two with probable allergic aspergillosis. A simple and effective treatment of aspergilloma, by local surgical evacuation of the cavity followed by irrigation with natamycin (Pimaricin), is described in three cases. Prior treatment of these cases with inhalations or intrabronchial instillations of natamycin was of doubtful benefit. The therapy of allergic aspergillosis is reviewed and an active approach is urged, based on the probable pathogenesis of the disease. This includes consideration of physical methods of removing bronchial plugs, mucolytic agents, steroids, and antifungal drugs given by aerosol in the absence of any that are suitable for systemic use. Steroids improved ventilatory function and were effective in resolving and preventing further episodes of pulmonary eosinophilia, but not usually in clearing the fungus from the bronchial tree, probably because permanent damage had already been sustained; they also carry the theoretical risk of allowing fungal invasion. Natamycin inhalations alone are considered of little value in the active disease, although their place in prophylaxis and when used with steroids remains to be evaluated. Mucolytic agents may help to clear the bronchial secretions, especially when these have become chronically impacted.
Feasibility and effectiveness of a low cost campaign on antibiotic prescribing in Italy: community level, controlled, non-randomised trial
Authors: G. Formoso, B. Paltrinieri, A. M. Marata, C. Gagliotti, A. Pan, M. L. Moro, O. Capelli, N. Magrini
Journal: BMJ (2013)

<b>Objectives</b> To test the hypothesis that a multifaceted, local public campaign could be feasible and influence antibiotic prescribing for outpatients. <b>Design</b> Community level, controlled, non-randomised trial. <b>Setting</b> Provinces of Modena and Parma in Emilia-Romagna, northern Italy, November 2011 to February 2012. <b>Population</b> 1 150 000 residents of Modena and Parma (intervention group) and 3 250 000 residents in provinces in the same region but where no campaign had been implemented (control group). <b>Interventions</b> Campaign materials (mainly posters, brochures, and advertisements on local media, plus a newsletter on local antibiotic resistance targeted at doctors and pharmacists). General practitioners and paediatricians in the intervention area participated in designing the campaign messages. <b>Main outcomes measures</b> Primary outcome was the average change in prescribing rates of antibiotics for outpatient in five months, measured as defined daily doses per 1000 inhabitants/day, using health districts as the unit of analysis. <b>Results</b> Antibiotic prescribing was reduced in the intervention area compared with control area (−4.3%, 95% confidence interval −7.1% to −1.5%). This result was robust to "sensitivity analysis" modifying the baseline period from two months (main analysis) to one month. A higher decrease was observed for penicillins resistant to β lactamase and a lower decrease for penicillins susceptible to β lactamase, consistent with the content of the newsletter on antibiotic resistance directed at health professionals. The decrease in expenditure on antibiotics was not statistically significant in a district level analysis with a two month baseline period (main analysis), but was statistically significant in sensitivity analyses using either a one month baseline period or a more powered doctor level analysis. Knowledge and attitudes of the target population about the correct use of antibiotics did not differ between the intervention and control areas. <b>Conclusions</b> A local low cost information campaign targeted at citizens, combined with a newsletter on local antibiotic resistance targeted at doctors and pharmacists, was associated with significantly decreased total rates of antibiotic prescribing but did not affect the population's knowledge and attitudes about antibiotic resistance. <b>Trial registration</b> ClinicalTrials.gov NCT01604096.
The Growing Demand for Medical Care
Authors: Victor R. Fuchs
Journal: New England Journal of Medicine (1968)

Recent years have witnessed a sharp upsurge of interest in the economics of health.On the one hand, physicians, hospital administrators, public health officials, and other health experts are becoming increasingly aware of the need to carry out informed systematic analyses of the problems of organizing, financing, and distributing health services.On the other hand, economists are discovering the tremendous economic importance and challenge of health care and are beginning to apply to this field the analytical tools and concepts that have proved useful in a large variety of other situations.One such concept is that of demand, and this paper attempts to analyze the growing demand for medical care.The application of economics to medical care is not a simple matter.It is desirable, therefore, to define terms before the analysis is begun.Demand, to the economists, is a technical term with a fairly precise meaning.When an economist talks about the demand for medical care, or any other good or service, he is talking about a willingness and ability to pay.This term should not be confused with "need" or "want" or "desire," although these words are frequently used interchangeably
US heart doctors defend new prevention guidelines
Authors: M. McCarthy
Journal: BMJ (2013)

The American Health Association and the American College of Cardiology have defended their new prevention guidelines after critics charged that a risk assessment tool included in the document might put millions of Americans on cholesterol lowering drugs unnecessarily.

“We stand behind our guidelines [and] the process that was used to create them,” said Mariell Jessup, president of the American Heart Association, in a statement issued in response to the criticism, which has been reported widely in the US media.

At issue is a risk calculator designed to help guide the decision whether a patient should be prescribed a statin, by estimating the patient’s 10 year risk of having a heart attack …
Flow Study and SPECT Imaging for the Diagnosis of Giant Cell Tumor of Bone
Authors: ARTHUR Z. KRASNOW, ALI T. ISITMAN, B DAVID COLLIER, FORREST T. BATES, ROBERT S. HELLMAN
Journal: Clinical Nuclear Medicine (1988)

A case of giant cell tumor of bone is reported in which the blood flow study along with SPECT imaging improved the visualization and diagnosis of the abnormality.
Clinical evaluation of a serological assay using a monoclonal antibody (TB72) to the 38 kDa antigen of Mycobacterium tuberculosis
Authors: GH Bothamley, RM Rudd
Journal: European Respiratory Journal (1994)

We examined an enzyme-linked immunosorbent assay (ELISA) modification of a radioimmunoassay, using the TB72 monoclonal antibody, as a serological test for tuberculosis in a clinical setting. Sera were obtained from 238 patients with suspected pulmonary tuberculosis, 30 patients treated for tuberculosis, 28 contacts, and 480 random samples from inpatients. Antibody levels were measured as the dilution of serum causing 50% inhibition of binding of the TB72 monoclonal antibody, which binds to an epitope of the 38 kDa antigen specific to the Mycobacterium tuberculosis complex, a positive titre being &gt; 3. Positive antibody titres were present in 21 out of 25 (84%) patients with smear-positive and 22 out of 27 (82%) patients with smear-negative, culture-positive tuberculosis, and 37 out of 41 (90%) patients successfully treated for tuberculosis but without bacteriological confirmation of disease. Three out of 82 (4%) patients with a firm alternative diagnosis to tuberculosis gave a positive result. Serological tests were negative within 2.5 yrs of successful treatment. Patients without a definite diagnosis one year after tuberculosis had been suspected, and those who had received inadequate treatment for tuberculosis, were frequently positive (21 out of 31 and 21 out of 32, respectively). Positive tests concurred with tuberculin reactivity in 8 out of 11 contacts given chemoprophylaxis. Screening of 480 random serum samples gave 22 positive titres, 16 of which were not associated with tuberculosis; none of these 16 had an antibody titre &gt; 10. We conclude that the TB72 test provides additional information in the diagnosis and treatment of tuberculosis. Antibody titres &gt; 10 suggests active tuberculosis; titres of 3-10 merit observation.
Epidemiology of Norwalk Gastroenteritis and the Role of Norwalk Virus in Outbreaks of Acute Nonbacterial Gastroenteritis
Authors: JONATHAN E. KAPLAN
Journal: Annals of Internal Medicine (1982)

Outbreaks of Norwalk gastroenteritis, which may involve persons of all ages, occur during all seasons and in various locations. Waterborne, foodborne, and person-to-person modes of transmission have been described, and secondary person-to-person transmission is common. Outbreaks generally end in about 1 week; longer outbreaks occur only when new groups of susceptible persons are introduced, usually in the setting of a persistent common source of infection. The illness is generally mild and characterized by nausea, vomiting, diarrhea, and abdominal cramps. Vomiting is the predominant symptom among children, whereas diarrhea is commoner among adults. Forty-two percent of 74 outbreaks of acute nonbacterial gastroenteritis investigated by the Centers for Disease Control from 1976 to 1980 were attributed to the Norwalk virus. The rest resembled Norwalk outbreaks clinically and epidemiologically and were probably caused by 27-nm viral agents similar to the Norwalk virus.
Weekly Docetaxel and Prednisolone versus Prednisolone Alone in Androgen-Independent Prostate Cancer: A Randomized Phase II Study
Authors: Sophie D. Fosså, Anne-Birgitte Jacobsen, Claes Ginman, Inga N. Jacobsen, Sissel Overn, Jon R. Iversen, Thomas Urnes, Alv A. Dahl, Marijke Veenstra, Berit Sandstad
Journal: European Urology (2007)
Mechanism of Effect of Thoracic Inferior Vena Cava Constriction on Renal Water Excretion
Authors: Robert J. Anderson, Pravit Cadnapaphornchai, Judith A. Harbottle, Keith M. McDonald, Robert W. Schrier
Journal: Journal of Clinical Investigation (1974)

Persistent secretion of vasopressin and/ or diminished distal fluid delivery have been proposed to explain the impaired water excretion associated with low-output cardiac failure. In the present investigation cardiac output (CO) was diminished in anesthetized dogs undergoing a water diuresis by constriction of the thoracic inferior vena cava (TIVC). In intact animals (group I) acute TIVC constriction decreased CO from 3.5 to 2.2 liters/min (P < 0.005) as urinary osmolality (U(osm)) increased from 103 to 543 mosmols/ kg (P < 0.001) and free water clearance (C(H2o)) decreased from 2.1 to -0.6 ml/min (P < 0.001). This antidiuretic effect was disassociated from changes in renal arterial and venous pressures, glomerular filtration rate, solute excretion, and renal innervation. To examine the role of vasopressin in this antidiuresis, studies (group II) were performed in acutely hypophysectomized, steroid-replaced animals. In these animals TIVC constriction decreased CO to a similar degree from 3.4 to 2.1 liters/min (P < 0.001). However, the effects on U(osm) (87-104 mosmols/kg) and C(H2o) (2.1-1.6 ml/min) were significantly less than in intact dogs. In another group of hypophysectomized animals, (group III) renal arterial and venous pressures were not controlled, and the effect of TIVC constriction on U(osm) was not significant (65-79 mosmols/kg) although C(H2o) decreased from 3.3 to 1.9 ml/min (P < 0.001). In both the group II and III studies, there were linear correlations between the changes in C(H2o) and the urine flow. Studies were also performed in baroreceptor-denervated animals with intact hypothalamo-neurohypophyseal tracts, and acute TIVC constriction altered neither U(osm) nor C(H2o) when renal arterial pressure was controlled. These results therefore indicate that the effect of TIVC constriction on U(osm) is primarily vasopressin mediated while the effect on C(H2o) is mediated both by vasopressin release and diminished distal fluid delivery. A decrease in renal arterial pressure, or some consequence thereof, seems to be an important determinant of the latter effect.
The single‐dose pharmacokinetics of alitretinoin and its metabolites are not significantly altered in patients with cirrhosis
Authors: J.P. Thyssen, L. Vester, C. Grønhøj Larsen, K. Smidt, P. Jakobsen, S.H. Hansen, D. Vind‐Kezunovic, L.L. Gluud, F. Grønhøj Larsen
Journal: British Journal of Dermatology (2013)

Journal Article The single‐dose pharmacokinetics of alitretinoin and its metabolites are not significantly altered in patients with cirrhosis Get access J.P. Thyssen, J.P. Thyssen Department of Dermato‐allergology Copenhagen University Hospital Gentofte Hellerup Denmark Search for other works by this author on: Oxford Academic Google Scholar L. Vester, L. Vester Department of Dermato‐allergology Copenhagen University Hospital Gentofte Hellerup Denmark Search for other works by this author on: Oxford Academic Google Scholar C. Grønhøj Larsen, C. Grønhøj Larsen Department of Otolaryngology, Head and Neck Surgery Copenhagen University Hospital Rigshospitalet Copenhagen Denmark Correspondence Frederik Grønhøj Larsen. E‐mail: fg@hudklinikkentaastrup.dk Search for other works by this author on: Oxford Academic Google Scholar K. Smidt, K. Smidt Department of Biomedicine‐Pharmacology Aarhus University Aarhus Denmark Search for other works by this author on: Oxford Academic Google Scholar P. Jakobsen, P. Jakobsen Department of Biomedicine‐Pharmacology Aarhus University Aarhus Denmark Search for other works by this author on: Oxford Academic Google Scholar S.H. Hansen, S.H. Hansen Department of Pharmacy University of Copenhagen Copenhagen Denmark Search for other works by this author on: Oxford Academic Google Scholar D. Vind‐Kezunovic, D. Vind‐Kezunovic Department of Dermato‐allergology Copenhagen University Hospital Gentofte Hellerup Denmark Search for other works by this author on: Oxford Academic Google Scholar L.L. Gluud, L.L. Gluud Department of Internal Medicine Copenhagen University Hospital Gentofte Hellerup Denmark Search for other works by this author on: Oxford Academic Google Scholar F. Grønhøj Larsen F. Grønhøj Larsen Taastrup Dermatology Clinic Taastrup Denmark Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 170, Issue 2, 1 February 2014, Pages 408–414, https://doi.org/10.1111/bjd.12546 Published: 01 February 2014
FUNGAL INFECTION IN OTOLOGY.
Authors: G. D. L. SMYTH
Journal: British Journal of Dermatology (1964)

Journal Article FUNGAL INFECTION IN OTOLOGY. Get access G. D. L. SMYTH, M.D., F.R.C.S., D.L.O. G. D. L. SMYTH, M.D., F.R.C.S., D.L.O. Senior Registrar, Ear, Nose and Throat Department, Royal Victoria Hospital, Belfast Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 76, Issue 10, 1 October 1964, Pages 425–428, https://doi.org/10.1111/j.1365-2133.1964.tb14466.x Published: 01 October 1964