tbuckley/cabot-search huggingface dataset:
Sickle Cell Anemia in Adults: Avoiding Crises, Organ Damage
Authors: Laurie Jones
Journal: Annals of Internal Medicine (1998)

Currents15 June 1998Sickle Cell Anemia in Adults: Avoiding Crises, Organ DamageLaurie JonesLaurie JonesSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-12_Part_1-199806150-00040 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Patients with sickle cell anemia have, until recently, spent their short lives mostly under the care of pediatricians. Now that patients are living into their 40s and beyond, internists are more likely to see adults with sickle cell anemia. (Editor's Note: See Ann Intern Med. 1998; 128:882-4 for information on other childhood diseases being seen in adults.)The transition from pediatric care to adult care can be difficult for young adult patients. Adolescents are accustomed to their parents communicating with the physician and managing their day-to-day health care. As patients approach their 20s, that responsibility shifts from the parent to ... Author, Article, and Disclosure InformationAuthors: Laurie Jones PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byExertional rhabdomyolysis and renal failure in patients with sickle cell trait: Is it time to change our approach? 15 June 1998Volume 128, Issue 12_Part_1Page: 1055-1056KeywordsAfrican American peopleAnemiaChildrenHematology and oncologyHemoglobinLungsMuscular dystrophiesSickle cell diseaseThoraxYoung adults ePublished: 15 August 2000 Issue Published: 15 June 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Identification of Human Glandular Kallikrein in the Beta Cell of the Pancreas
Authors: Onesmo ole-MoiYoi, Geraldine S. Pinkus, Jocelyn Spragg, K. Frank Austen
Journal: New England Journal of Medicine (1979)

To determine the cellular localization of glandular kallikrein in the human pancreas, immunohistochemical studies were performed with a monospecific antibody against the antigenically identical urinary kallikrein (urokallikrein). The localization of glandular pancreatic kallikrein to the beta cells of the islets was the same as that of insulin in normal human pancreas and in two islet-cell tumors. When beta cells were lacking in islet-cell tumors or in the pancreas of a patient with juvenile-onset diabetes, kallikrein antigen was not detectable. Anti-urokallikrein absorbed with purified urinary or pancreatic kallikrein no longer identified a pancreatic antigen, whereas absorption with insulin had no effect. The beta-cell localization of human pancreatic kallikrein, an endopeptidase that, in concert with carboxypeptidase B, converts bovine proinsulin to a polypeptide with the electrophoretic mobility of insulin, suggests that pancreatic kallikrein may be involved in the physiologic activation of proinsulin.
Functional Blockade of Platelet-Derived Growth Factor Receptor-β but Not of Receptor-α Prevents Vascular Smooth Muscle Cell Accumulation in Fibrous Cap Lesions in Apolipoprotein E–Deficient Mice
Authors: Hideto Sano, Tetsuo Sudo, Masayuki Yokode, Toshinori Murayama, Hiroshi Kataoka, Nobuyuki Takakura, Satomi Nishikawa, Shin-Ichi Nishikawa, Toru Kita
Journal: Circulation (2001)

Background —The vascular smooth muscle cell (VSMC) is the central cell component involved in the fibroproliferative response in atherogenesis. As the lesion advances, VSMCs migrate from the media into the subendothelial space, thereby forming fibrous plaque lesions. Platelet-derived growth factor (PDGF) has been known to be a potent chemoattractant and mitogen for SMCs, but the pathophysiological role of the 2 PDGF receptors, receptor-α (PDGFR-α) and receptor-β (PDGFR-β) in atherogenesis is poorly understood. To clarify this problem, we prepared antagonistic rat monoclonal antibodies, APA5 and APB5, against murine PDGFR-α and PDGFR-β, respectively. Methods and Results —Apolipoprotein E–deficient mice were fed a high-fat diet containing 0.3% cholesterol from 6 weeks of age and subjected to injection with 1 mg/d IP of either antibody from 12 to 18 weeks every other day. In the mice injected with APB5, the aortic atherosclerotic lesion size and the number of intimal VSMCs were reduced by 67% and 80%, respectively, compared with the control mice injected with irrelevant rat IgG. In contrast, the mice that received APA5 showed only minimal reduction of lesion size, and a large number of VSMCs were observed in the intima. In the intima of advanced lesions, APB5 immunolabeled VSMCs, whereas APA5 could detect VSMCs mainly in the media. Conclusions —These results indicate that PDGFR-β plays a significant role in formation of fibrous atherosclerotic lesions and that regulation of the signal transduction through PDGFR-β could affect atherogenesis in mice.
Acknowledgement of "no fault" medical injury: review of patients' hospital records in New Zealand
Authors: P. Davis
Journal: BMJ (2003)

Investigations of the epidemiology of adverse events have advanced the safety of patients in hospital. 1These studies, however, were done in tort jurisdictions, where the fear of litigation may have inhibited frank and open discussion. 2 New Zealand abolished tort liability in 1972, instead providing an administrative system of compensation without the need to prove fault. 3 We analysed data on adverse events in hospitals in New Zealand and the extent to which medical injury is acknowledged in patient records.
How to become an MP
Authors: Steven Duncan Ford
Journal: BMJ (2007)

Ours is a participatory democracy-startling chiefly for the lack of participation.Membership of the hopelessly debt laden political parties is at an all time low, and the esteem in which parliament is held is likewise low.A variety of means to improve the situation have been mooted, but little seems to change.Could we doctors make a change?It is often noted that the public has more trust in doctors and other healthcare workers than in politicians; this is the right time, a last chance perhaps, to take our approval ratings out for a psephological test drive.We have witnessed problems arising from the healthcare "reforms" and can predict more of the same.As a group we have been on the receiving end of much government inspired unpleasantness: the precedence of budgets over care of patients, fragmentation of care, Modernising Medical Careers and the medical training application service (MTAS), crassly incompetent management at all levels, contract chaos, hostile press briefings, black propaganda, downright lies, tendentious media comment, privatisation, unfeasibly complex recertification, licensure, and appraisal procedures, and so on.Is alerting the populace to the problems and offering alternatives in some way problematic or unprofessional?Are parliamentarians, their advisers, and the commentators more competent at generating and implementing reform than we are?The broad sentiment of the profession toward the current reforms is negative, although no one shrinks from the need to improve continuously in personal as well as system performance and standards.If we are
Abstract PR6: Resistance to EGFR inhibition via the emergence of EGFRvIII-independent tumor growth-promoting mechanisms in glioblastoma
Authors: Jill Wykosky, Akitake Mukasa, Lynda Chin, Webster Cavenee, Frank Furnari
Journal: Clinical Cancer Research (2010)

Abstract A major hurdle in the clinical success of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for the treatment of glioblastoma multiforme (GBM) is the occurrence of resistance, the mechanisms for which remain largely unknown. Amplification of EGFR and/or expression of its constitutively active mutant, EGFRvIII, are among the most frequently found molecular alterations in GBMs. Recently, we have shown that U373 cells engineered to express doxycycline (dox)-repressible EGFRvIII were dependent upon the expression of this receptor not only for tumor initiation, but also for maintenance and progression of tumors in a xenograft mouse model. Interestingly, following a period of growth stasis in vivo due to silencing of EGFRvIII, some tumors regained the ability to grow rapidly, which is strikingly similar to the clinical scenario of resistance. These aggressive breakthrough tumors, termed “escapers,” remained silenced for EGFRvIII and employed distinctly different signaling pathways when collectively compared to the initial EGFRvIII-dependent tumors. Escapers exhibited elevated activity of components of the MAPK signaling pathway, and cell lines established from the tumors were significantly more sensitive to inhibition of Mek than cells derived from EGFRvIII-dependent tumors. Removal of dox and reexpression of EGFRvIII in escapers markedly suppressed tumor growth, suggesting that the unique signaling pathway preferences of escapers are not compatible with those pathways preferentially utilized by EGFRvIII. Genes were identified by microarray analysis that were specifically expressed at higher levels in the escapers. These genes represent candidates for involvement in the process of overcoming EGFRvIII-dependence and, thus, may also contribute to resistance to EGFR inhibition. Significantly, escaper cells that reexpressed EGFRvIII were resistant to the in vitro growth- inhibitory effects of the TKI gefitinib as measured by colony formation in soft agar. Thus, the emergence of EGFRvIII-independent tumor growth-promoting mechanisms in escapers is characterized by a switch in pathway signaling preferences and upregulation of novel genes, and confers resistance to EGFR inhibition. The genes and pathways identified may shed light on novel mechanisms of TKI resistance and point towards potential targets for the development of agents that could be used in combination with TKIs to circumvent resistance while improving clinical response. Citation Information: Clin Cancer Res 2010;16(14 Suppl):PR6.
Prevalence of Asymptomatic Coronary Artery Disease in Men with Vasculogenic Erectile Dysfunction: A Prospective Angiographic Study
Authors: Charalambos Vlachopoulos, Konstantinos Rokkas, Nikolaos Ioakeimidis, Constadina Aggeli, Andreas Michaelides, Georgios Roussakis, Charalambos Fassoulakis, Athanasios Askitis, Christodoulos Stefanadis
Journal: European Urology (2005)
432 FIBROSIS STAGING PREDICTS VIROLOGICAL RESPONSE IN HEPATITIS C GENOTYPE 1 PATIENTS: INTERIM DATA FROM THE PROPHESYS TRIAL
Authors: A. Horban, M. Rodriguez-Torres, H. Cheinquer, M. Curescu, S. Pol, G.F. Silva, A. Orlandini, S.S. Lee, A. Ascione, D. Messinger, F. Tatsch, P. Ferenci
Journal: Journal of Hepatology (2011)
Need for Inexpensive Obstetric Nurses
Authors: W. C. Gayler
Journal: JAMA (1913)

<h3>To the Editor:</h3> —Dr. Milligan's letter on this subject (The JournalA. M. A., Aug. 23, 1913, p. 617) treats of a matter that is of tremendous importance in St. Louis, as well as in Detroit. He bewails the fact that there is not a supply of clean, sensible, practical nurses whose services may be had by the family of small means. We have nurses of this kind, but they are failures because they belong to one of the two following classes: Class 1 consists of women who, after helping in twenty or more cases, feel confident of their ability to manage an obstetric case without the guiding hand of a physician. Some of these women are honest. Their chief defect is that they are not aware of the extent of their ignorance. Some are not so honest, produce abortions occasionally, and make a miserable failure of their avocation. This
Simultaneous tracheal and oesophageal pH measurements in asthmatic patients with gastro-oesophageal reflux.
Authors: C I Jack, P M Calverley, R J Donnelly, J Tran, G Russell, C R Hind, C C Evans
Journal: Thorax (1995)

BACKGROUND--An association between asthma and gastro-oesophageal reflux is well recognised but the underlying mechanism is unclear. One suggestion is that gastric juice is aspirated into the tracheal and upper airways but detection of these events is difficult and involves radioisotopic studies. A new method of making direct measurements of tracheal and oesophageal pH over a 24 hour period is described, together with its application to patients with asthma. METHODS--The technique involves insertion of simultaneous tracheal and oesophageal pH probes under general anaesthesia. Continuous monitoring of pH over a 24 hour period is possible, permitting comparison with peak flow readings during wakefulness and at night should the patient be disturbed. Representative data from four patients with asthma (mean FEV1 62% predicted) and symptomatic gastro-oesophageal reflux, together with data from three non-asthmatics, is presented. RESULTS--Thirty seven episodes of gastro-oesophageal reflux lasting more than five minutes were recorded. Of these, five were closely followed by a fall in tracheal pH from a mean (SE) of 7.1 (0.2) to 4.1 (0.4) and a fall in peak expiratory flow (PEFR) of 84 (16) l/min. When gastro-oesophageal reflux occurred without tracheal aspiration the fall in PEFR was 8 (4) l/min. CONCLUSIONS--This new technique was well tolerated and allowed quantitation of the number, duration, and timing of episodes of tracheal micro-aspiration. Unlike acid reflux without aspiration, these events appear to be related to significant acute changes in lung function in asthmatic patients. Further studies with this new method may elucidate the role of gastro-oesophageal reflux in asthma.
Lipophilic Silver Nanoparticles and Their Polymeric Entrapment into Targeted‐PEG‐Based Micelles for the Treatment of Glioblastoma
Authors: Erica Locatelli, Francesca Broggi, Jessica Ponti, Patrick Marmorato, Fabio Franchini, Stefano Lena, Mauro Comes Franchini
Journal: Advanced Healthcare Materials (2012)

A simple method for the synthesis of lipophilic Ag NPs have been developed. The coated Ag NPs have been entrapped into a FDA-approved and targetable PEG-based polymeric nanoparticles, and this nanocarrier has been conjugated with the peptide chlorotoxin. Uptake experiments have shown a cell-specific recognition of the Ag-1-PNPs-Cltx on U87MG cell lines in comparison to Balb/3T3. The uptake of Ag into the cells was quantified and an interesting cytotoxic effect (IC50 = 45 μM) has been found on glioblastoma cell lines.
China bans smoking on trains and buses
Authors: R. Tomlinson
Journal: BMJ (1997)

China is to ban smoking on its public transport system from 1 May, the latest in a series of government regulations designed to encourage the world's biggest nation of smokers to stub out their cigarettes.

The ban will cover railway carriages, ship and aeroplane cabins, buses, subways, and taxis, as well as ticket halls and waiting rooms. However, smoking will be allowed in specially designated areas, in particular the connecting passageways between train carriages, which may raise new safety concerns. The announcement was made last week by the National Committee for Patriotic Health Campaign and by …
Role of GM-CSF in tolerance induction by mobilized hematopoietic progenitors
Authors: Hassen Kared, Bertrand Leforban, Ruddy Montandon, Amédée Renand, Esther Layseca Espinosa, Lucienne Chatenoud, Yvonne Rosenstein, Elke Schneider, Michel Dy, Flora Zavala
Journal: Blood (2008)
Dangers of diazoxide.
Authors: M S Knapp, R Cove-Smith, G Hall, M McIllmurray
Journal: BMJ (1972)

Active surveillance (AS) can be considered as a treatment strategy for low risk papillary thyroid microcarcinoma (PTMC), with the absence of clinically apparent lymph nodes, extrathyroidal extensions, and distant metastasis. After reviewing the reports on AS of low risk PTMCs worldwide, we introduced AS, and discussed the selection criteria for active surveillance candidates based on different guidelines and the follow-up schedules. Moreover, the requirement of cytological diagnosis, progression evaluation methods, necessity of thyrotropin suppression, and medical costs were issues that both clinicians and patients considered. The usefulness of AS for low risk PTMC patients depended on accurate and confidential evaluation of patient risk. Clinicians may adopt measures like dynamic monitoring, risk stratification, and making personal follow-up schedules to minimize these potential risks. By appropriately selecting PTMC patients, AS can be an effective alternative treatment to immediate surgery.
Estimating the Influence of Selection on the Variable Amino Acid Sites of the Cytochrome b Protein Functional Domains
Authors: David A. McClellan, Kevin G. McCracken
Journal: Molecular Biology and Evolution (2001)

We evaluated the effects of selection on the molecular evolution of the functional domains of the mammalian cytochrome b gene as it relates to physicochemical properties shown to correlate with rates of amino acid replacement. Two groups of mammals were considered: pocket gophers of the rodent family Geomyidae, and cetaceans and ungulates of the monophyletic taxon Cetartiodactyla. Several characteristics of cytochrome b evolution were common to both mammal groups. The evolution of the matrix domain reflected the region's relative lack of function. Goodness of fit to neutral expectations indicated that external influences have had very little effect on the evolution of the matrix, although in some cases conservative and moderate changes have been favored. Although rates of synonymous nucleotide substitution have been relatively high, the transmembrane domain exhibited poor goodness of fit to neutral expectations. However, the evolution of the transmembrane domain has been constrained by negative selection, allowing a preponderance of conservative and moderate amino acid replacements. We hypothesize that a high rate of substitution is maintained in spite of negative selection because the codons of the transmembrane coding region are predisposed to conservative changes in all amino acid properties. The evolutionary patterns of the intermembrane domain in pocket gophers and cetartiodactyls, however, were very different. Changes inferred from the pocket gopher phylogenetic tree exhibited a significant fit to neutral expectations for each of the amino acid properties. Changes inferred from the cetartiodactyl tree exhibited significant fit to neutral expectations for polarity and isoelectric point, but not for composition, molecular volume, polar requirement, or hydropathy. In each case, lack of fit was due to selection that promoted conservative or moderate change, with the noteworthy exception of polar requirement. We detected an unexpectedly large change in polar requirement (from aspartic acid to threonine) in two separate lineages (Camelus bactrianus and all cetaceans) at amino acid position 159. This inferred change occurred in a region of the cyt-b protein that directly interacts with external surface proteins of the cytochrome bc1 complex and resulted in a reversion to a more common character state in vertebrates.
CHOLESTEROL AND CHOLESTEROL ESTER CONTENT OF BOVINE COLOSTRUM
Authors: Richard E. Shope, John W. Gowen
Journal: The Journal of Experimental Medicine (1928)

The total amount of cholesterol found in colostrum and milk is comparatively low. The amount of cholesterol found in colostrum declines at an ever decreasing rate as milk secretion develops until at 48 hours the cholesterol is nearly the same as that found in milk 3 months or 7 months after parturition. The morning milk differs from the evening milk in that the cholesterol bound as ester is greater in amount.
Cross-sectional relations of serum aldosterone and urine sodium excretion to urinary albumin excretion in a community-based sample
Authors: C.S. Fox, M.G. Larson, S.-J. Hwang, E.P. Leip, N. Rifai, D. Levy, E.J. Benjamin, J.M. Murabito, J.B. Meigs, R.S. Vasan
Journal: Kidney International (2006)
John Dawson (1734-1820).
Authors: C. C. Booth
Journal: BMJ (1970)

BRiMTI 171instructions, however, must not be too detailed as to prevent them from being read at the time of the emergency or to in- hibit personal initiative.Other important members of the hospital staff also have vital tasks to perform, but it is equally important that their instructions should be explicit and detailed and that individual initiative, so far as the organizational side is concerned, should be discouraged.Other members of the staff-medical, nursing, and ancillary-must know who to report to in order to receive verbal or written instructions.Of the many lessons we learnt, three stand out.Firstly, communications must be secure, both inside the hospital, with direct lines connecting vital centres, and outside, with a direct radio link between the major accident officer and the site senior medical officer.The hospital must also have exdirectory lines, so that outgoing calls can still be made if the switchboard is swamped with incoming calls.Secondly, writ- ten instructions in the form of action cards must be provided in key positions.We have installed major accident boxes containing copies of the major accident procedure, action cards, and other items of equipment in the control centre and accident and emergency department and at the main recep- tion desk.Thirdly, hospital personnel must be made constantly aware of their duties in a major accident, by means of permanent display charts and by regular depart- mental discussions with the major accident officer.
98.6°F
Authors: Sue Binkley
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Endocrinology is taught to Temple University undergraduate and graduate pre—health professional and biology students. Last spring, oral thermometers were ordered so that the students could measure body temperatures in a "class experiment" this fall semester. We were surprised to find our class experiment "scooped" by the recent article in<i>JAMA</i>.<sup>1</sup> We thought you might be interested in our results. Ninety-three students (50 women and 43 men of mixed heritage) volunteered. The students all took their temperatures with oral mercury fever thermometers. The thermometers (Tem-Con Clinical Thermometers, Florida Medical Industries Inc, Leesburg, Fla) were calibrated simultaneously in a water bath. Only thermometers that read 38.4°C to 38.6°C (101.2°F to 101.4°F) in the water bath were used. Students, who had been seated for 45 minutes, took their temperatures for 3 minutes (timed with a stopwatch) ending at 10:52 AM. The mean body temperature was 36.8°C (98.2°F) (SEM, ±0.047°F;