tbuckley/cabot-search huggingface dataset:
Measurement of circumference of the knee with ordinary tape measure.
Authors: J J Nicholas, F H Taylor, R B Buckingham, D Ottonello
Journal: Annals of the Rheumatic Diseases (1976)

The circumference of the knees and thighs at three locations was measured in 10 patients on two consecutive occasions by three observers. Analysis of the results for interobserver, intraobserver and among-patient variation established that a change in circumference noted by different observers on two different days is significant if it exceeds 1-5 cm at the midpatella, 2-7 cm at 7 cm above, and 3-5 cm at 15 cm above the patella. If a single observer performs both measurements, the change need exceed only 1-0, 2-0, and 2-7 cm, respectively, to be significant.
Menopause and Risk Factors for Coronary Heart Disease
Authors: Karen A. Matthews, Elaine Meilahn, Lewis H. Kuller, Sheryl F. Kelsey, Arlene W. Caggiula, Rena R. Wing
Journal: New England Journal of Medicine (1989)

Postmenopausal women are believed to have a higher risk of coronary artery disease than premenopausal women. In this study, we prospectively determined changes in coronary risk factors that were attributable to natural menopause in 541 healthy, initially premenopausal women 42 to 50 years of age. After approximately 2 1/2 years, 69 women had spontaneously stopped menstruating for at least 12 months, and 32 women had stopped natural menstruation and received hormone-replacement therapy for a period of at least 12 months. An equal number of age-matched premenopausal women in the study group served as controls. In women who had a natural menopause and did not receive hormone-replacement therapy, serum levels of high-density lipoprotein (HDL) cholesterol declined as compared with those of premenopausal controls (-0.09 vs. 0.00 mmol per liter; P = 0.01), and levels of low-density lipoprotein (LDL) cholesterol increased (+0.31 vs. +0.14 mmol per liter; P = 0.04). In menopausal women who received hormone-replacement therapy, HDL and LDL cholesterol levels did not change, but the levels of triglycerides (+0.42 vs. -0.04 mmol per liter; P less than 0.001), apolipoprotein A-I (+0.18 vs. +0.03 g per liter; P less than 0.01), and apolipoprotein A-II (+0.05 vs. -0.03 g per liter; P less than 0.05) increased as compared with premenopausal controls. Natural menopause did not affect blood pressure, plasma glucose or insulin levels, body weight, the total number of kilojoules consumed in the diet, or the total number of kilojoules expended in physical activity. These results suggest that a natural menopause has an unfavorable effect on lipid metabolism, which may contribute to an increase in the risk of coronary disease. Hormone-replacement therapy may prevent some of these changes.
Doctor of Pharmacy
Authors: Donald E. Routzahn
Journal: JAMA (1983)

To the Editor.—  Dr John Biles' COMMENTARY makes several points that require further elaboration to define more accurately the doctor of pharmacy degree and refute the aura of elitism that was created by him around this degree.  First of all, the first five years of study in both the baccalaureate and PharmD curricula are almost identical, with the student's choice in elective classes accounting for the only differences. The sixth year of study in the PharmD program offers the student a chance to pursue subjects of particular clinical interest.  Second, the implication was made that only PharmD students are required to pass state board examinations to gain licensure to practice. All pharmacy students, irrespective of degree, must successfully complete identical state board examinations after completing the required course work and internship period before licensure is granted.  Third, Dr Biles lists 12 supportive services to physicians, nurses, dentists, and patients that
Abstract P1-09-08: Breast cancer (BC) outcomes after implementation of “Seguro popular” at the National Institute of Medical Sciences and Nutrition, Salvador Zubiran (INCMNSZ) in Mexico
Authors: A Castro Sánchez, MI Meneses Medina, Y Chávarri Guerra, SI Pérez Álvarez, E León Rodríguez, A Armengol Alonso
Journal: Cancer Research (2013)

Abstract Background: In Mexico 60% of newly diagnosed BC patients present with locally advanced disease. In the United States, 88-95% of patients present with early stage disease, however in Mexico, only 10% of patients are diagnosed at this stage. The Seguro Popular (SP), a national insurance scheme for Mexico's poor and uninsured population, was implemented for BC in 2007. The SP covers diagnostics, local and systemic treatment for BC patients. The INCMNSZ is a third level hospital where patients receive diagnosis and treatment for non-malignant diseases, and also routinely conducts BC annual mammography screening for women ≥ 50 years old. We aimed to evaluate BC outcomes in our patients following the implementation of SP at our institution. Methods: From January 2011 to May 2013, we prospectively evaluated a cohort of 93 patients with BC included in the SP program at the INCMNSZ. A retrospective cohort of 99 patients without SP access who received neoadjuvant chemotherapy from January 2007 to December 2009 was used for comparative analysis. Complete pathologic response (pCR) was defined as complete absence of invasive tumor in breast and axillary nodes. We used Fisher's exact test to compare pCR between groups. Results: A total of 93 patients were diagnosed with BC and included in the SP program. 10 patients were excluded from the analysis- (5 were lost to follow-up and 5 had missing data. Median age was 52 (46-59) years and 37 patients (45%) were premenopausal at diagnosis), median follow up 11.8 months. 20 patients (24%) had stage I, 36 (43%) stage II, 7 (8%) stage III, and 20 (24%) stage IV. 55 (66%) patients had hormone receptor (HR) positive (ER + and/or PR+), 15 (18%) HER2+ and 13 (16%) had triple negative (TN) tumors. Thirty-two (39%) patients received neoadjuvant chemotherapy. 27% of patients achieved pCR (17% in HR positive, 20% in TN and 50% in HER2+ tumors) compared to 15% in the non SP cohort (11% in HR positive, 22% in TN and 14% in HER2+ tumors). HER2+ tumors from the SP cohort reached significantly higher pCR rates than in the non SP cohort (p = 0.029). Discussion: Our results confirmed that about half of our patients were diagnosed with early stage BC, which highlights the importance of a screening program at our institution. Increased pCRs in the HER2+ subgroup may reflect wider access to trastuzumab after implementation of SP. Although we acknowledge a short period of follow-up in our cohort, our results in pCR are comparable to those previously reported in the literature. We believe the SP had a positive impact on access to care and outcomes in our patients. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-09-08.
Allergen vaccination with a liposome-encapsulated extract of Dermatophagoides pteronyssinus : A randomized, double-blind, placebo-controlled trial in asthmatic patients
Authors: Antonio Basomba, Ana I. Tabar, Dolores Hernández F. de Rojas, Blanca E. García, Remedios Alamar, José M. Olaguíbel, Jaime Moscoso del Prado, Santiago Martín, Pilar Rico
Journal: Journal of Allergy and Clinical Immunology (2002)
AIDS Drug Development, Availability Intensify
Authors: Marsha F. Goldsmith
Journal: JAMA (1989)

RECENT ACTIONS by federal health officials deliver on promises made in Montreal at the Fifth International Conference on Acquired Immunodeficiency Syndrome (AIDS) to speed up development, clinical trials, and availability of drugs to combat human immunodeficiency virus (HIV) disease. A month ago, the Food and Drug Administration (FDA) approved for marketing ganciclovir, produced by Syntex Corporation, Palo Alto, Calif, which is used to treat cytomegalovirus retinitis. The agency also gave the status of "investigational new drug for treatment"—thus allowing expanded premarket distribution—to recombinant human erythropoietin used to treat AIDS-associated anemia, produced by Ortho Pharmaceutical Corporation, Raritan, NJ. Ortho has announced that the company will provide the drug free during testing to patients who are anemic either as a result of HIV infection or because of the effects of taking zidovudine, or AZT. Two weeks earlier, the FDA approved for marketing aerosolized pentamidine (made by Lyphomed Inc, Rosemont, Ill) as prophylaxis
1,1-Dichloroethylene hepatotoxicity: Proposed mechanism of action and distribution and binding of <sup>14</sup> C radioactivity following inhalation exposure in rats
Authors: Rudolph J. Jaeger, Lawrence G. Shoner, Linda Coffman
Journal: Environmental Health Perspectives (1977)

1,1-Dichloroethylene is reported to produce renal tumors in male mice. It is an hepatotoxin in fasted rats after inhalation. We found that trichloropropane epoxide, an inhibitor of epoxide hydrase, enhances hepatic injury as measured by serum sorbitol dehydrogenase elevation. A significant elevation of hepatic citric acid concentration was seen in fasted but not fed rats. We hypothesized that mitochondrial injury was associated with inhibition of the tricarboxylic acid cycle and postulated that monochloroacetic acid was a toxic metabolite of 1,1-DCE. Fluoroacetic acid and chloroacetic acid were similar in their ability to inhibit oxygen uptake when pyruvic and malic acids were substrates in isolated mitochondria supplemented with adenosine diphosphate. In experiments where 1,1-DCE metabolism was estimated, no difference between the rate of uptake in a 2-hr period was detected between fed and fasted animals. Urinary output of radioactivity at 26 hr for fed and fasted rats was similar. Water-soluble (i.e. TCA-soluble) 1,1-DCE metabolites were found in tissues of fasted rats in excess of that seen in fed rats. The kidney had the largest concentration of total metabolites. Tissue-bound, or TCA-insoluble, radioactivity was associated with the mitrochondrial and microsomal fraction of fasted rats in excess of that seen in fed rats. The disappearance of TCA-insoluble radioactivity from the mitochondrial and microsomal fractions was comparable in rate between fed and fasted rats respectively. These results suggest that 1,1-DCE is metabolized quite rapidly in the organism to TCA-soluble components which are excreted by the kidneys. Metabolites of 1,1-DCE may enter the metabolic pool, since a reasonably short turnover of 14C-labeled, bound material was observed. The metabolite of 1,1-DCE appears to inhibit the mitochondria so that citric acid accumulates. This may occur by a process of lethal synthesis.
G-protein-coupled receptor 30/adenylyl cyclase/protein kinase A pathway is involved in estradiol 17ß-<scp>d</scp>-glucuronide-induced cholestasis
Authors: Andrés E. Zucchetti, Ismael R. Barosso, Andrea C. Boaglio, Cecilia L. Basiglio, Gisel Miszczuk, M. Cecilia Larocca, M. Laura Ruiz, Carlos A. Davio, Marcelo G. Roma, Fernando A. Crocenzi, Enrique J. Sánchez Pozzi
Journal: Hepatology (2013)

Estradiol-17ß-D-glucuronide (E17G) activates different signaling pathways (e.g., Ca(2+) -dependent protein kinase C, phosphoinositide 3-kinase/protein kinase B, mitogen-activated protein kinases [MAPKs] p38 and extracellular signal-related kinase 1/2, and estrogen receptor alpha) that lead to acute cholestasis in rat liver with retrieval of the canalicular transporters, bile salt export pump (Abcb11) and multidrug resistance-associated protein 2 (Abcc2). E17G shares with nonconjugated estradiol the capacity to activate these pathways. G-protein-coupled receptor 30 (GPR30) is a receptor implicated in nongenomic effects of estradiol, and the aim of this study was to analyze the potential role of this receptor and its downstream effectors in E17G-induced cholestasis. In vitro, GPR30 inhibition by G15 or its knockdown with small interfering RNA strongly prevented E17G-induced impairment of canalicular transporter function and localization. E17G increased cyclic adenosine monophosphate (cAMP) levels, and this increase was blocked by G15, linking GPR30 to adenylyl cyclase (AC). Moreover, AC inhibition totally prevented E17G insult. E17G also increased protein kinase A (PKA) activity, which was blocked by G15 and AC inhibitors, connecting the links of the pathway, GPR30-AC-PKA. PKA inhibition prevented E17G-induced cholestasis, whereas exchange protein activated directly by cyclic nucleotide/MAPK kinase, another cAMP downstream effector, was not implicated in cAMP cholestatic action. In the perfused rat liver model, inhibition of the GPR30-AC-PKA pathway totally prevented E17G-induced alteration in Abcb11 and Abcc2 function and localization.Activation of GPR30-AC-PKA is a key factor in the alteration of canalicular transporter function and localization induced by E17G. Interaction of E17G with GPR30 may be the first event in the cascade of signaling activation.
Early Diagnosis and Treatment of Pancreatic Dysplasia in Patients with a Family History of Pancreatic Cancer
Authors: Teresa A. Brentnall, Mary P. Bronner, David R. Byrd, Rodger C. Haggitt, Michael B. Kimmey
Journal: Annals of Internal Medicine (1999)

Background: Pancreatic cancer, the fourth most common cause of cancer death in the United States, is hereditary in an estimated 10% of cases. Surveillance of patients with a familial predisposition for pancreatic cancer has not been systematically evaluated. Objective: To develop a surveillance program that can identify and treat patients who have precancerous conditions of the pancreas and a family history of pancreatic cancer. Design: Prospective cohort study. Setting: University medical center. Patients: 14 patients from three kindreds with a history of pancreatic cancer. Interventions: Endoscopic ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), spiral computed tomography, and serum carcinoembryonic antigen and CA19-9 analysis were performed in all patients. Four affected patients were tested for the K- ras mutation. Main Outcome Measurement: Pancreatic dysplasia was determined by histologic evaluation. Results: Seven of the 14 patients were believed to have dysplasia on the basis of clinical history and abnormalities on endoscopic ultrasonography and ERCP and were referred for pancreatectomy. All 7 patients had histologic evidence of dysplasia in pancreatectomy specimens. Findings on endoscopic ultrasonography were subtle, nonspecific, and similar to those seen in patients with chronic pancreatitis. Findings on ERCP ranged from mild and focal side-branch duct irregularities and small sacculations to main-duct strictures and grapelike clusters of saccules. Some of these changes are typical of chronic pancreatitis, but others are more distinctive. Spiral computed tomography and serum tumor markers had low sensitivity in the detection of pancreatic dysplasia. Analysis for the K- ras mutation yielded positive results in 3 of 4 patients with dysplasia. Conclusions: Thorough screening of patients with a family history of pancreatic cancer is feasible. Clinical data combined with imaging studies (endoscopic ultrasonography and ERCP) can be used to identify high-risk patients who have dysplasia. The role of molecular genetic testing is uncertain at this time.
Systemic hypertension induced by hepatic overexpression of human preproendothelin-1 in rats.
Authors: V Niranjan, S Télémaque, D deWit, R D Gerard, M Yanagisawa
Journal: Journal of Clinical Investigation (1996)

Endothelin-1 (ET-1) has been implicated in the regulation of vascular tone in various pathological conditions. To examine the effect of in vivo overexpression of the peptide in rats, we prepared recombinant adenovirus stocks encoding the human preproET-1 cDNA (Ad.ET-1) or Escherichia coli lacZ (Ad.betaGal), each driven by cytomegalovirus early promoter. Ad.ET-1 or Ad.betaGal was injected into the caudal vein of rats and the animals were studied under anesthesia 96 h later. Hepatic overexpression of the virus-derived human ET-1 mRNA was accompanied by a 13-fold elevation of liver ET-1 content in the Ad.ET-1 group. Circulating plasma ET-1 levels in the Ad.ET-1 group were sixfold higher than those in the Ad.betaGal group. Mean arterial blood pressure was increased by 28 mmHg in the Ad.ET-1 group as compared with the Ad.betaGal group. In the Ad.ET-1 group, intravenous infusion of the ET(A) receptor antagonist FR 139317 reduced the blood pressure to levels seen in the Ad.betaGal group, whereas the same antagonist did not significantly alter the blood pressure in the Ad.betaGal group. Intravenous infusion of the ET(B) receptor antagonist BQ-788 caused a small but significant increase in blood pressure in both groups. These findings demonstrate that endogenous overexpression of preproET-1, accompanied by an elevation of plasma ET-1 concentrations to the levels seen in pathophysiological states, can cause systemic hypertension through the activation of the ETA receptor.
X-Linked Mental Deficiency Megalotestes Syndrome
Authors: Rogelio H. A. Ruvalcaba
Journal: JAMA (1977)

Members of two kindreds had mental deficiency and megalotestes. The familial occurrence suggests an X-linked recessive trait or autosomal-dominant trait with male sex limitation. The increased testicular size was apparently due to excess fluid content. (<i>JAMA</i>238:1646-1650, 1977)
Serial Contrast-Enhanced Cardiac Magnetic Resonance Imaging Demonstrates Regression of Hyperenhancement Within the Coronary Artery Wall in Patients After Acute Myocardial Infarction
Authors: Tareq Ibrahim, Markus R. Makowski, Antanas Jankauskas, David Maintz, Martin Karch, Sylvia Schachoff, Warren J. Manning, Albert Schömig, Markus Schwaiger, Rene M. Botnar
Journal: JACC. Cardiovascular imaging (2009)
Skin Tests, Penicillin G Procaine, and Pseudoanaphylaxis
Authors: Richard D. Mirel
Journal: JAMA (1978)

ALTHOUGH true hypersensitivity to penicillin G procaine is well recognized, there has been recent emphasis on nonallergic or pseudoanaphylactic reactions to this preparation.<sup>1,2</sup>True hypersensitivity to penicillin is characterized by anaphylactoid-type reactions, while the pseudoanaphylactictype response is thought to be due to the toxic reaction from the procaine or microembolization of penicillin G procaine aggregates. Since there is no symptom complex resembling anaphylaxis and the term "pseudoanaphylaxis" is ambiguous, "nonanaphylactic reactions" will be used in this report. The nonanaphylactic reaction described by Galpin et al<sup>1</sup>resulted from the inadvertent intravenous administration of penicillin G procaine. In that report, readministration of penicillin was not accompanied by any adverse reaction. Skin testing to penicillin was not reported. The following case report describes ventricular irritability temporally related to intramuscular administration of procaine penicillin G. Initially, this was thought to represent some type of nonanaphylactic or toxic reaction to procaine; subsequent skin
ACTH and Cortisone Therapy for Recurrent Massive Gastric Hemorrhage after Subtotal Gastrectomy
Authors: Emmanuel Deutsch, John J. Todd, Robert M. Hayward
Journal: New England Journal of Medicine (1956)

THE purpose of this report is to indicate the value of ACTH and cortisone in massive gastric bleeding due to capillary fragility associated with erosions of the gastric mucosa. This local capillary fragility may be converted to capillary resistance. The effectiveness of ACTH and cortisone in hemostasis has been described by several hematol-gists1 2 3 4 5 6 7 8 in treatment of thrombocytopenic purpura. Here, the improvement in bleeding time corresponded with the rise in capillary resistance and not with the change in the platelet count.Vascular Factors in HemostasisThe mechanism whereby ACTH affects hemostasis is indicated at least partly by Robson and Duthie,2 who . . .
Medicine among Nilotics in the Sud.
Authors: S J Bowcock
Journal: BMJ (1981)

So you are going to Ler. Well, I wish you luck. I don't know how the doctor stands it out there. It's the fly capital of the world, the pilot remarked cheerfully to me as we took off in a small single-engine plane. He was taking me, together with the fortnightly supply of food, drugs, and mail, to the American couple living there. Ler was the last stop on a long journey over _ miles of crocodile L-t,-^ AroST?8^^5^ i infested swampland in I HT m*0,Wrm' o?? tne southern Sudan: an  edira?^uy *? area known as the Sud ( yV:?(fig !)? I* is extremely EGYPT  ^?, SAUW flat inhospitable country,  /? j ^S A**fflA ?4 totally cut off by floods *rL?miUM  ?'?*? f during tbe rains, while ? _ .^g'^^y-i^^^^L^^. A during the dry season y-'-V^?%:':'v^g^  the receding swamps I ?Jfc : : ? m'W:-:'-'^?\Wtt A become a semidesert. I '*>?:?: :^!v??^^:;::^#?  *^^a I Ap911 ^rom tne ^ort \'.-V%V.1?-;???^?iJ^F.->' ? Sfe I ^ghtly Pi3116 service the I  ?:???!'? ? ?-'  #T V C*^ I on^y otner regular means L^^r^^ of communication with T ^^/;:^  [ the outside world was r1 v;r  _ ^fcfe^-^'y-^k' ?'? '?' v*.1 ^y private radio. p*-* '^^^?fc??lS^ The southern Sudan T  ?-* K^ > I suffered some 17 years : A ^y K^*-J ?:i?l ?f dvil war during the Zaire , Py^N? -?apsEl I 1960s ^d '70sThis 1 i--? IvSsT'^^^Pl: resulted in all external Y%*N?^ ^ be?lg dliven OUt L ' V *   Cq^yl [ and schools and hospi |_^ /^S^ V  cl?!P^ ta^s Deing destroyed, so ^ '-^^?* the people lived without medical services for years. I chose this area for my elective because the people of the Upper Nile, the Dinka and Nuer tribes, are extremely isolated and have preserved their culture intact. I also expected to find some very primitive and basic medicine; the reality proved to be more than I imagined. There was no running water or electricity in either the house or the hospital, and everywhere there were broken windows and handleless doors. Two wells served the whole area and frequently ran dry. Paradoxically in the middle of a swamp the greatest problem was water. On arrival I was carefully warned that my room was known as the scorpion room, but I was told not to worry since there were far worse things than a few scorpions in the southern Sudan. I shall never forget my first visit to the hospital. I expected dirt but was not prepared for what I saw. Through lack of water everything was filthy: the walls, the patients, the beds, and the mattresses were all covered with a multitude of flies. Ler is a government hospital, but the doctor working there is employed by a missionary organisation and thus does not have the control or support necessary to maintain the standards that she would wish. Of 20 nurses on the payroll, only two were working. As a result I did nursing and laboratory duties as well as those of a doctor. In addition to becoming adept at the ancient art of drawing water from the well and kindling charcoal fires, I also learned how to do a third-world cross-match for transfusions and to recognise parasites such as amoeba, strongyloides, and schistosomes in stools and malarial parasites in blood films.