tbuckley/cabot-search huggingface dataset:
Teaching old drugs new tricks: asthma therapy adjusted by patient perception or noninvasive markers
Authors: P. G. Gibson
Journal: European Respiratory Journal (2005)

Asthma management is having a makeover. Three very different treatment approaches are parading the conference catwalks. Each uses long-acting β-agonists (LABA) and inhaled corticosteroids (ICS) as the basis of maintenance therapy. However, they differ substantially in how the treatment is adjusted, and in what outcomes have been reported. One approach advocates escalating ICS doses to achieve physician-assessed symptom control 1 and has recently been reviewed in the European Respiratory Journal 2. Another advocates the use of objective markers of airway inflammation (induced sputum, airway hyperresponsiveness) to adjust treatment 3, 4, and the third approach lets the patient off the leash to use LABA/ICS as needed for short-term symptom management 5.

The limitations of our current treatment approaches for asthma are well known 6, and each of these new approaches has been found to be superior to their comparator in well-conducted randomised controlled trials. So, there is a sense of optimism and excitement surrounding these different approaches to asthma management. But do they constitute a new summer frock, working with and enhancing what we have, or are they more like cosmetic surgery, artificially covering a decay in asthma management that results from a mismatch between expectation and reality?

Asthma is a variable disease, and exacerbations are responsible for a disproportionate amount of the morbidity and mortality from asthma. Current management approaches have limited efficacy for exacerbations 7. Doubling ICS doses has not been shown to be effective for exacerbation management 8, and intensive self-management programmes are required to reinforce adherence and reduce exacerbations 9. Using these approaches, an emergency department visit for asthma can be prevented in one out of every 22 patients who complete an asthma self-management programme (number needed to treat (NNT) = 22) 9. Several limitations to this approach are that …
Themis controls thymocyte selection through regulation of T cell antigen receptor–mediated signaling
Authors: Guo Fu, Sébastien Vallée, Vasily Rybakin, Marielena V McGuire, Jeanette Ampudia, Claudia Brockmeyer, Mogjiborahman Salek, Paul R Fallen, John A H Hoerter, Anil Munshi, Yina H Huang, Jianfang Hu, Howard S Fox, Karsten Sauer, Oreste Acuto, Nicholas R J Gascoigne
Journal: Nature Immunology (2009)
Respiratory-Syncytial-Virus Infections, Reinfections and Immunity
Authors: Frederick W. Henderson, Albert M. Collier, Wallace A. Clyde, Floyd W. Denny
Journal: New England Journal of Medicine (1979)

To better understand acquired immunity to respiratory-syncytial-virus infections, we analyzed data from a 10-year study of respiratory illness in normal children who were followed longitudinally from early infancy. Immunity was measured in terms of failure to become infected or reduction in severity of clinical illness upon reinfection. Outbreaks of infections occurred seven times over the 10-year-period. During epidemics the attack rate for first infection was 98 per cent. The rate for second infections (75 per cent) was modestly reduced (P less than 0.001); that for third infections was 65 per cent. Age and history of infection both influenced illness. Immunity induced by a single infection had no demonstrable effect on illness associated with reinfection one year later; however, a considerable reduction in severity occurred with the third infection. These observations suggest that amelioration of illness--rather than prevention of infection--may be a realistic goal for immunoprophylaxis.
Herpes simplex virus type 2 in acute aseptic meningitis.
Authors: B Skoldenberg, S Jeansson, S Wolontis
Journal: BMJ (1973)

Latent Morbidity after Abortion SIR,-Therapeutic abortion is now one of the operations most commonly performed in the U.K., and it is right that the short-term and long-term hazards should be fully explored.Unfortunately, the report by Margaret and Arthur Wynn, of which you write so eulo- gistically in your leading article (3 March, p. 506), presents no new data, and its only true contribution is polemical.Dr. D. M. Potts (24 March, p. 739) has already shown that the interpretation by the Wynns of the risks of subsequent ectopic pregnancy, low-birth-weight babies, and con- genital malformations were erroneous.Simi- larly Mr. A. D. R
One-Time Screening for Colorectal Cancer with Combined Fecal Occult-Blood Testing and Examination of the Distal Colon
Authors: David A. Lieberman, William V. Harford, Dennis J. Ahnen, Dawn Provenzale, Stephen J. Sontag, Thomas G. Schnell, Gregorio Chejfec, Donald R. Campbell, Theodore E. Durbin, John H. Bond, Douglas B. Nelson, Stephen L. Ewing, George Triadafilopoulos, Francisco C. Ramirez, John G. Lee, Judith F. Collins, M. Brian Fennerty, Tiina K. Johnston, Christopher L. Corless, Kenneth R. McQuaid, Harinder Garewal, Richard E. Sampliner, Thomas G. Morales, Ronnie Fass, Robert E. Smith, Yogesh Maheshwari, David G. Weiss
Journal: New England Journal of Medicine (2001)

Fecal occult-blood testing and sigmoidoscopy have been recommended for screening for colorectal cancer, but the sensitivity of such combined testing for detecting neoplasia is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence of neoplasia and the sensitivity of one-time screening with a fecal occult-blood test plus sigmoidoscopy.
Medical Genius and Contemporary Criticism
Authors: WINSTON F. HARRISON
Journal: Annals of Internal Medicine (1930)

Article1 March 1930Medical Genius and Contemporary CriticismWINSTON F. HARRISON, M.D., C.M.WINSTON F. HARRISON, M.D., C.M.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-3-9-928 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe concept "Genius" in medicine is difficult to formulate and to define accurately. That genius is a natural gift, something born within a man, the word itself implies. Some would define it as a spontaneous faculty of the mind which accomplishes remarkable things without apparent effort. Yet the genius that has won the greatest and most enduring success has been joined with tireless industry and painstaking. There is an old saying that genius consists in sufficient patience. For convenience let us think here of the word as designating great men in medical history who, whatever their status may be to... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: WINSTON F. HARRISON, M.D., C.M.Affiliations: Montreal, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1930Volume 3, Issue 9Page: 928-942 ePublished: 1 December 2008 Issue Published: 1 March 1930 PDF downloadLoading ...
Erythrocyte echinocytosis in liver disease. Role of abnormal plasma high density lipoproteins.
Authors: J S Owen, D J Brown, D S Harry, N McIntyre, G H Beaven, H Isenberg, W B Gratzer
Journal: Journal of Clinical Investigation (1985)

Echinocytes were frequently found in patients with liver disease when their blood was examined in wet films, but rarely detected in dried, stained smears. When normal erythrocytes (discocytes) were incubated with physiologic concentrations of the abnormal high density lipoproteins (HDL) from some jaundiced patients, echinocytosis developed within seconds. Other plasma fractions were not echinocytogenic. There was a close correlation between the number of echinocytes found in vivo and the ability of the corresponding HDL to induce discocyte-echinocyte transformation. On incubation with normal HDL, echinocytes generated in vitro rapidly reverted to a normal shape, and echinocytes from patients showed a similar trend. Echinocytosis occurred without change in membrane cholesterol content, as did its reversal, and was not caused by membrane uptake of lysolecithin or bile acids. Abnormal, echinocytogenic HDL showed saturable binding to approximately 5,000 sites per normal erythrocyte with an association constant of 10(8) M-1. Nonechinocytogenic patient HDL and normal HDL showed only nonsaturable binding. Several minor components of electrophoretically separated erythrocyte membrane proteins bound the abnormal HDL; pretreatment of the cells with trypsin or pronase reduced or eliminated binding. Echinocytosis by abnormal HDL required receptor occupancy, rather than transfer of constituents to or from the membrane, because cells reversibly prefixed in the discoid shape by wheat germ agglutinin, and then exposed to abnormal HDL, did not become echinocytes when the HDL and lectin were successively removed. Binding did not cause dephosphorylation of spectrin. We conclude that the echinocytes of liver disease are generated from discocytes by abnormal HDL, and we infer that the shape change is mediated by cell-surface receptors for abnormal HDL molecules.
Microvascular Complications of NIDDM in Hispanics and Non-Hispanic Whites: San Luis Valley Diabetes Study
Authors: Richard F Hamman, Gary A Franklin, Elizabeth J Mayer, Sally M Marshall, Julie A Marshall, Judith Baxter, Louise B Kahn
Journal: Diabetes Care (1991)

The goal of this article was to examine the differences in the rates of microvascular complications of non-insulin-dependent diabetes mellitus (NIDDM) in Hispanic and non-Hispanic white subjects. This was a geographically based case-control study where prevalent cases of NIDDM were identified in medical records. Subjects attended a 4-h clinic to confirm NIDDM diagnosis and assess complication end points. Retinopathy was defined by stereofundus photographs. Distal symmetric neuropathy was determined by standardized clinical examination. Nephropathy was indicated by serum creatinine level, urine protein-creatinine ratio, and urine albumin concentration. This study consisted of 279 NIDDM subjects confirmed by oral glucose tolerance test and World Health Organization criteria aged 20–74 yr (187 Hispanic and 92 non-Hispanic white subjects). Duration-adjusted prevalence of retinopathy was significantly higher in non-Hispanic white subjects (54.1 per 100, 95% confidence interval [CI] 44.4–63.7) than in Hispanics (41.8 per 100, 95% CI 34.8–48.8). This excess occurred only in non-Hispanic white subjects with background retinopathy but not in those with more severe retinopathy. Hispanics and non-Hispanic white subjects did not differ significantly for the prevalence of neuropathy (31.6 per 100 in non-Hispanic white subjects and 26.3 per 100 in Hispanics) or nephropathy by any measure. There were no significant differences in duration of diabetes or mean glycohemoglobin levels between ethnic groups. Microvascular complications of NIDDM are not in excess among Colorado Hispanics, and retinopathy may be somewhat more common in non-Hispanic white people.
Lucent Liver in the Newborn
Authors: Edward S. Wind
Journal: JAMA (1977)

WHEN the diagnosis of pneumoperitoneum is suspected from the clinical information in the case of a neonate, it is generally a simple matter to confirm the diagnosis roentgenographically. Filming is performed in either upright, lateral, or left lateral decubitus positions. When a perforation is of such severity that massive amounts of gastric or intestinal air enter the peritoneal cavity, a supine roentgenogram demonstrates the "football sign," which consists of an oval lucency demarcating the peritoneum with visualization of the falciform ligament (Fig 1).<sup>1</sup>With pneumoperitoneum, the physical findings that would normally alert the neonatologist to this diagnosis are occasionally not apparent, and an abdominal x-ray film taken with the patient in a recumbent position does not show the football sign. We have found that a homogeneous lucency or streak-like lucencies seen over the liver provide easy recognition of intraperitoneal air, and an appropriate left lateral decubitus or lateral roentgenogram
Deficiency of circulating IgA and IgM in adult patients with lichen planus
Authors: L. STANKLER
Journal: British Journal of Dermatology (1975)

Investigations on thirteen consecutive adult patients with classical lichen planus revealed a significant lowering in the levels of circulating IgA and IgM. Patients with lichen planus may have an immunological defect which makes them susceptible to infection with an unknown virus.
STRICTURE OF THE UPPER PORTION OF THE TRACHEA SUCCESSFULLY TREATED BY DIVULSION THROUGH THE LARYNX.
Authors: JOHN O. ROE
Journal: JAMA (1896)

The following case of stricture of the upper part of the trachea, due to organic contraction, can not, on account of its rarity, fail to be of interest.  On November 23, 1895, Miss D., aged 27 years, was referred to me on account of frequent and urgent attacks of dyspnea, which had for a considerable time been exceedingly distressing to her. She gave the following history: In March, 1888, she had a severe attack of diphtheria, from which it was thought at the time she had fully recovered. During the following year, however, it was noticed that she had edema of the feet. The edema was found to be associated with albuminuria and was ascribed to that cause. Notwithstanding this she enjoyed a fair degree of health.  In October, 1890, she became hoarse nearly every day as evening came on. This hoarseness continued until December, when she began to have
Cavernous Transformation of Portal Vein, Esophageal Varices, and Intravascular Coagulation
Authors: J. L. MOAKE
Journal: Annals of Internal Medicine (1975)

Letters1 March 1975Cavernous Transformation of Portal Vein, Esophageal Varices, and Intravascular CoagulationJ. L. MOAKE, M.D., W. ABRAMOVITS, M.D., Y. BEN-MENACHEM, M.D.J. L. MOAKE, M.D.Search for more papers by this author, W. ABRAMOVITS, M.D.Search for more papers by this author, Y. BEN-MENACHEM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-3-383 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCavernous transformation of the portal vein may be a sequela of presinusoidal portal vein obstruction as small veins dilate in a compensatory effort to provide circulation to the liver (1, 2). Portal venous blood is extensively rerouted through gastroesophageal veins, and hemorrhage from varices is a common complication.We have studied a 67-year-old black woman with hepatosplenomegaly and no history of alcohol intake who has survived 31 years after initial hospitalization for bleeding esophageal varices. She was recently re-admitted with dysphagia and stool positive for occult blood. Chest radiographs, fluoroscopy, and tomography showed a large pulsatile mass in the posterior...References1. EIDELMAN A: Cavernous transformation of the portal vein. A case report. Gastroenterologia 108:283-290, 1967 CrossrefMedlineGoogle Scholar2. RÖSCHDOTTER JC: Extrahepatic portal obstruction in childhood and its angiographic diagnosis. Am J Roentgenol Radium Ther Nucl Med 112:143-149, 1971 CrossrefMedlineGoogle Scholar3. DEYKIN D: The clinical challenge of disseminated intravascular coagulation. N Engl J Med 282:636-644, 1970 Google Scholar4. COLMANROBBOYMINNA RSJ: Disseminated intravascular coagulation: an approach. Am J Med 52:679-689, 1972 CrossrefMedlineGoogle Scholar5. KASABACHMERRITT HK: Capillary hemangioma with extensive purpura; report of a case. Am J Dis Child 59:1063-1070, 1940 CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Departments of Medicine and Radiology University of Texas Medical School Houston, Texas 77025 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySpurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes 1 March 1975Volume 82, Issue 3Page: 383-384KeywordsBloodGastroenterology and hepatologyHemorrhageHepatosplenomegalyHospitalizationsLiverPortal veinsThoraxTomographyVeins Issue Published: 1 March 1975 PDF DownloadLoading ...
Disordered Minds: The First Century of Eastern State Hospital in Williamsburg, Virginia, 1766-1866
Authors: Joan Titley
Journal: JAMA (1971)

The Enlightenment of the 18th century modified public attitudes about the incurability of the insane. In the last years of the 18th and the first decades of the 19th century, laymen and physicians alike attempted by humane treatment and "moral therapy" to return the afflicted from the asylums to society. The archives of these asylums record those who were then identified as insane and the therapies that were hoped would cure them; yet few definitive histories of these institutions have appeared.<i>Disordered Minds</i>is the history of the first public-supported institution for the insane in this country, Eastern State Hospital in Williamsburg, Virginia. Dr. Dain, reviewing the asylum's first 100 years, 1766-1866, covers three broad areas: the history of the asylum as an institution—its buildings, staff, budget; second, the custodial care and treatment given the patients, putting this in context with contemporary care elsewhere; and third, the relation of the
Diagnostic Laparoscopy: An Update
Authors: U. S. Karnam, K. R. Reddy
Journal: Endoscopy (2002)

Diagnostic laparoscopy has been in use since the last century. Advances in technology, coupled with increasing evidence of enhanced outcomes following its use, have renewed interest in this modality. Diagnostic laparoscopy guides surgeons in preventing unnecessary laparotomies in settings of acute abdomen, oncologists for accurate staging of malignancies from the esophagus to the colon, and hepatologists in the evaluation of acute as well as chronic liver diseases. Prospective clinical studies are awaited that will allow experimental technological advances, refining the methods of diagnostic laparoscopy, to be translated into more widespread use.
Dayananda Sirisena Wanigaratne
Authors: S. Wanigaratne, D. Wanigaratne
Journal: BMJ (2008)

After winning the junior science prize in 1957 at St Aloysius’ College, Galle, Dayananda Sirisena Wanigaratne (“Daya”) went on to pursue a career in medicine. He worked as a medical officer, specialising in malariology, moving into general medicine at …
Abstract 16593: Flecainide and R-Propafenone Annihilate Calcium Waves in Calsequestrin Null Ventricular Myocytes By Decreasing the Number of Subcellular Calcium Wave Initiation Sites
Authors: Eleonora Savio Galimberti, Venjamin Y Sidorov, Bjorn C Knollmann
Journal: Circulation (2011)

Background-  Mutations in the genes that encode either the ryanodine receptors (RyR2) or calsequestrin (casq2) can lead to catecholaminergic-polymorphic ventricular tachycardia (CPVT), a Ca 2+ -triggered arrhythmia. We recently reported that the RyR2 open-channel blockers flecainide (FLEC) and R-propafenone (RPROP) reduce spark mass and prevent Ca 2+  waves in intact myocytes and CPVT in mice lacking calsequestrin (casq2-/-). We hypothesized that by decreasing spark mass FLEC and RPROP lead to a sub-threshold Ca 2+  signal that reduces the likelihood of activating neighboring RyR2, thereby reducing the number of initiation sites and, thus, the generation of Ca 2+  waves.   Methods and results-  To test this hypothesis, we characterized the initiation sites in an experimental model of Ca 2+  waves - permeabilized casq2-/- myocytes, and compared it against wild-type (WT) cells. We also quantified the effects of FLEC and RPROP on Ca 2+  wave initiation sites in casq2-/- cells. Myocytes were imaged in 2D mode using confocal microscopy. Initiation sites were defined as the sites where the initial burst and fusion of sparks originates a propagated Ca 2+  wave. Under control conditions ([EGTA]=0.05 mM, [Ca 2+ ] t =0.06 mM), casq2-/- myocytes exhibit initiation sites ranged between 1 and 4 (2.3±0.1 (n=21)), localized at the ends as well as on the lateral sides of the cell. The simultaneous activation of various initiation sites determines the confluence of robust Ca 2+  waves that enhances the propagation of the wave along the entire myocyte. In contrast, WT cells depict a significantly smaller number of initiation sites (between 1 and 2 (1.3±0.1 (n=15)). In WT the sites are localized predominantly at one end of the myocyte and their frequency of discharge is ~ 40 % lower compared to casq2-/-. When casq2-/- cells are exposed either FLEC (25 µM) or RPROP (25 µM) the number of initiation sites significantly decreased to approximately 60% of control values (FLEC=1.3±0.1 (n=15), RPROP=1.4±0.1 (n=9), p   Conclusion-  The data presented here suggest that the decrease in the number of initiation sites is an underlying mechanism responsible for the annihilation of Ca 2+  waves by FLEC or RPROP and, thus, for preventing delayed-after-depolarizations and ventricular arrhythmias.
BURDEN OF HOSPITAL ADMISSION AND REPEAT ANGIOGRAPHY IN ANGINA PECTORIS PATIENTS WITH AND WITHOUT CORONARY ARTERY DISEASE
Authors: Lasse Jespersen, Steen Abildstrom, Anders Hvelplund, Jan Madsen, Soren Galatius, Frants Pedersen, Soren Hojberg, Eva Prescott
Journal: Journal of the American College of Cardiology (2014)
Australia turns to drug company representatives to cut prescribing
Authors: B. Burton
Journal: BMJ (2002)

In a bid to cut the rising costs of government subsidised drugs—a rise partly caused by inappropriate prescribing—the Australian government has opted to enlist the sales force of pharmaceutical companies.

The decision has astonished consumer groups but been welcomed by its proponent, the Australian Pharmaceutical Manufacturers Association.

According to last week's Budget papers, savings will be achieved by ensuring that restrictions on the government's pharmaceutical benefits scheme, under which the government subsidises the costs of approved drugs, will be communicated to doctors through …
California Authorization of Funds for the Antismoking Campaign
Authors: Molly Joel Coye
Journal: JAMA (1993)

To the Editor.  —Your recent reports on the proposed redirection of tobacco tax revenues from prevention to medical treatment in California 1,2 were both incorrect and misleading, and did a grave disservice to those of us who are struggling to balance the competing public health goals of prevention and medical care in the midst of a disastrous budget situation. The factual irregularities contained in the article are serious, but too numerous to address here. Instead, I would like to address the broader policy issue raised in these articles and comment on your report of the California Senate hearings on my confirmation as director of the Department of Health Services (DHS).  The deficit in the California state budget this year was larger than the entire budgets of all but two other states in this country, and it has continued to soar out of control. As the recession worsened last summer, the
Impact of F-18 FDG PET-CT for the Diagnosis and Management of Infection in JARVIK 2000 Device
Authors: Sylvie Costo, Eurydice Hourna, Massimo Massetti, Annette Belin, Gérard Bouvard, Denis Agostini
Journal: Clinical Nuclear Medicine (2011)

Fifteen months after implantation of a Jarvik 2000 left ventricle assistance device, a 60-year-old man developed infection at the percutaneous retroauricular skull-mounted pedestal. PET/CT demonstrated hypermetabolism in the left cutaneous retroauricular pedestal, on the thoracic internal cable, and in the left lung. A second F-18 FDG PET/CT performed after 3 months of antibiotic treatment showed minimal residual hypermetabolism around the proximal and cervical internal cable. The pedestal was then replaced and a third PET/CT scan 3 months after the completion of antibiotic treatment was entirely normal. F-18 FDG PET/CT scan may be useful for monitoring infection in patients with left ventricle assistance device.