tbuckley/cabot-search huggingface dataset:
Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis
Authors: E G. V Evans, B. Sigurgeirsson
Journal: BMJ (1999)

To compare the efficacy and safety of continuous terbinafine with intermittent itraconazole in the treatment of toenail onychomycosis.Prospective, randomised, double blind, double dummy, multicentre, parallel group study lasting 72 weeks.35 centres in six European countries.496 patients aged 18 to 75 years with a clinical and mycological diagnosis of dermatophyte onychomycosis of the toenail.Study patients were randomly divided into four parallel groups to receive either terbinafine 250 mg a day for 12 or 16 weeks (groups T12 and T16) or itraconazole 400 mg a day for 1 week in every 4 weeks for 12 or 16 weeks (groups I3 and I4).Assessment of primary efficacy at week 72 was mycological cure, defined as negative results on microscopy and culture of samples from the target toenail.At week 72 the mycological cure rates were 75.7% (81/107) in the T12 group and 80. 8% (80/99) in the T16 group compared with 38.3% (41/107) in the I3 group and 49.1 % (53/108) in the I4 group. All comparisons (T12 v I3, T12 v I4, T16 v I3, T16 v I4) showed significantly higher cure rates in the terbinafine groups (all P<0.0001). Also, all secondary clinical outcome measures were significantly in favour of terbinafine at week 72. There were no differences in the number or type of adverse events recorded in the terbinafine or itraconazole groups.Continuous terbinafine is significantly more effective than intermittent itraconazole in the treatment of patients with toenail onychomycosis.
Vulnerability of Children to Lead Exposure and Toxicity
Authors: Jane S. Lin-Fu
Journal: New England Journal of Medicine (1973)

LEAD poisoning in adults is largely an occupational hazard that can be kept under reasonable control, and the source and degree of exposure are generally known. In recent decades, improvements in industrial methods and in occupational health standards, such as institution of periodic examinations of exposed workers for early evidence of undue lead absorption, have reduced severe occupational lead poisoning considerably, particularly in the larger industries. In contrast, childhood plumbism generally occurs as accidental poisoning among young children who cannot be kept under constant surveillance. Although peeling lead-based paint in old houses has been implicated as the major source of . . .
Accepting what we can learn from advertising's mirror of desire
Authors: Peter Mansfield
Journal: BMJ (2004)

Policy implicationsThe aim of our research is to raise awareness of mythology in drug advertising, which may lead to doctors being better able to resist misleading promotion.This implies a need for closer regulation of journals as a privileged channel of communication from the drug industry to clinicians.It also highlights a rhetorical mode of persuasion in contrast with rational argument.By recognising that clinicians are also consumers, researchers and regulators could learn from advertisers how to change beliefs and behaviour more effectively than by reason alone. 19
Adenovirus-mediated CD40 ligand (CD40L) gene therapy induces tumor and protective antitumor in an orthotopic rat model for hepatocellular carcinoma (HCC)
Authors: V. Schmitz, M. Barajas, L. Wang, D. Peng, M. Zabala, M. Duarte, C. Qian, J. Prieto
Journal: Journal of Hepatology (2001)
Evaluation of Draping Techniques in Prevention of Surgical-Wound Contamination
Authors: J. Kenneth Jacobs
Journal: JAMA (1963)

ONE of the greatest challenges facing the modern surgeon is the prevention of infection in clean surgical wounds. From the Middle Ages, when abscess formation was considered "laudable," through the discoveries of Pasteur, Lister, von Bergmann, and others, this subject has occupied the time and resources of numerous investigators. Although remarkable improvement in infection rates has been achieved, an incidence of 0.25%<sup>1</sup>to 3.2%<sup>2</sup>and even higher persists. No single factor can be incriminated, but many factors acting separately or together are responsible. Meleney defined five major sources of wound contamination<sup>3</sup>: (1) the patient's skin, (2) the nose and throat of the operating room personnel, (3) bacteria in the air of the operating room, (4) the hands of the doctors and nurses, and (5) the instruments and materials used during the operative procedure. The purpose of this presentation is to report the results of investigation of only
Structural skull defects in type IV Ehlers-Danlos syndrome
Authors: Roberto Esposito, Paolo Crocchiolo, Massimo Galli, Adriano Lazzarin
Journal: British Journal of Dermatology (1984)

Journal Article Structural skull defects in type IV Ehlers‐Danlos syndrome Get access Roberto Esposito, Roberto Esposito Department of Biomedical Sciences and Technologies (Institute of Infectious Diseases) University of Milano, Italy Search for other works by this author on: Oxford Academic Google Scholar Paolo Crocchiolo, Paolo Crocchiolo Department of Biomedical Sciences and Technologies (Institute of Infectious Diseases) University of Milano, Italy Search for other works by this author on: Oxford Academic Google Scholar Massimo Galli, Massimo Galli Department of Biomedical Sciences and Technologies (Institute of Infectious Diseases) University of Milano, Italy Search for other works by this author on: Oxford Academic Google Scholar Adriano Lazzarin Adriano Lazzarin Department of Biomedical Sciences and Technologies (Institute of Infectious Diseases) University of Milano, Italy Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 110, Issue 1, 1 January 1984, Pages 122–124, https://doi.org/10.1111/j.1365-2133.1984.tb07323.x Published: 01 January 1984
Intracardiac Echocardiography Is Superior to Conventional Monitoring for Guiding Device Closure of Interatrial Communications
Authors: Thomas Bartel, Thomas Konorza, Jawed Arjumand, Tiko Ebradlidze, Holger Eggebrecht, Guido Caspari, Ulrich Neudorf, Raimund Erbel
Journal: Circulation (2003)

Background— This study sought to test whether intracardiac echocardiography (ICE) is superior to conventional monitoring in guiding device closure of interatrial communications (atrial septal defect [ASD] and patent foramen ovale [PFO]). Methods and Results— Forty-four patients undergoing device closure of ASD (n=6) or PFO (n=38) were randomized to have the procedure guided by either ICE (group 1; n=22) or by transesophageal echocardiography (TEE) (group 2; n=22). All interventions were completed successfully. In 1 patient from group 2, atrial fibrillation occurred 1 day after device implantation; the patient was successfully cardioverted on the next day. There were no other complications. Fluoroscopy time (FT) (6.0±1.7 minutes versus 9.5±1.6 minutes; P &lt;0.0001) as well as procedure time (PT) (33.4±4.7 minutes versus 37.8±5.6 minutes; P &lt;0.01) were shorter in group 1 than in group 2. Group 2 patients required general anesthesia without (n=19) or with endotracheal intubation (n=3). In contrast, ICE allowed continuous monitoring of the whole procedure, including balloon sizing before device closure, without sedation. Conclusions— ICE is a safe tool to guide device closure of PFO and ASD. Supine patients tolerate ICE better than TEE. ICE reduces FT and PT. ICE seems to be advantageous, especially when long continuous or repeated echocardiographic viewing is required.
Irreversibly sickled erythrocytes in sickle cell anemia: A quantitative reappraisal
Authors: Griffin P. Rodgers, Constance Tom Noguchi, Alan N. Schechter
Journal: American Journal of Hematology (1985)

Abstract Irreversibly sickled cells (ISCs), considered by some to be of major pathophysiologic significance, have been reported to comprise between 5–50% of the total red cell population in patients with homozygous sickle cell anemia. Since the deformation of erythrocytes containing sickle hemoglobin is highly dependent on the concentration of hemoglobin in the deoxy conformation, any method established to enumerate the true ISC count requires the hemoglobin to be in the full oxy or liganded conformation. Because the oxygen dissociation curve for sickle erythrocytes is significantly shifted to the right, extremely high partial pressures of oxygen are required to approach full saturation. On the other hand, fully liganding the hemoglobin in the oxy conformation with carbon monoxide (CO) can be readily accomplished. We found that there is a significant reduction in the average number of sickled forms in the peripheral blood of sickle cell anemia patients after incubation in CO (to a value of 6.5 ± 3.5%) when compared to conventional methods for ISC preparations. These results suggest that fully liganded erythrocytes should be used in quantitating ISCs in studies of the pathophysiology of this disease, especially since ISCs are likely to affect rheology differently from reversibly sickling cells.
New insights into weaning from mechanical ventilation: left ventricular diastolic dysfunction is a key player
Authors: John Papanikolaou, Demosthenes Makris, Theodosios Saranteas, Dimitrios Karakitsos, Elias Zintzaras, Andreas Karabinis, Georgia Kostopanagiotou, Epaminondas Zakynthinos
Journal: Intensive Care Medicine (2011)
Abstract 4446: Activation of HER Family signaling as a mechanism of acquired resistance to ALK Inhibitors in EML4-ALK-positive Non-Small Cell Lung Cancer.
Authors: Junko Tanizaki, Isamu Okamoto, Takafumi Okabe, Kazuko Sakai, Kaoru Tanaka, Hidetoshi Hayashi, Hiroyasu Kaneda, Ken Takezawa, Kazuto Nishio, Kazuhiko Nakagawa
Journal: Cancer Research (2013)

Abstract Purpose: Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) such as crizotinib show marked efficacy in patients with non-small cell lung cancer positive for the echinoderm microtubule-associated protein-like 4 (EML4)-ALK fusion protein. However, acquired resistance to these agents has already been described in treated patients, and the mechanisms of such resistance remain largely unknown. Experimental Design: We established lines of EML4-ALK-positive H3122 lung cancer cells that are resistant to the ALK inhibitor TAE684 (H3122/TR cells) and investigated their resistance mechanism with the use of immunoblot analysis, ELISA, reverse transcription and real-time PCR analysis, and an annexin V binding assay. We isolated EML4-ALK-positive lung cancer cells (K-3) from a patient who developed resistance to crizotinib and investigated their characteristic. Results: The expression of EML4-ALK was reduced at the transcriptional level, whereas phosphorylation of the epidermal growth factor receptor (EGFR), HER2, and HER3 was up-regulated, in H3122/TR cells compared with those in H3122 cells. This activation of HER family proteins was accompanied by increased secretion of EGF. Treatment with an EGFR-TKI induced apoptosis in H3122/TR cells, but not in H3122 cells. The TAE684-induced inhibition of extracellular signal-regulated kinase (ERK) and STAT3 phosphorylation observed in parental cells was prevented by exposure of these cells to exogenous EGF, resulting in a reduced sensitivity of cell growth to TAE684. K-3 cells also manifested HER family activation accompanied by increased EGF secretion. Conclusions: EGF-mediated activation of HER family signaling is associated with ALK-TKI resistance in lung cancer positive for EML4-ALK. Citation Format: Junko Tanizaki, Isamu Okamoto, Takafumi Okabe, Kazuko Sakai, Kaoru Tanaka, Hidetoshi Hayashi, Hiroyasu Kaneda, Ken Takezawa, Kazuto Nishio, Kazuhiko Nakagawa. Activation of HER Family signaling as a mechanism of acquired resistance to ALK Inhibitors in EML4-ALK-positive Non-Small Cell Lung Cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4446. doi:10.1158/1538-7445.AM2013-4446
Focal Adhesion Kinase Is a Component of Antiviral RIG-I-like Receptor Signaling
Authors: Rebecca A. Bozym, Elizabeth Delorme-Axford, Katharine Harris, Stefanie Morosky, Mine Ikizler, Terence S. Dermody, Saumendra N. Sarkar, Carolyn B. Coyne
Journal: Cell Host & Microbe (2012)
The Physiologic and Psychological Effects of the Bedside Presentation
Authors: R J Simons, R G Baily, R Zelis, C W Zwillich
Journal: New England Journal of Medicine (1989)

The bedside case presentation is a time-honored method of teaching medicine. Proponents of this exercise argue that it serves several unique functions. It validates the history, demonstrates key findings on the physical examination, and serves as a model for the interaction between physician and patient. Critics of the bedside presentation, however, have suggested that it may be stressful for patients, which could be especially detrimental to those with ischemic heart disease. To resolve this controversy, we conducted an objective study of the effect of the bedside presentation on patients with suspected acute myocardial infarction who had been admitted to a . . .
Effect of Adrenergic Beta-Receptor Blocking Drugs on Blood Flow in the Coronary and Other Vascular Fields
Authors: W. G. Nayler, I. McInnes, J. B. Swann, D. Race, T. E. Lowe
Journal: Cardiovascular Research (1968)

Journal Article Effect of Adrenergic Beta-Receptor Blocking Drugs on Blood Flow in the Coronary and Other Vascular Fields Get access Winifred G. Nayler, Winifred G. Nayler From the Baker Medical Research Institute, Victoria, Australia† † Postal address: Baker Medical Research Institute, Commercial Road, Prahran, Victoria 3181, Australia. Search for other works by this author on: Oxford Academic PubMed Google Scholar I. McInnes, I. McInnes From the Baker Medical Research Institute, Victoria, Australia† Search for other works by this author on: Oxford Academic PubMed Google Scholar J. B. Swann, J. B. Swann From the Baker Medical Research Institute, Victoria, Australia† Search for other works by this author on: Oxford Academic PubMed Google Scholar D. Race, D. Race From the Baker Medical Research Institute, Victoria, Australia† Search for other works by this author on: Oxford Academic PubMed Google Scholar T. E. Lowe T. E. Lowe From the Baker Medical Research Institute, Victoria, Australia† Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 2, Issue 4, October 1968, Pages 371–378, https://doi.org/10.1093/cvr/2.4.371 Published: 01 October 1968 Article history Received: 19 December 1967 Published: 01 October 1968
WIRE EXTENSION IN TREATMENT OF MANDIBULAR FRACTURES
Authors: R. Brooke
Journal: BMJ (1935)

THE CHID GUIDANE CLINIC -hE RITISM sensitive, overbearing or affable.Behind these personality phases can at times be sensed a whole series of biochemical states or changes, perhaps periodic changes such as -are seen in epilepsy, asthma, migraine.The endocrinal balance, allergic incompatibilities, and immunity development may all be actively manifest in the young child.
Prolonged exposure of human beta cells to elevated glucose levels results in sustained cellular activation leading to a loss of glucose regulation.
Authors: Z Ling, D G Pipeleers
Journal: Journal of Clinical Investigation (1996)

Human beta cells can be maintained in serum-free culture at 6 mmol/liter glucose, with 80% cell recovery and preserved glucose-inducible functions after 1 wk. Between 0 and 10 mmol/liter, glucose dose-dependently increases the number of beta cells in active protein synthesis (15% at 0 mmol/liter glucose, 60% at 5 mmol/liter, and 82% at 10 mmol/liter), while lacking such an effect in islet non-beta cells (> 75% activated irrespective of glucose concentrations). As in rat beta cells, this intercellular difference in glucose sensitivity determines the dose-response curves during acute glucose stimulation of human beta cells. During 2-h incubations, human beta cells synthesize 7 fmol insulin/10(3) cells at 0 mmol/liter glucose, 20 fmol at 5 mmol/liter, and 31 fmol at 10 mmol/liter. Culture at higher (10 or 20 mmol/liter) glucose does not affect beta cell recovery but decreases by 50-85% the net effect of glucose upon insulin synthesis and release. These reduced responses to glucose are not caused by diminished cellular activities but are the consequence of a shift of beta cells to a state of sustained activation. The presence of more activated cells at low glucose eliminates glucose-dependent cell recruitment as a mechanism for adjusting beta cell responses to acute variations in glucose concentration. It leads to elevated basal biosynthetic (3-fold) and secretory (10-fold) activities, and, hence, to a 4-fold reduction in the beta cell insulin content and the amount of insulin released at maximal glucose stimulation. Prolonged exposure of human beta cells to high glucose can thus lead to a loss of their glucose regulation as a consequence of sustained cellular activation, without signs of glucose-induced toxicity or desensitization.
[458] PRETREATMENT INCREASED T-HELPER 1 TYPE CYTOKINE PRODUCTION OF PERIPHERAL BLOOD MONOCYTES MAY PREDICT RAPID VIROLOGICAL RESPONSE TO PEG-IFN+RBV THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C
Authors: G. Par, T. Berki, L. Palinkas, M. Halasz, L. Szereday, A. Miseta, Zs. Faust, G. Hegedus, Gy. Mozsik, B. Hunyady, A. Par
Journal: Journal of Hepatology (2007)
‘Resolving’ Splenic Uptake of Tc-99m MDP in Aplastic Anemia
Authors: JORDAN A. NEGRIN, JOHN J. SZIKLAS, RICHARD P. SPENCER, GARY M. LEVINE, RONALD J. ROSENBERG
Journal: Clinical Nuclear Medicine (1991)

A 75-year-old woman who had been on drug therapy for a seizure disorder presented with pancytopenia. A bone scan revealed uptake of Tc-99m MDP in the spleen with an intensity equal to that of the kidneys or the lumbar vertebrae. Four months later, splenic accumulation of the bone imaging agent was markedly decreased (and the spleen was functional in terms of uptake of Tc-99m sulfur colloid). While the full “natural history” of splenic uptake of the Tc-99m diphosphonates is unknown, at least in this case it was markedly “resolving” over time.
Longitudinal cohort study on the effectiveness of lipid apheresis treatment to reduce high lipoprotein(a) levels and prevent major adverse coronary events
Authors: Beate R Jaeger, Yvonne Richter, Dorothea Nagel, Franz Heigl, Anja Vogt, Eberhard Roeseler, Klaus Parhofer, Wolfgang Ramlow, Michael Koch, Gerd Utermann, Carlos A Labarrere, Dietrich Seidel
Journal: Nature Reviews Cardiology (2009)
Effect of inhaled heparin on allergen-induced early and late asthmatic responses in patients with atopic asthma.
Authors: Z Diamant, M C Timmers, H van der Veen, C P Page, F J van der Meer, P J Sterk
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Heparin possesses anti-inflammatory properties, which appeared to be dependent on the dose, timing, and the route of administration in animal studies. In asthma, a single dose of inhaled heparin only slightly reduced the early asthmatic response (EAR) but failed to protect against the late asthmatic response (LAR) to inhaled allergen. We studied the effect of multiple doses of inhaled heparin on the EAR and LAR to inhaled house-dust mite extract in eight stable asthmatics in a two-period, randomized, double-blind, crossover study. During both study periods, a standardized allergen challenge was performed and PC20 histamine was measured 24 h before and 24 h postallergen. Five doses of unfractionated heparin sodium (1,000 U/kg/dose) or placebo were inhaled 90 and 30 min preallergen, and 2, 4, and 6 h postallergen. Airway response was measured by FEV1, and the EAR (0-3 h) and LAR (3-10 h) were expressed as corresponding areas under the time-response curves (AUC). The acute effects of heparin and placebo on baseline FEV1 were not different (p > 0.07). Although not reaching significance, heparin attenuated the EAR by an average of 40% (mean AUC(0-3) +/- SEM: 29.5 +/- 6.0 [placebo] and 17.8 +/- 5.5% fall x h [heparin]; p = 0.08), while it significantly reduced the LAR by an average of 36% (AUC(3-10) +/- SEM: 169.3 +/- 20.0 [placebo] and 109.1 +/- 23.6% fall x h [heparin]; p = 0.005). We conclude that inhaled heparin reduces the LAR to allergen in asthmatic subjects, which may be due to its anti-inflammatory activity. Our finding suggests that heparin may have potential as anti-asthma therapy.
Mesothelioma in man and experimental animals.
Authors: M Kannerstein, J Churg
Journal: Environmental Health Perspectives (1980)

Asbestos has been established as the cause of most cases of diffuse malignant mesothelioma occurring in the industrialized world. The morphology of mesothelioma may be complex, and the employment of chemical, histochemical and ultrastructural studies are often helpful in identification. Diagnostic difficulties may to some degree blur the extent of its prevalence and reliance on exposure history may not reveal its association with asbestos. Reference panels can be useful in assessing the former and analysis of lung tissue asbestos content may help to clarify the latter, especially in the low dose range. Electron microscopy may prove to be of assistance in this respect, possibly with particular attention to the peripheral areas of the lung. Animal experimentation has supported epidemiologic conclusions and revealed the phenomenon of fiber carcinogenesis. The morphology of mesothelioma in experimental animals is very similar to that in humans, including ultrastructural and biochemical features.
Contestability: a middle path for health care
Authors: C. Ham
Journal: BMJ (1996)

Quietly in the night, competition in British health care has slipped away, its passing unremarked and little noticed by those who brought it into this world. The death sentence was first signalled by William Waldegrave when he was secretary of state for health. As Mr Waldegrave commented at the time, the NHS market “isn't a market in the real sense … it's competition in the sense that there will be comparative information available.”1 The change of direction was confirmed by Virginia Bottomley. In her valedictory speech in 1995 Mrs Bottomley extolled the virtues of planning and collaboration; the word “competition” scarcely crossing her lips.2 Her successor, Stephen Dorrell, has echoed this line, most notably in a personal letter to the chairs of health authorities and trusts. In his letter Mr Dorrell referred to the achievements of the NHS management reform, and at no point did he mention markets and the benefits that would arise from competition in future. Indeed, when was the last time any health minister urged those in the NHS to leave behind the legacy of planning and grasp the competitive opportunities available to them?

The decoupling of markets and health care is not a uniquely British phenomenon, as developments in Sweden and to a lesser extent the Netherlands indicate. After a decade in which competition was seen as …
Meeting the Challenge of Chronic Illness
Authors: Timothy P Daaleman
Journal: BMJ (2006)

M y grandfather once remarked that getting old and living with a chronic illness wasn't so bad, when you consider the alternative. His wry resignation captures perfectly the sentiment of many of my older patients, an attitude that I find increasingly shared by other stake-holders in chronic illness care, such as physicians, pharmacists, nurses, and administrators. Meeting the Challenge of Chronic Illness seeks to shake us from our collective acquiescence by sounding an alarm to the coming crisis of a population that is ageing with chronic illness, a care system that is marked by disparate …