tbuckley/cabot-search huggingface dataset:
Effect of Self-care Book
Authors: James F. Fries
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The study by Moore et al (1980;243:2317) is the first randomized, controlled study of any selfcare approach. This study found that our book,<i>Take Care of Yourself</i>, was read by an unexpectedly large portion of involuntary recipients (84% read some portion of the book); readers were more confident about their approach to health problems; and there were major decreases in total visits (6% and 9%) and visits for upper respiratory tract infections (17% and 11%) associated with the book. The study also has lessons for those who, like ourselves, are involved in research in this area. As a mass media intervention, a reference book is characterized by low cost per recipient and relatively low percentages of behavior change. For these reasons it is widely accepted that cost-effectiveness or cost benefit is the appropriate basis for evaluation. Moore et al state that the power of their test is
Controversy grows over India's genetically modified potato
Authors: G. Mudur
Journal: BMJ (2003)

A genetically modified potato developed in India to contain extra protein is under attack, with opponents claiming that it will result in the neglect of traditional sources of protein and thus exacerbate protein deficiency.

A senior Indian biotechnology official said last week that the potato, which has undergone nearly three years of field trials, could be approved for commercial cultivation before the end of this year.

Dr Manju Sharma, India's biotechnology secretary, said that the results of the field trial results were very encouraging and that the government would like to use the potato to reduce protein deficiency.

The potato, which …
Severe Candidal Infections
Authors: JOHN E. EDWARDS
Journal: Annals of Internal Medicine (1978)

Disseminated candidiasis has become an important infection, particularly in immunocompromised and postoperative patients. Although serologic tests may, in some settings, facilitate a premortem diagnosis, the disease is usually diagnosed by comprehensive clinical evaluation. Detection of the relatively newly recognized peripheral manifestations of candidemia may be vital to early diagnosis: endophthalmitis, osteomyelitis, arthritis, myocarditis, meningitis, and macronodular skin lesions. Studies in patients with chronic mucocutaneous candidiasis and in-vitro manipulations have begun to elucidate normal immune defense mechanisms against Candida, including serum factors, phagocytosis, intracellular killing mechanisms, and lymphocyte function (particularly T cell). The primary drugs for the treatment of disseminated candidiasis are still amphotericin B or amphotericin B plus 5-fluorocytosine; the mainstay of therapy for chronic mucocutaneous candidiasis is amphotericin B. Other antifungals and immune system-stimulating modalities (transfer factor, thymosin, thymus epithelial cell transplantation, and levamisol) may be useful for chronic mucocutaneous candidiasis in some settings and deserve further evaluation.
Precaution (<i>Ihtiyāt</i>): Do Not Proceed
Authors: Ahmed B. Al-Khafaji, Ali Moughania, Mohammed Al-Saadi
Journal: The American Journal of Bioethics (2015)

Drs. Padela and Mohiuddin (2015) propose a framework for treatment cessation by Muslim physicians supported by Islamic quality-of-life considerations, interpreted by the authors as the state of the...
Psychosocial Stress, Physical Symptoms, and Anxiety in Greek Students
Authors: James Georgas, Eliza Giakoumaki
Journal: Psychotherapy and Psychosomatics (1988)

Specific stressor events may be a function of variables such as age, sex, marital status, and urban-rural differences. Psychosocial stress as measured by a Greek adaptation of the Schedule of Recent Experiences was studied in relation to physical symptoms, manifest anxiety, and social desirability in 138 Greek university students. Psychosocial stress was found to be related to physical symptoms and manifest anxiety only in females. The types of stressor events of the students were different from those of a sample of older Greek teachers. The implications of the findings for Greek culture are discussed.
<i>Chlamydia trachomatis</i>Infection in Patients with Acute Salpingitis
Authors: Per-Anders Mårdh, Torvald Ripa, Lars Svensson, Lars Weström
Journal: New England Journal of Medicine (1977)

We examined the prevalence of Chlamydia trachomatis in the cervix and the fallopian tubes of patients with acute salpingitis. Cycloheximide-treated McCoy cells were used as the growth medium. For purposes of comparison, women with infections confined to the lower genital tract and women without signs of genital infections were also studied. C. trachomatis was isolated from the cervix in 19 of 53 patients with acute salpingitis, in one of 18 lower-genital-tract infections and in none of 12 without signs of genital infection. C. trachomatis was recovered from six of the 20 valid specimens from the fallopian tubes of the patients with acute salpingitis. Our results indicate that chlamydia is a common etiologic agent in acute salpingitis.
Hemodynamic changes in the peripheral circulation after repeat low density lipoprotein apheresis in familial hypercholesterolemia.
Authors: P Rubba, A Iannuzzi, A Postiglione, N Scarpato, S Montefusco, A Gnasso, G Nappi, C Cortese, M Mancini
Journal: Circulation (1990)

Repeat low density lipoprotein (LDL) apheresis and blood flow determinations in the forearm and leg were performed in 10 patients (age range, 13-49 years; four male, six female) with familial hypercholesterolemia (eight homozygous, two heterozygous). To perform LDL apheresis, plasma was first separated by a polysulphone hollow fiber filter; then, LDL was selectively removed from plasma by dextran sulphate cellulose beads packed in columns. Blood flows in the forearm and leg were determined at rest and during a reactive hyperemia test (peak flow). This test was performed noninvasively by a strain-gauge plethysmograph with semicontinuous registration of arterial blood flow variables before the first apheresis and 3 weeks after the last of six procedures for apheresis. Resting arterial blood flows in the forearm and leg were slightly increased after repeat LDL apheresis (p less than 0.05). Peak blood flow in the leg significantly increased (+34%, p less than 0.01). No change in peak blood flow in the forearm was observed. Systolic blood pressures were slightly but significantly reduced (p less than 0.05); forearm peripheral resistances were also reduced (p less than 0.05). Flow response was not related to LDL receptor status. Blood and plasma viscosities were determined before and 7 days after the last apheresis. Blood viscosity was significantly reduced after LDL apheresis at shear rates of 11.25-450 sec-1. Plasma viscosity did not change.
Depressive States: A Pharmacotherapeutic Study
Authors: S. H. Kraines
Journal: JAMA (1965)

The thesis of this volume is that amitriptyline (Elavil) hydrochloride is the drug of choice in the treatment of depressive states. A total of 137 female patients were treated in a double-blind, wellstructured, comprehensive analysis —clinical and statistical—of symptoms and response. Analysis of the tables and of the statements made, however, does not provide conclusive proof of the superiority of this drug.  After the first week of treatment, imipramine hydrochloride (Tofranil) was superior in effectiveness to amitriptyline; after one month's therapy, amitriptyline was superior; after six months follow-up, both drugs reached the finish line at the same time.  In terms of results, amitriptyline showed 84% improvement, and imipramine a 79% improvement in the 137 case studies.  Admitting that electric-shock therapy is simple, safe, and effective, the authors state that the relapse rate of patients treated with electric shock is between 20% and 30%. In the authors' series, the relapse
Amelioration of the effects of ischemic cardiac arrest by the intracoronary administration of cardioplegic solutions.
Authors: G J Todd, G F Tyers
Journal: Circulation (1975)

Interruption of coronary flow during cardiac surgical procedures provides a bloodless flaccid heart and allows precise and rapid correction of complex cardiac defects. However, myocardial damage occurs in direct proportion to the duration of the ischemia. As the induction of cardioplegia simulataneous with the initiation of cardiac ischemia helps to preserve cardiac energy reserves and thus myocardial integrity, the identification of a consistently reliable cardioplegic technique is desirable. Isolated perfused working rat hearts were made ischemic for one hour by aortic cross-clamping and were compared with hearts rendered cardioplegic at the onset of ischemia by the intracoronary administration of 5 ml of a hypothermic solution: 1) Krebs-Henseleit buffer, 2) Ringer's lactate, 3) tetrodotoxin, 4) potassium chloride, or 5) potassium citrate. Cardiac output, heart rate, aortic pressure and coronary flow were determined pre and post-ischemia. When compared to time-matched controls and hearts arrested with potassium or tetrodotoxin, the ischemia and ischemia-Ringer's lactate groups showed significant post cross-clamp depression of all measured parameters. Intracoronary Ringer's lactate, although often used as an adjunct to ischemic arrest, was not of significant value. In contrast, hearts arrested with tetrodotoxin, potassium chloride or potassium citrate showed no significant post-ischemic functional or histologic deficit. Perfusion with hypothermic Krebs-Henseleit buffer protected the myocardium better than did Ringer's lactate but less well than the tetrodotoxin or isotonic high potassium solutions. The induction of hypothermic metabolic arrest of the heart by briefly perfusing the coronary arteries via the aortic root with isotonic buffered solutions results in markedly improved myocardial tolerance to one hour of ischemia and avoids the problems of low cardiac output and ventricular irritability previously reported with hypertonic potassium citrate arrest.
Reducing heart failure admission rates in England 2004–2011 are not related to changes in primary care quality: national observational study
Authors: Rachel Brettell, Michael Soljak, Elizabeth Cecil, Martin R. Cowie, Philippe Tuppin, Azeem Majeed
Journal: European Journal of Heart Failure (2013)

Heart failure (HF) is an important clinical problem. Expert consensus has defined HF as a primary care-sensitive condition for which the risk of unplanned admissions may be reduced by high quality primary care, but there is little supporting evidence. We analysed time trends in HF admission rates in England and risk and protective factors for admission.We used Hospital Episodes Statistics to produce indirectly standardized HF admission counts by general practice for 2004-2011. Clustered negative binomial regression analysis produced admission risk ratios and assessed the significance of potential explanatory covariates. These included population factors (deprivation; HF, coronary heart disease, and smoking prevalence), primary care resourcing [access; general practitioner (GP) supply], and primary care quality ('Quality and Outcomes Framework' indicator.) There were 327,756 HF admissions of patients registered with 8405 practices over the study period. There was a significant reduction in admissions over time, from 6.96/100,000 in 2004 to 5.60/100,000 in 2010 (P < 0.001). Deprivation and HF prevalence were risk factors for admission. GP supply and access protected against admission. However, these effects were small and did not explain the large and highly significant annual trend in falling admission rates.The observed fall in admissions over time cannot be explained by the primary care covariates we included. This analysis suggests that the potential for further significant reduction in emergency HF admissions by improving clinical quality of primary care (as currently measured) may be limited. Further work is required to identify the reasons for the reduction in admissions.
The QRS complex during myocardial ischemia. An experimental analysis in the porcine heart.
Authors: R P Holland, H Brooks
Journal: Journal of Clinical Investigation (1976)

Although ST segment deflections have been widely utilized as a means of assessing the degree of underlying ischemic injury, the relationship of QRS complex alterations to the ischemic process is poorly understood. In this study we made a beat-to-beat analysis of the QRS complex in terms of ventricular activation time (CT) and R wave voltage (V) in the acutely ischemic porcine myocardium and analyzed the relationship of these responses to changes in the area of ischemic involvement, altered myocardial energy demands, and plasma [K+]0 levels. With the onset of ischemia the QRS complex underwent a specific and reproducible biphasic sequence with an initial decrease in CT and V indicating a transient increase in the conduction velocity of the ischemic tissue. Subsequently both CT and V returned briefly to control and then increased dramatically, now indicating a marked decrease in conduction velocity. The time when CT first began to increase (Tc) was shortened by enlarging the area of ischemia or after an inotropic intervention and was lengthened by decreasing the area of ischemia or with administration of propranolol. Moreover Tc was found to be inversely proportional to plasma [K+]0 in the range 3.4-8.8 mM, above which the initial decrease in CT and V was no longer present. We conclude that this biphasic sequence of QRS alterations in early myocardial ischemia is attributable to a progressive leakage of potassium out of the ischemic cells which in turn alters both the time-course and transmural pathway of the activation process through the ischemic tissue. These changes are related to both inotropic state and the area of ischemic involvement.
Corwin's Double Binaural Stethoscope.
Authors: A. M. Corwin
Journal: JAMA (1895)

Chicago, Feb. 12, 1895. <h3>To the Editor:</h3> —The accompanying cut represents the instrument which I have used in class demonstration of physical diagnosis in Rush Medical College for the past two years, with very great satisfaction both to myself and the students. By it both teacher and taught are enabled to hear sounds under like circumstances of time and place, and the instructor is therefore sure that what he hears and describes is heard by the student. Demonstration of sounds by the use of separate stethoscopes is sometimes tedious and uncertain, owing to the varying manner of applying the instrument, and the variable occurrence of adventitious sounds both in time, place and character, owing to the difference in the depth of respiration, occurrence of cough, and the various changes, functional and pathologic, which take place within the body. The first instrument made, was a combination of two of Knight's stethoscopes,
Blood Pressure in Chronic Renal Failure
Authors: John M. Ulvila
Journal: JAMA (1972)

Control of hypertension is important in the management of chronic renal failure. Data presented here support the view that hypertension in chronic renal failure develops because many patients must have elevated blood pressure in order to excrete the amounts of sodium usually ingested. The data indicate that there is a wide spectrum with respect to the excretion of sodium by the diseased kidney and those patients who excrete the lowest amount of sodium have the greatest difficulty with control of blood pressure. Attempts to lower blood pressure by restricting sodium in the diet often cause such a marked reduction in sodium excretion that the patient has to reduce dietary sodium intake to an intolerably low level in order to stay in balance. In such patients preliminary experience indicates that furosemide can increase sodium excretion sufficiently to maintain sodium balance on an acceptable diet without an increase in blood pressure.
SerpinB1 in cystic fibrosis airway fluids: quantity, molecular form and mechanism of elastase inhibition
Authors: J. Cooley, M.K. Sontag, F.J. Accurso, E. Remold-O’Donnell
Journal: European Respiratory Journal (2010)

Neutrophil serine proteases (NSPs), especially elastase, are major agents of lung destruction in cystic fibrosis (CF) patients. This study investigated SerpinB1, a highly efficient inhibitor of NSPs, in CF lung disease. Bronchoalveolar lavage fluid (BALF) from 31 children with CF and 24 control children was examined for amount and molecular species of SerpinB1, and its mechanism of action was studied. CF BALF had more SerpinB1 than control BALF (geometric mean 3.9 (95% CI 2.60–5.62) versus 1.37 (1.20–1.55) μg·mL −1 ; p&lt;0.001). BALF levels of SerpinB1 were higher for infected versus uninfected CF subjects (5.5 versus 2.7 μg·mL −1 ; p&lt;0.04) and substantially higher for elastase-positive versus -negative CF subjects (8.41 versus 1.89 μg·mL −1 ; p&lt;0.001). Most SerpinB1 in CF BALF had been cleaved. Adding recombinant SerpinB1 to CF BALF stoichiometrically inhibited endogenous elastase, indicating that the inhibitor functions in the CF microenvironment. In vitro simulations comparing SerpinB1 and α 1 -antitrypsin (SerpinA1) showed that both rapidly form irreversible inhibitory covalent complexes with elastase and that these differed in survival time. The SerpinB1–elastase complex survived only briefly due to fragmentation of bound elastase, releasing cleaved SerpinB1, the molecular form in CF BALF. The findings define an innate role for SerpinB1 in CF airways.
Studies on membrane-bound renin in the mouse and rat.
Authors: C M Wilson, P E Ward, E G Erdös, A Gecse
Journal: Circulation Research (1976)

Membrane-bound renin was isolated from the submaxillary gland and kidney of the white Swiss Webster mouse and from the kidney of the rat. Administration of the male sex hormone testosterone or an anabolic steroid, such as nandrolone phenpropionate (Durabolin), induces renin activity in microsomal fraction of the submaxillary gland of the young female mouse. Actinomycin D blocks this induction partially. Renin that sedimented with the microsomal fraction was isolated from the homogenized kidney of the mouse by density gradient centrifugation. Microsomal renin was also isolated from rat kidney disrupted by the N2 cavitation technique. The enzyme in the microsomal fraction that had been washed extensively was only partially active, but freezing and thawing or Triton X-100 activated microsomal renin. The same microsomal fraction contained active kallikrein. In pilot studies a plasma membrane-enriched fraction was isolated from the microsomal fraction of the homogenized rat kidney cortex that had both renin and kallikrein activity.
811. ACE-Targeted eNOS and BMPR2 Gene Therapy Attenuates Pulmonary Hypertension in a Chronic Hypoxia Rat Model
Authors: Ann M. Reynolds, Mark D. Holmes, David T. Curiel, Andrew H. Baker, Paul N. Reynolds
Journal: Molecular Therapy (2005)

Idiopathic pulmonary arterial hypertension is a fatal disease characterized by vascular remodeling and right ventricular failure. Modern vasodilator therapies improve prognosis but ultimately most patients succumb or require heart-lung transplantation. We previously developed targeted adenoviral (Ad) strategies for pulmonary vascular gene delivery based on the use of a bispecific conjugate (Fab-9B9) that targets Ad infection to angiotensin converting enzyme (ACE) expressed on pulmonary vascular endothelium. In the current study we determined whether targeting achieved therapeutic gains when using Ad gene delivery of endothelial nitric oxide synthase (eNOS), then evaluated a more novel approach using targeted delivery of the gene for bone morphogenetic protein receptor type 2, based on the knowledge that mutations in this receptor and defects in BMPR2 signaling account for many of the inherited forms of IPAH. Rats (n=6) were injected with 5|[times]|109 pfu of either irrelevant virus, AdCMVeNOS, AdCMVeNOS+Fab9B9 or saline (PBS), then exposed to 10% oxygen atmosphere for three weeks, then right ventricular systolic pressure (RVSP), mean pulmonary artery pressure (PAP) and right ventricular hypertrophy (Fulton Index, FI) were determined. A concurrent group of rats maintained in normoxic conditions was used as a control. Hypoxia lead to increased RVSP (42.2|[plusmn]|4.6mmHg), PAP (34.5|[plusmn]|2.8 mmHg) and FI (0.48|[plusmn]|0.02) vs normoxic controls (22.3|[plusmn]|0.8, 19.4|[plusmn]|1.2 and 0.26|[plusmn]|0.01 respectively). AdCMVeNOS attenuated RVSP(33.9|[plusmn]|1.9), PAP(27|[plusmn]|2.3) and FI(0.41|[plusmn]|.03), with a further therapeutic gain seen with Fab-9B9 targeting (RVSP 28.0|[plusmn]|1.8). A separate experiment using irrelevant virus+Fab-9B9, AdCMVBMPR2+Fab-9B9 or PBS showed that BMPR2 gene delivery attenuated the hypoxia-induced increase in RVSP, PAP and FI by 27%, 34% and 50% respectively. Irrelevant Ad alone or with Fab-9B9 had no effect. Thus, the novel findings are that Ad-mediated eNOS delivery attenuates chronic hypoxia-induced PHT, and this effect is improved with targeting. This is also the first demonstration that upregulation of BMPR2 signaling attenuates pulmonary hypertension, suggesting a therapeutic strategy for patients with BMPR2 mutations.
UNCINARIASIS IN THE SOUTH, WITH SPECIAL REFERENCE TO MODE OF INFECTION.
Authors: CLAUDE A. SMITH
Journal: JAMA (1904)

In this paper I shall attempt to present some additional light on the mode of infection in uncinariasis or hookworm disease. The views as presented before this Section a year ago<sup>1</sup>have been confirmed, not only by my own observations, but also by those of physicians in different sections, who, after reading the article inThe Journal, have written to me regarding the disease as it exists in their sections. <h3>DISTRIBUTION AND PREVALENCE OF THE DISEASE.</h3> It has been my fortune to see cases of the disease from all of the coast states in the south, from Virginia to Texas, inclusive, with the exception of Mississippi, but reports received from that state show that it is prevalent there as well. While my observations have necessarily been confined principally to my own state, yet the evidence indicates that the disease is equally as prevalent in all our southern states.
Levothyroxine Dosage After Thyroidectomy for Metastatic Papillary Cancer
Authors: Robert H. Caplan
Journal: JAMA (1976)

To the Editor.—  Dr Frame recommended a reduction of thyroid hormone to the equivalent of 0.2 mg/day of levothyroxine sodium in a patient with papillary thyroid cancer (235: 955, 1976). This recommendation was based on studies indicating that thyroid-stimulating hormone (TSH) is suppressed to normal levels in a majority of patients with primary hypothyroidism treated with this dosage 1 ; however, the radioimmunoassay is not sensitive enough to separate normal from low levels of TSH. 2 Because it is desirable to suppress TSH to less than normal levels in patients with TSH-dependent thyroid neoplasms, and because many patients tolerate 0.3 mg/day of levothyroxine sodium without clinical evidence of hyperthyroidism, it seems prudent to treat patients with thyroid cancer with higher replacement doses of thyroid hormone than is necessary for the treatment of hypothyroidism. 3 Perhaps the response of TSH to thyrotropin-releasing hormone (TRH) may provide a more sensitive index of the