tbuckley/cabot-search huggingface dataset:
Are Sulfonylurea and Insulin Therapies Associated With a Larger Risk of Cancer Than Metformin Therapy? A Retrospective Database Analysis
Authors: Bernd Kowall, Wolfgang Rathmann, Karel Kostev
Journal: Diabetes Care (2014)

Several meta-analyses of observational studies suggested that metformin use reduces cancer risk in type 2 diabetes. However, this result was not confirmed by the few available randomized controlled trials (RCTs), and many observational studies on metformin and cancer were potentially afflicted with time-related bias. We aimed to avoid this bias when comparing cancer incidence in users of sulfonylurea, insulin, and other diabetes medications, respectively, with cancer incidence in metformin users.In a retrospective observational study, we used the German Disease Analyzer database with patient data from general practices throughout Germany. The study sample included 22,556 patients diagnosed with type 2 diabetes. During the median follow-up time of 4.8 years, 1,446 (6.4%) patients developed any cancer. In Cox regression analyses with either monotherapies or first diabetes medications as drug exposure, users of sulfonylurea (or insulin or other antidiabetes medications) were compared with metformin users.In multivariable adjusted models, hazard ratios were 1.09 (95% CI 0.87-1.36) for sulfonylurea monotherapy, 1.14 (95% CI 0.85-1.55) for insulin monotherapy, and 0.94 (95% CI 0.67-1.33) for other diabetes medications compared with metformin monotherapy. Results were similar for comparison of first diabetes medications.In a retrospective database analysis, taking into account potential time-related biases, no reduced cancer risk was found in metformin users. To clarify the association between diabetes medication and cancer risk, further well-designed observational studies and RCTs are needed.
Effect of erythrocytapheresis on arterial oxygen saturation and hemoglobin oxygen affinity in patients with sickle cell disease
Authors: Kou Uchida, Wayne R. Rackoff, Kwaku Ohene-Frempong, Haewon C. Kim, Michael P. Reilly, Toshio Asakura
Journal: American Journal of Hematology (1998)

An important purpose of blood transfusion in patients with sickle cell disease is to improve arterial oxygen saturation (SaO2) and thereby reduce red cell sickling. To investigate the degree of improvement in SaO2 by blood transfusion, we determined the hemoglobin oxygen affinity, transcutaneous oxygen saturation (Tc-SO2), and pulse rate before and after automated partial exchange transfusion (erythrocytapheresis). In 13 patients with sickle cell disease who underwent 24 erythrocytapheresis procedures, the mean oxygen tension at half saturation (P50) was significantly reduced from 30.4 ± 2.2 to 26.0 ± 1.6 mm Hg (P < 0.01) immediately after exchange transfusion. Mean Tc-SO2 values increased from 96.2 ± 2.8 to 98.5 ± 2.1% (P < 0.01). Approximately 50% of the increase in Tc-SO2 after erythrocytapheresis could be explained by the increase in hemoglobin oxygen affinity. An increase in arterial oxygen pressure (PaO2) following erythrocytapheresis, suggested by the calculated PaO2 in this study, may explain some of the increase in Tc-SO2. We conclude that improvement in Tc-SO2 in patients with sickle cell disease resulted from changes in hemoglobin oxygen affinity as well as blood oxygen pressure following erythrocytapheresis. Am. J. Hematol. 59:5–8, 1998. © 1998 Wiley-Liss, Inc.
Augmented Urography: Additional History
Authors: Benedict R. Harrow
Journal: JAMA (1964)

<h3>To the Editor:—</h3> I agree wholeheartedly with the conclusions of Hamby and Kirsh (<i>JAMA</i><b>189:</b>582 [Aug 17] 1964) that abdominal compression improves the diagnostic quality of excretory urograms. However, their statement that abdominal pressure had not been previously successful is not true. In 1955 I reported on this technique (<i>Radiology</i><b>65:</b>265, 1955) and have since demonstrated complete filling of the renal pelvis in a very high percentage of cases. The need for retrograde pyelograms has correspondingly decreased. Scandinavian physicians deserve credit for demonstrating this important principle. Olle Olsson, A. Lindbom, and J. Frimann-Dahl published extensively on this subject, with brilliant illustrations. Although the efficacy of compression has been demonstrated for almost 20 years, the procedure, for some unknown reason, has only recently come into general use in the United States. The authors' method of using small compression blocks is excellent, although other methods have proved equally efficacious.
A paper that changed my practice: Communication in the doctor-patient relationship
Authors: S. Goodacre
Journal: BMJ (2002)

In 1972 J P Recordon, a Cambridgeshire general practitioner, wrote an article on communication in general practice.1 The article arose out of a Balint group that he had been attending for three years under the leadership of Dr Marie Singer.

Balint groups, organised along the lines suggested by Michael Balint,2 were all the rage in the early 1970s; some tended a little too much towards amateur psychoanalysis, but they certainly pioneered the examination of the nature of the consultation in general practice and analysed what subconscious undercurrents might be going …
Outward potassium currents in freshly isolated smooth muscle cell of dog coronary arteries.
Authors: D W Wilde, K S Lee
Journal: Circulation Research (1989)

Outward membrane currents were characterized in single coronary smooth muscle cells of adult beagle dogs. The cells averaged 96.4 x 7.1 microns and had a resting potential of -50.7 mV, an input resistance of 307.9 M omega, a capacitance of 32.3 pF, and a calculated membrane surface area of 4,037 microns2. The cells contracted in response to external application of acetylcholine or high K+. In voltage clamp by use of the suction pipette method, outward current began to appear at -50 mV and reached 15.2 nA at 50 mV with a current density of 376.5 microA/cm2. The current was reduced by external tetraethylammonium, Ba2+, and internal Cs+, and its reversal potential had a Nernst relation to external K+ concentration. Elevation of external Ca2+ (Ca2+o) from 0 to 0.3 mM increased total K+ current by up to 300%; elevation of internal Ca2+ (Ca2+i) to 5 x 10(-7) M by internal perfusion increased total outward current to a similar extent, suggesting a large difference in Ca2+ transmembrane sensitivity. Total whole-cell K+ current consisted of two components: an initial time-independent current (Ii) followed by a time-dependent current (It). Ii and It were through separate K+ channels based on differences in a) sensitivity to Ca2+09b) modulation by an inward Ca2+ current, c) current amplitudes and activation kinetics, and d) responses to pharmacological agents. It was the largest component, measuring 4.5 nA in 0 mM Ca2+o but increasing to 11.9 nA in 0.3 mM Ca2+o with a steep 2.5 power function. It activated with a biexponential time course; in Ca2+o-free solution, its time course was relatively insensitive to voltage changes but became voltage sensitive in the presence of Ca2+o. Further, such sensitivity was abolished or enhanced by Co2+ or Bay K 8644, respectively. We concluded that there are two types of Ca2+-sensitive K+ currents, Ii and It, in coronary smooth muscle cells. Via an inward Ca2+ channel Ca2+o strongly modulates It, both in amplitude and kinetics.
Alcohol: Nutrient and Poison
Authors: C. RICHARD FLEMING
Journal: Annals of Internal Medicine (1977)

Editorial Notes1 October 1977Alcohol: Nutrient and PoisonC. RICHARD FLEMING, M.D., JOHN A. HIGGINS, M.D.C. RICHARD FLEMING, M.D.Search for more papers by this author, JOHN A. HIGGINS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-4-492 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDoctor Osler overstated the case when he said all problems would be solved by eliminating alcohol. Nonetheless alcoholism is perhaps the most costly disease with which the medical profession has to deal. Ethanol is a nutrient that when habitually taken in excess causes illness, disability, and death.In a symposium, "Fermented Food Beverages in Nutrition," held at the Mayo Clinic from 15 to 17 June 1977, the Nutrition Foundation gathered experts from industry, biochemistry, nutrition, and medicine to review the biochemistry of fermentation, the nutrient value of wine and beer, and the physical, psychosocial, and nutritional problems associated with alcoholism....References1. ATWATERBENEDICT WF: Cited by PASSMORE R: The energy value of alcohol. Presented at the symposium "Fermented Food Beverages in Nutrition," Mayo Clinic, Rochester, Minnesota, 15-17 June 1977. To be published Google Scholar2. GASTINEAU C: Nutrition note. Alcohol and calories. Mayo Clin Proc 51:88, 1976 MedlineGoogle Scholar3. HURTNELSONDICKSONHIGGINSMORSE RREJR: Nutritionalstatus of alcoholics before and after admission to an alcoholism treatment unit. Presented at the symposium "Fermented Food Beverages in Nutrition," Mayo Clinic, Rochester, Minnesota, 15-17 June 1977. To be published Google Scholar4. LIEBER C: Liver adaptation and injury in alcoholism. N Engl J Med 288:356-362, 1973. CrossrefMedlineGoogle Scholar5. PIROLALIEBER RC: Hypothesis: energy wastage in alcoholism and drug abuse: possible role of hepatic microsomal enzymes. Am J Clin Nutr 29:90-93, 1976 CrossrefMedlineGoogle Scholar6. PIROLALIEBER RC: The energy cost of the metabolism of drugs, including ethanol. Pharmacology 7:185-196, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Mayo Clinic; Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe influence of food on the absorption and metabolism of drugs: an updateThe influence of food on the absorption and metabolism of drugsThe Use of Carbohydrate-Electrolyte Supplements in Residential Treatment of Chemical DependenceNutritional management of alcoholism 1 October 1977Volume 87, Issue 4Page: 492-493KeywordsAlcoholismAlcoholsBeveragesBiochemistryDisabilitiesEthanolFoodNutrientsNutritionWine Issue Published: 1 October 1977 PDF DownloadLoading ...
Peripheral T cells undergoing superantigen-induced apoptosis in vivo express B220 and upregulate Fas and Fas ligand.
Authors: T Renno, M Hahne, J Tschopp, H R MacDonald
Journal: The Journal of Experimental Medicine (1996)

Staphylococcal enterotoxin B (SEB) is a bacterial superantigen (SAg) that predominantly interacts with V(beta)8+ T cells. In vivo treatment of mice with SEB leads to an initial increase in the percentage of V(beta)8+ T cells, followed by a decrease in the numbers of these cells, eventually reaching lower levels than those found before treatment with the SAg. This decrease is due to apoptosis of the SEB-responding cells. In the present study, we use the distinct light scattering characteristics of apoptotic cells to characterize T cells that are being deleted in response to SEB in vivo. We show that dying, SEB-reactive T cells express high levels of Fas and Fas ligand (Fas-L), which are implicated in apoptotic cell death. In addition, the B cell marker B220 is upregulated on apoptotic cells. Moreover, we show that the generation of cells with an apoptotic phenotype is severely impaired in response to SEB in functional Fas-L-deficient mutant gld mice, confirming the role of the Fas pathway in SAg mediated peripheral deletion in vivo.
Gout in The Bible and The Talmud
Authors: FRED ROSNER
Journal: Annals of Internal Medicine (1977)

Comments1 June 1977Gout in The Bible and The TalmudFRED ROSNER, M.D., F.A.C.P.FRED ROSNER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-6-833_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent article and editorial on the pathogenesis of gout (1,2) illustrate the continuing interest in this ancient disease (3). The first modern description of gout is attributed to Thomas Sydenham (AD 1624-1689) in his classic work entitled Tractatus de Podagra et Hydrope. This disease may have already been known, however, in Biblical and Talmudic times.King Asa of Judah (915-875 BC) reigned happily and peacefully for more than 40 years. In his old age, he suffered from a disease in his feet considered to be gout. The key passage is found in I Kings 15:23:Now...References1. SIMKIN P: The parthogenesis of Podagra. Ann Intern Med 86:230-233, 1977 LinkGoogle Scholar2. MCCARTY D: The gouty toe—a multifactorial condition. Ann Intern Med 86:234-236, 1977 LinkGoogle Scholar3. TALBOTTYU JT: Gout and Uric Acid Metabolism. New York, Stratton Intercontinental, 1976 Google Scholar4. DEVRIESWEINBERGER AA: King Asa's presumed gout: twentieth century A.D. discussion of ninth century B.C. Biblical patient. NY State J Med 75:452-445, 1975 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: FRED ROSNER, M.D., F.A.C.P.Affiliations: Queens Hospital Center Affiliation of the Long Island Jewish-Hillside Medical Center Queens, NY 11432 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1977Volume 86, Issue 6Page: 833-833KeywordsGoutPathogenesis ePublished: 1 December 2008 Issue Published: 1 June 1977 PDF downloadLoading ...
Joint Planning for Patient Care
Authors: George G. Reader
Journal: JAMA (1967)

Nurses and physicians have always shared responsibility for patients, but until recently, the physician has usually considered the nurse his delegate to carry out explicit orders and in general to make the patient more comfortable. Although the exceptional nurse has always recognized a separate role, this has been limited to a rather small segment of the nursing profession. Those who entered the field of public health in its early development were quick to see a unique content and a separate responsibility in planning with, and teaching, patients Hospital nurses too have been concerned with "doing for the patient, or teaching him to do, or teaching someone to do for him, those things which he would ordinarily do for himself if he had the strength, or the will, or the knowledge or the motivation," but this concept has not been universal. With the rapid expansion of the content of medicine and
Use of selected toxicology information resources in assessing relationships between chemical structure and biological activity.
Authors: J S Wassom
Journal: Environmental Health Perspectives (1985)

This paper addresses the subject of the use of selected toxicology information resources in assessing relationships between chemical structure and specific biological end points. To assist the researcher in how to access the primary literature of genetic toxicology, teratogenesis, and carcinogenesis, three specific specialized information centers are discussed--Environmental Mutagen Information Center, Environmental Teratology Information Center, and Environmental Carcinogenesis Information Center. Also included are descriptions of information resources that contain evaluated (peer-reviewed) biological research results. The U.S. Environmental Protection Agency Genetic Toxicology Program, the International Agency for Research on Cancer Monographs, and the Toxicology Data Bank are the best sources currently available to obtain peer-reviewed results for compounds tested for genotoxicity, carcinogenicity, and other toxicological end points. The value of published information lies in its use. It has become evident that most information cannot be accepted at face value for interpretation and analysis when subjected to stringent quality evaluation criteria. This deficit can be corrected by rigid editorship and the cognizance of authors. Increased interest in alternative methods to in vivo animal testing will be exemplified by use of short-term bioassays and in structure-activity relationship studies. With respect to this latter area, it must be remembered that mechanically (computer generated) derived data cannot substitute, at least at this stage, for data obtained from actual animal testing. The future of structure-activity relationship studies will rest only in their use as a predictive tool.
Growth as a solid tumor or reduced glucose concentrations in culture reversibly induce CD44-mediated hyaluronan recognition by Chinese hamster ovary cells.
Authors: Z Zheng, R D Cummings, P E Pummill, P W Kincade
Journal: Journal of Clinical Investigation (1997)

The density, molecular isoform, and posttranslational modifications of CD44 can markedly influence growth and metastatic behavior of tumors. Many CD44 functions, including some involving tumors, have been attributed to its ability to recognize hyaluronan (HA). However, only certain CD44-bearing cells bind soluble or immobilized HA. We now show that CD44 made by wild-type Chinese hamster ovary (CHO-K1) cells and a ligand-binding subclone differ with respect to N-linked glycosylation. While both bear CD44 with highly branched, complex-type glycoforms, CD44 expressed by the wild type was more extensively sialylated. CHO-K1 cells which failed to recognize HA when grown in culture gained this ability when grown as a solid tumor and reverted to a non-HA-binding state when returned to culture. The ability of CHO-K1 cells to recognize HA was also reversibly induced when glucose concentrations in the medium were reduced. Glucose restriction influenced CD44-mediated HA binding by many but not all, of a series of murine tumors. Glucose concentrations and glycosylation inhibitors only partially influenced CD44 receptor function on resting murine B lymphocytes. These observations suggest that glucose levels or other local environmental conditions may markedly influence glycosylation pathways used by some tumor cells, resulting in dramatic alteration of CD44-mediated functions.
The Prediction of Psychomaintenance in Chronic Asthma
Authors: Jerald F. Dirks, Sharon K. Robinson, Peter N. Moore
Journal: Psychotherapy and Psychosomatics (1981)

An earlier report of a Bayesian model to predict psychomaintenance-determined rehospitalization among chronic asthmatic patients was replicated and refined. The present findings further demonstrate the existence and effect of psychomaintenance, the efficacy of psychometrically based prediction of psychomaintenance, and suggest one possible way of understanding reports of the effectiveness of psychologic treatment among medically ill patients.
What is the future for training overseas graduates?
Authors: M. Sridhar
Journal: BMJ (2000)

Editorial by Welsh 

The United Kingdom has traditionally accepted many overseas doctors for higher medical training. They receive some structured training and they also fill posts in the NHS. Traditionally, entry was via the PLAB (Professional and Linguistic Assessment Board) test conducted by the General Medical Council (GMC). Although the GMC undertakes responsibility for the conduct of the tests and registering these doctors, it takes no responsibility for identifying or providing training posts. In the past, the relatively unlimited number of registrar posts in medical subspecialties meant that these doctors could take up posts for as long a period as required to fulfil their training and diploma requirements and also gain valuable experience in their chosen specialty. However, recent changes to the career structure and other factors have led to what I believe is a crisis.

> The situation gives no cause for pride 

We recently advertised for a four month locum senior house officer post in medicine. We received 224 applications. All but three were …
Molecular Biology Yields New Strategies for Combating Drug-Resistant Tumors
Authors: Beverly Merz
Journal: JAMA (1987)

DRUG RESISTANCE keeps cancer chemotherapy from working the way it should. Because chemotherapy employs drugs that kill tumor cells preferentially, it should eradicate the malignancy before irreversible damage is done to the host. But it fails to do so when, at concentrations that are tolerable to normal host tissue, cytotoxic agents are no longer able to dispatch tumor cells. Recently 24 investigators, who have spent many years trying to determine how and why tumor cells can adapt and thrive in the presence of toxic agents, spent two days discussing their findings. The occasion was the Ninth Annual Bristol-Myers Symposium on Cancer Research in Washington, DC, the home of the organizing institution, the Vincent T. Lombardi Cancer Research Center, Georgetown University School of Medicine and Hospital. Several themes surfaced: That the first evidence of drug resistance is often a change in tumor-cell chromosomes; that a single mechanism is often responsible for
Cigarette Smoking and Effects on Hormone Function in Premenopausal Women
Authors: Gayle C. Windham, Patrick Mitchell, Meredith Anderson, Bill L. Lasley
Journal: Environmental Health Perspectives (2005)

Cigarette smoke contains compounds that are suspected to cause reproductive damage and possibly affect hormone activity; therefore, we examined hormone metabolite patterns in relation to validated smoking status. We previously conducted a prospective study of women of reproductive age (n = 403) recruited from a large health maintenance organization, who collected urine daily during an average of three to four menstrual cycles. Data on covariates and daily smoking habits were obtained from a baseline interview and daily diary, and smoking status was validated by cotinine assay. Urinary metabolite levels of estrogen and progesterone were measured daily throughout the cycles. For the present study, we measured urinary levels of the pituitary hormone follicle-stimulating hormone (FSH) in a subset of about 300 menstrual cycles, selected by smoking status, with the time of transition between two cycles being of primary interest. Compared with nonsmokers, moderate to heavy smokers (>/= 10 cigarettes/day) had baseline levels (e.g., early follicular phase) of both steroid metabolites that were 25-35% higher, and heavy smokers (>/= 20 cigarettes/day) had lower luteal-phase progesterone metabolite levels. The mean daily urinary FSH levels around the cycle transition were increased at least 30-35% with moderate smoking, even after adjustment. These patterns suggest that chemicals in tobacco smoke alter endocrine function, perhaps at the level of the ovary, which in turn effects release of the pituitary hormones. This endocrine disruption likely contributes to the reported associations of smoking with adverse reproductive outcomes, including menstrual dysfunction, infertility, and earlier menopause.
Royal colleges back call to end the detention of children
Authors: Z. Kmietowicz
Journal: BMJ (2010)

Three medical royal colleges have backed a call from the charity Medical Justice for the government to release immediately any children and their families detained for reasons of immigration and to close all such facilities.

An investigation by the charity has found that detaining children for immigration purposes causes widespread anxiety, suffering, and harm. Several children have attempted to end their lives and physical health problems have been exacerbated or directly caused by detention, says the report.

Medical Justice, which arranges for doctors to visit detainees in UK immigration removal centres, says that both Nick Clegg, the deputy prime minister, and the …