tbuckley/cabot-search huggingface dataset:
Cerebrospinal Fluid Levels of Antiretroviral Medications
Authors: Karen T. Tashima
Journal: JAMA (1998)

BackgroundTreatment and prevention of HIV-1-related central-nervous-system disease may be dependent on penetration of antiretroviral drugs into the central nervous system. Few data are available about cerebrospinal-fluid penetration and concomitant changes of HIV-1-RNA concentrations during treatment with antiretroviral agents. We investigated these effects in HIV-1-infected people.Methods28 antiretroviral-naive individuals with CD4 cell counts of 200/µL or more and plasma HIV-1-RNA concentrations of 10000 or more copies/mL who were free of neurological symptoms were randomly assigned lamivudine plus either stavudine (n=17) or zidovudine (n=11). We did lumbar punctures on 28 individuals before and 22 individuals after 12 weeks of treatment to assess HIV-1-RNA and drug concentrations in cerebrospinal fluid.FindingsAll 28 individuals had detectable HIV-1-RNA concentrations in the cerebrospinal fluid (median 4.64 log10 copies/mL and 4.20 log10 copies/mL in the lamivudine plus zidovudine and lamivudine plus stavudine groups, respectively). There was no correlation between plasma and cerebrospinal-fluid HIV-1-RNA concentrations (r=0.18, p=0.35). After 12 weeks of treatment none of the individuals had detectable HIV-1-RNA concentrations in the cerebrospinal fluid. The highest drug concentration in the cerebrospinal fluid was for lamivudine followed by stavudine and zidovudine. Concentrations were consistent over time, unlike plasma concentrations. Therefore, we found time-dependent cerebrospinal-fluid to plasma drug-penetration ratios, which were highest for zidovudine followed by stavudine and lamivudine.InterpretationThe two drug combinations were equally effective in the decrease of cerebrospinal fluid HIV-1-RNA concentrations. All drugs penetrated the cerebrospinal fluid. Antiretroviral drugs other than zidovudine might be useful in the prevention of AIDS dementia complex.
Out of body experiences and their neural basis
Authors: Olaf Blanke
Journal: BMJ (2004)

Competing interests: CM intends to set up a biotech company for global marketing of an adenovirus vector for human transfection with the resolve gene of lemmings, which is upregulated by simultaneous serum uisge beatha and Wernicke area AuldLangSyne detection.Well, maybe, if he gets round to it.
A modified technique to overcome the limitations of intraductal ultrasound for diagnosis of common bile duct stones
Authors: S. Varadarajulu
Journal: Endoscopy (2008)

The use of intraductal ultrasound at endoscopic retrograde cholangiopancreatography (ERCP) enables the identification of more than 95 % of common bile duct stones, regardless of their size or composition, or the diameter of the duct [1]. However, false-positive studies have been reported to occur because of the inherent difficulty of differentiating common bile duct stones from air bubbles using intraductal ultrasound [1]. To overcome this limitation and achieve optimal imaging, we propose a new technique that can be adopted when intraductal ultrasound is performed at ERCP.
Dietary glycemic index and risk of type 2 diabetes mellitus in middle-aged Japanese men
Authors: Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Toshinari Takamura, Katsushi Yoshita, Yuko Morikawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Shuichi Kaneko, Satoshi Sasaki, Hideaki Nakagawa
Journal: Metabolism (2011)
Dangers of Cigarette Smoking
Authors: George E. Moore
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Barach's critical letter of June 1,1970 (<b>212</b>:1525, 1970) concerning the American Cancer Society's television announcements about the dangers of cigarette smoking had a puzzling assortment of quotations and statements. The sentence, "No one has yet shown that to dwell on the thought of saving one's life is morally or physically healthful," is certainly contrary to the physician's responsibility in preventing disease, preserving, and improving the state of individual health. Barach's worry about the charisma of the physician who "increasingly devotes himself to warnings" is countered by asking the public if they would retain confidence in physicians who fail to warn them of threats to their health and well being. Should physicians divorce themselves from concern over the lack of pure water, immunizations, proper diets, and the dangers of cigarette smoking? I think not. Public health measures are positive or prohibitory according to the reception given to
Strategies for coping with information overload
Authors: R. Smith
Journal: BMJ (2010)

You need a machine to help you

Fraser and Dunstan (doi:10.1136/bmj.c6815) show that even within a narrow specialty it is impossible to keep up with published medical reports.1 Trainees in cardiac imaging reading 40 papers a day five days a week would take over 11 years to bring themselves up to date with the specialty. But by the time they had completed that task, another 82 000 relevant papers would have been published, requiring another eight years’ reading. And this analysis assumes that trainees need to know about cardiac imaging only, whereas they surely need to keep up with other areas of medicine and healthcare. The authors conclude that it is impossible to be an expert⇓. 



W Heath Robinson

This problem is not new. Dave Sackett, the “father” of evidence based medicine, found some 20 years ago that to keep up to date in internal medicine it was necessary to read 17 articles a day 365 days a year.2 He also found that the median time spent reading by newly graduated doctors was zero, while for senior consultants it was 30 minutes, with 40% reading nothing.2

Some 10 years ago I asked around 100 doctors how much of what they should read to do their job better they actually read. About 80% said less than 50%, and 10% said less than 1%.3 More than half felt guilty about this, and when asked to describe in one word how they felt about their information supply it was mostly negative (impossible, overwhelmed, crushed, …
Beta-adrenergic receptor density correlates with norepinephrine uptake activity in the failing human heart
Authors: Robert P. Frantz, Helen M. Elam, Margaret R. Youngman, Naoki Imai, Marcia Shubert, Joginder N. Bhayana, Robert M. Mentzer, Chang-seng Liang
Journal: Journal of the American College of Cardiology (1991)
INEBRIETY AND IMBECILITY—A MEDICOLEGAL STUDY.
Authors: T. D. CROTHERS
Journal: JAMA (1895)

The following records of two cases bring into prominence again the old conception of inebriety, and the recent modern view accepted by the more intelligent courts and jurors. In March, 1894, John Cronin was tried and convicted for the murder of Albert Skinner. " The facts relating to his crime are these: He was a farm laborer 37 years old, living about Hartford. He has been a periodic drinker since early life, and when sober is a quiet peaceable man; when drinking is excitable, irritable, abusive and often quarrelsome. He has been arrested and confined in jail twice for intoxication. His drink periods have been growing longer and the sober intervals shorter for the past few years. He has been growing more irritable and stupid when drunk lately. "For at least two weeks before the murder he was idle and drank continuously. He was intoxicated on the night before the murder.
The Role of Ambient Ozone in Epidemiologic Studies of Heat-Related Mortality
Authors: Colleen E. Reid, Jonathan M. Snowden, Caitlin Kontgis, Ira B. Tager
Journal: Environmental Health Perspectives (2012)

A large and growing literature investigating the role of extreme heat on mortality has conceptualized the role of ambient ozone in various ways, sometimes treating it as a confounder, sometimes as an effect modifier, and sometimes as a co-exposure. Thus, there is a lack of consensus about the roles that temperature and ozone together play in causing mortality.We applied directed acyclic graphs (DAGs) to the topic of heat-related mortality to graphically represent the subject matter behind the research questions and to provide insight on the analytical options available.On the basis of the subject matter encoded in the graphs, we assert that the role of ozone in studies of temperature and mortality is a causal intermediate that is affected by temperature and that can also affect mortality, rather than a confounder.We discuss possible questions of interest implied by this causal structure and propose areas of future work to further clarify the role of air pollutants in epidemiologic studies of extreme temperature.
Serious hazards of transfusion (SHOT) initiative
Authors: P. Nederlof
Journal: BMJ (2000)

# Conclusion was not supported by data presented {#article-title-2} EDITOR—Williamson et al report on the safety of transfusions in the first two annual reports of the serious hazards of transfusion (SHOT) initiative.1 Although they found 366 cases of serious complications after transfusion, they conclude that transfusions are extremely safe. This conclusion is not supported by their data because they do not mention the total number of transfusions. A rate of complications would be useful for junior doctors, who usually have to seek patients' consent to procedures. Do any such data exist? 1. 1.↵1. Williamson LM, 2. Lowe S, 3. Love EM, 4. Cohen H, 5. Soldan K, 6. McClelland DBL, 7. et al . Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports. BMJ 1999; 319: 16–19. (3 July.) [OpenUrl][1][Abstract/FREE Full Text][2] # Autologous transfusion would avoid many of the problems of blood transfusion {#article-title-4} EDITOR—Two articles in the BMJ last year highlight important issues in blood transfusion—namely, safety and autologous transfusion—and emphasise the need for education and standardisation of procedures.1 2 Provan raises the issues of availability and cost.1 The requirement for red cells is increasing annually by 2-3% against a static or even falling number of donations. One solution, suggested by both Provan1 and the NHS Executive, 3 is to increase the use of autologous transfusion. The safest and … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DWilliamson%26rft.auinit1%253DL%2BM%26rft.volume%253D319%26rft.issue%253D7201%26rft.spage%253D16%26rft.epage%253D19%26rft.atitle%253DSerious%2Bhazards%2Bof%2Btransfusion%2B%2528SHOT%2529%2Binitiative%253A%2Banalysis%2Bof%2Bthe%2Bfirst%2Btwo%2Bannual%2Breports%26rft_id%253Dinfo%253Apmid%252F10390452%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=319/7201/16&atom=%2Fbmj%2F320%2F7241%2F1075.1.atom
Effect of Biochemical Components on Rheologic Properties of Nasal Mucus in Chronic Sinusitis
Authors: YUICHI MAJIMA, TERUHIKO HARADA, TAKESHI SHIMIZU, KAZUHIKO TAKEUCHI, YASUO SAKAKURA, SUSUMU YASUOKA, SUMIKO YOSHINAGA
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

The effect of biochemical components on the viscoelasticity of nasal mucus from 24 patients with chronic sinusitis (CS) was investigated by multiple stepwise regression analysis. The dynamic viscosity ( η′ ) and the elastic modulus (G ′ ) of nasal mucus were determined with an oscillating sphere magnetic rheometer at oscillatory frequencies of 1 and 10 Hz. The η′ and G ′ values of mucus determined at 1 Hz were 1.6 ± 1.5 Pa/s and 31.8 ± 31.0 Pa, respectively, and these values were much higher than optimal viscoelasticity for mucociliary transport. The concentrations of fucose, N-acetyl neuraminic acid, albumin, IgG, secretory-IgA, and lysozyme were measured in the same mucus samples. The multiple regression analysis showed that the concentration of fucose, a marker of mucous glycoproteins, was the most important determinant of η′ and G ′ . The analysis also revealed that the level of IgG was the next important determinant. The coefficients of multiple determination for fucose and IgG were 0.732 and 0.733 when the response variables were η′ and G ′ , respectively. The results indicate that locally produced mucous glycoproteins may largely contribute to the high viscoelasticity of nasal mucus in CS.
The Impact of Tumor Multifocality on Outcomes in Patients Treated With Radical Nephroureterectomy
Authors: Thomas F. Chromecki, Eugene K. Cha, Harun Fajkovic, Vitaly Margulis, Giacomo Novara, Douglas S. Scherr, Yair Lotan, Jay D. Raman, Wassim Kassouf, Karim Bensalah, Alon Weizer, Eiji Kikuchi, Marco Roscigno, Mesut Remzi, Kazumasa Matsumoto, Thomas J. Walton, Armin Pycha, Vincenzo Ficarra, Pierre I. Karakiewicz, Richard Zigeuner, Karl Pummer, Shahrokh F. Shariat
Journal: European Urology (2011)
Abstract 3375: Targeting glucose metabolism by 2-deoxyglucose in gastrointestinal stromal tumors
Authors: Thomas Mühlenberg, Susanne Grunewald, Martin Schuler, Sebastian Bauer
Journal: Cancer Research (2014)

Abstract Introduction Most patients with gastrointestinal stromal tumors (GIST) respond to imatinib (IM) but eventually progress with then limited therapeutic options. Fluorodeoxyglucose (FDG) is used for visualizing tumors by positron emission tomography (PET) and has been particularly helpful for predicting tumor response in highly FDG-avid GIST. 2-deoxy-glucose (2DG) inhibits glucose metabolism in cancer cells, which depend exclusively on aerobe glycolysis for ATP production (Warburg Effect). 2DG is currently investigated in several clinical trials. Here we evaluated the therapeutic potential of 2DG in GIST in vitro and in vivo. Methods Two IM-sensitive (IM-S; GIST-T1, GIST882) and 3 IM-resistant (IM-R; GIST430, GIST48, GIST48B) cell lines were studied. Cell viability was evaluated by Sulforhodamin B (SRB) assay after 6 days of 2DG treatment and combinations with IM and ABT-263, a BH3-mimetic. Immunoblotting was done for KIT- and KIT-downstream signaling and markers of apoptosis. For in vivo experiments nude mice bearing GIST-T1 xenografts were treated for 21 days with 500mg/kg/d 2DG or vehicle control. Results Cell viability assays in KIT-expressing cell lines displayed IC50 values for 2DG between 0.5mM (GIST882) and 2.5mM (GIST48), while KIT-negative GIST48B was less sensitive (6mM). Notably, treating GIST-T1 in low-glucose media (1g/L, LG) reduced IC50 (1.1mM to 0.33mM) in a glucose dependent manner. Immunoblot studies revealed a dose- and glucose dependent inhibition of KIT glycosylation by 2DG with complete inhibition at 1mM in LG, which coincided with inhibition of KIT-phosphorylation and KIT-downstream signaling. The combination of 2DG with IM had additive antiproliferative effects in IM-S cell lines. In IM-R GIST430 a synergistic induction of apoptosis could be observed when combining KIT-inhibiting concentrations of 2DG with ABT-263 1µM. Treatment of mice with 2DG alone did not affect tumor growth. At this dose 2DG dependent inhibition of KIT-glycosylation or -phosphorylation was not observed. Conclusions 2DG shows promising GIST-specific antiproliferative effects by inhibiting KIT-glycosylation and -phosphorylation in vitro. These effects were additive when combined with imatinib. Further studies will investigate alternate treatment schedules as well as drug combinations with the aim of translating 2DG into a clinical trial in GIST. Citation Format: Thomas Mühlenberg, Susanne Grunewald, Martin Schuler, Sebastian Bauer. Targeting glucose metabolism by 2-deoxyglucose in gastrointestinal stromal tumors. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3375. doi:10.1158/1538-7445.AM2014-3375
Lp(a) Lipoprotein, Vascular Disease, and Mortality in the Elderly
Authors: Abraham A. Ariyo, Chau Thach, Russell Tracy
Journal: New England Journal of Medicine (2003)

As compared with what is known about predictors of vascular events in middle-aged persons, less is known about these events in the elderly. Lp(a) lipoprotein, which plays an important part in atherothrombogenesis, has been associated with an increased risk of vascular disease. We investigated this relation among older U.S. adults.
Acute Myocarditis with Bundle Branch Block due to Sulfonamide Sensitivity
Authors: ALFRED LILIENFELD, ELLIOT HOCHSTEIN, WILLIAM WEISS
Journal: Circulation (1950)

This is a case report of a patient who developed generalized manifestations of sulfonamide sensitivity, with evidence of involvement of the skin, mucous membrane, central nervous system, liver, and myocardium. Special attention is directed to the myocardial involvement, and particularly to the development of bundle branch block. The changes were reversible and complete recovery ensued.
Some Observations on Transurethral Prostatic Resection
Authors: Reed M. Nesbit
Journal: New England Journal of Medicine (1947)

WHEN resident surgeons are taught the performance of transurethral prostatic resection at the University of Michigan Hospital and when matters pertaining to resection are discussed with visiting urologists, it has appeared desirable to emphasize certain details of technic that have been found necessary to the successful execution of operation. Many of these appear not to have been adequately elaborated on in the literature, and for that reason it seems appropriate to report some of the particulars that are considered to be fundamental.The earliest description of operative procedures, purposefully designed to relieve obstructive uropathy, was written by Ambroise Paré, who, . . .
Renewed Efforts to Improve the Quality of Health Care
Authors: Mike Mitka
Journal: JAMA (1999)

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Thyroid dysfunction and affective illness
Authors: B. Harris, D. W Phillips, S. Othman, R. H Hall, J. H Lazarus, C. J Richards
Journal: BMJ (1991)

Thyroid dysfunction and affective illness SIR,-Professor E Szabadi's editorial on thyroid dysfunction and affective illness raised the question of whether subclinical dysfunction of the thyroid has a role in affective illnesses.'Lithium is well recognised to affect thyroid hormones; cases of hypothyroidism and hyperthyroidism have been reported.2Primary affective disorders may themselves have a role in the development of autoimmune thyroid disease.A recent study was designed to determine whether the development of autoimmune thyroid disease was due to lithium treatment or depressive illness.4Three main groups were studied: a control group, patients receiving treatment other than lithium for depression, and patients receiving lithium for their manic depressive illness.All patients were clinically and biochemically euthyroid.The serum samples obtained were tested for thyroid microsomal and thyroglobulin antibodies.None of the controls were positive for thyroid antibodies, but 7-5% of the patients receiving treatment other than lithium for depression were positive for the antibodies.This, however, is not significantly high when compared with the incidence in the general population.'The patients receiving lithium for their manic depressive illness showed a greatly increased incidence of thyroid antibodies (20%), in keeping with results of other studies.' 6 The authors concluded that lithium treatment induces the formation of antibodies in susceptible people, which may lead to the development of thyroid disease in these patients.A larger study will be necessary to determine whether affective disorders alone play any part in the development of subclinical hypothyroidism.
Effect of ACTH and Cortisone on Fat Absorption in Steatorrhea of Various Causes
Authors: Ernst J. Drenick, Elizabeth Hvolboll, James A. Halsted
Journal: New England Journal of Medicine (1955)

THE steatorrhea occurring in nontropical sprue or the "malabsorption syndrome" has been shown by several observers to be markedly decreased by treatment with ACTH or cortisone.1 2 3 4 5 6 The purpose of this study was to determine whether fat absorption in steatorrhea other than that caused by nontropical sprue might be improved by steroid therapy. Furthermore, it was hoped that the data obtained might help determine whether the steroid administration had a specific beneficial effect on fat absorption by the intestinal mucosa.Four patients with steatorrhea due to different mechanisms were studied. Case 1 had steatorrhea associated with a subtotal gastric resection and . . .
Studies on the in vitro behavior of agammaglobulinemic lymphocytes
Authors: S. R. Cooperband, F. S. Rosen, S. Kibrick
Journal: Journal of Clinical Investigation (1968)

Circulating lymphocytes from patients with congenital X-linked agammaglobulinemia, sporadic congenital agammaglobulinemia, and acquired agammaglobulinemia have been cultured in vitro. They have been shown to proliferate in a normal manner under stimulus of phytohemagglutinin and antigens to which the patient was sensitized. Agammaglobulinemic cells have been shown to synthesize protein at a rate similar to that of normal cells, and the character of the extracellular protein produced is also similar. Agammaglobulinemic lymphocytes have been found to produce a small quantity of immunoglobulin G, similar to that found in normal cell cultures. The quantity of immunoglobulin produced may be increased by exposure of the cells to phytohemagglutinin. From these data, it appears that the basic lesion responsible for agammaglobulinemia is not a deficiency in lymphocyte-mediated antigen recognition or cellular proliferation. It would also appear that the basic deficiency in these disorders does not involve the structural or regulatory genes necessary for the synthesis of immunoglobulins. By exclusion, the pathogenesis of the deficiency would appear to involve cells other than circulating lymphocytes.
Orchitis as a Complication of Infectious Mononucleosis
Authors: Carl Wolnisty
Journal: New England Journal of Medicine (1962)

INFECTIOUS mononucleosis is a disease of unknown etiology frequently seen in younger age groups and characterized by protean symptoms. Among the complications previously reported with this entity are encephalitis, polyneuritis, uveitis, optic neuritis, atypical pneumonia, pericarditis, hepatitis, splenomegaly and rupture, hemolytic anemia, interstitial nephritis and cutaneous lesions.1 Clinically bizarre signs and symptoms and multiple system involvement may be present. In 1960 Ralston, Saiki and Powers2 reported a case of infectious mononucleosis complicated by orchitis. The following is the report of a second case.Case ReportA 16-year-old boy had enjoyed his usual state of good health until May 8, 1961, . . .