tbuckley/cabot-search huggingface dataset:
A New Paradigm for the Treatment of Sepsis: Is It Time To Consider Combination Therapy?
Authors: Alan S. Cross, Steven M. Opal
Journal: Annals of Internal Medicine (2003)

Despite the advances in supportive care and the availability of potent antimicrobial agents, mortality from sepsis, a leading cause of death in intensive care units, has not improved. Over the last decade, clinical trials with numerous adjunctive therapies, including antiendotoxin antibodies and inhibitors of the inflammatory response, have yielded disappointing results. Recently, treatment with recombinant human activated protein C reduced mortality 6% compared with controls. Given the likelihood that many processes in the complex pathophysiology of sepsis are simultaneously activated, it is unlikely that therapy directed at any one of them, as has been done in the past, will dramatically improve survival. Rather, a combination of therapies directed at many arms of the septic process, much like the strategy used for cancer and HIV infection, is required. Given the likelihood that sepsis represents an excessive innate immune response to microbial products, vigorous attempts must be made to develop rapid assays that reflect the level of innate immune activation. Such assays could be used to identify patients who would benefit from therapy and to monitor their response so that overtreatment does not completely abrogate host defense mechanisms and render these patients susceptible to fatal infection. It is now time to test a new therapeutic paradigm based on an improved understanding of the pathophysiology of the septic process and the recognition that we may have reached the limits of adjunctive monotherapy.
Excessive Intake of Zinc Impairs Immune Responses
Authors: Ranjit Kumar Chandra
Journal: JAMA (1984)

The effect of administration of large amounts of zinc on immune response and serum lipoproteins was examined. Eleven healthy adult men ingested 150 mg of elemental zinc twice a day for six weeks. This was associated with a reduction in lymphocyte stimulation response to phytohemagglutinin as well as chemotaxis and phagocytosis of bacteria by polymorphonuclear leukocytes. Serum high-density lipoprotein concentration decreased significantly and low-density lipoprotein level increased slightly. The common food fad of zinc supplementation with resultant excessive intake could have deleterious effects in healthy persons.
Skeletal Muscle in Health and Disease: A textbook of muscle physiology
Authors: Peter Sperryn
Journal: British Journal of Sports Medicine (1995)

This publication is a review of topics related to physiotherapy for musculoskeletal conditions and will be most appropriate to the needs of those who seek to understand in detail the scientific foundations underpinning musculoskele- tal therapy.The book is one of a series intended to promote those intellectual processes that the general editors con- sider critical to clinical management.These include an accurate understanding of the clinical significance of theoretical data that informs practice, and the con- tinued systematic development of meth- ods of treatment and evaluation.Chapters are contributed by a variety of authors drawn from medicine and physiotherapy, and each explores some aspect of the anatomical, physiological, and biomechanical mechanisms relevant to musculosketal rehabilitation.The top- ics covered are diverse and include skel- etal muscle performance, pain sensitivity, articular adaptation and joint stiffness, muscle disuse atrophy and strength train- ing, and the clinical significance of correct alignment of the body segments.Unfortunately within the general field of musculoskeletal pathophysiology and therapy the contents do not address a specific theme.This lack of focus may render Key Issues in Musculoskeletal Physiotherapy less popular than other similar publications, although the subjects dis- cussed are, individually, of considerable importance.
Increased platelet receptor occupancy following eptifibatide therapy is associated with improved patency, tissue level perfusion, and ST-segment resolution in ST-segment elevation myocardial infarction: An INTEGRITI substudy
Authors: C.Michael Gibson, Lisa K. Jennings, Robert P. Giugliano, Robert A. Harrington, Matthew T. Roe, Sabina A. Murphy, Shila Cholera, Kenneth W. Baran, Hans-Peter Hobbach, Eugene Braunwald
Journal: Journal of the American College of Cardiology (2003)
Hyperglycemia facilitates urinary excretion of C-peptide by increasing glomerular filtration rate in non-insulin-dependent diabetes mellitus
Authors: Taro Wasada, Hiroyuki Kuroki, Hiroko Arii, Akiko Maruyama, Kozo Katsumori, Kaori Aoki, Setsu Saito, Yasue Omori
Journal: Metabolism (1995)
Emergency treatment against a patient's wishes.
Authors: D. Peckham
Journal: BMJ (1992)

Dispensing doctorsEDITOR, -David Roberts has grossly misinter- preted the statistics from the Prescription Pricing Authority in his letter on dispensing doctors.' Closer examination of the detail provided in the authority's annual report for 1990-1 shows that savings could be made if all dispensing was undertaken by pharmacists.
Data Sharing in a Humanitarian Organization: The Experience of Médecins Sans Frontières
Authors: Unni Karunakara
Journal: PLoS Medicine (2013)

Unni Karunakara and colleagues discuss how Médecins Sans Frontières decided to adopt a data sharing policy for routinely collected clinical and research data in humanitarian settings and its aspirations to create a truly open data set with the first step being managed access. Please see later in the article for the Editors' Summary
What Is a Person? An Ethical Exploration
Authors: Richard Dayringer
Journal: JAMA (1997)

Are<i>human</i>and<i>person</i>equivalent terms? Walters, Loma Linda University Medical Center theologian-philosopherethicist, does not think so. The notions that all humans are sacred and that only full persons are maximally valuable are colliding. For Walters, the physicalist model is based on the idea that all individuals, by virtue of their physical presence, share in the nature of humanness and therefore possess full moral standing. The personalist model is premised on the idea that only those individuals who possess particular higher capacities of the brain deserve full moral status. Walters writes, "My argument, in just a sentence, is that the<i>more nearly an individual human or animal approximates a life of self-consciousness (such as yours or mine), the greater the claim of that individual to maximal moral status</i>." Self-consciousness, for him, is a necessary and sufficient condition to be a person of full moral status. Consequently, "neither a conceptus nor
Cross Talk of Combined Gene and Cell Therapy in Ischemic Heart Disease
Authors: Sang-Ging Ong, Won Hee Lee, Mei Huang, Devaveena Dey, Kazuki Kodo, Veronica Sanchez-Freire, Joseph D. Gold, Joseph C. Wu
Journal: Circulation (2014)

Despite the promise shown by stem cells for restoration of cardiac function after myocardial infarction, the poor survival of transplanted cells has been a major issue. Hypoxia-inducible factor-1 (HIF1) is a transcription factor that mediates adaptive responses to ischemia. Here, we hypothesize that codelivery of cardiac progenitor cells (CPCs) with a nonviral minicircle plasmid carrying HIF1 (MC-HIF1) into the ischemic myocardium can improve the survival of transplanted CPCs.After myocardial infarction, CPCs were codelivered intramyocardially into adult NOD/SCID mice with saline, MC-green fluorescent protein, or MC-HIF1 versus MC-HIF1 alone (n=10 per group). Bioluminescence imaging demonstrated better survival when CPCs were codelivered with MC-HIF1. Importantly, echocardiography showed mice injected with CPCs+MC-HIF1 had the highest ejection fraction 6 weeks after myocardial infarction (57.1±2.6%; P=0.002) followed by MC-HIF1 alone (48.5±2.6%; P=0.04), with no significant protection for CPCs+MC-green fluorescent protein (44.8±3.3%; P=NS) when compared with saline control (38.7±3.2%). In vitro mechanistic studies confirmed that cardiac endothelial cells produced exosomes that were actively internalized by recipient CPCs. Exosomes purified from endothelial cells overexpressing HIF1 had higher contents of miR-126 and miR-210. These microRNAs activated prosurvival kinases and induced a glycolytic switch in recipient CPCs, giving them increased tolerance when subjected to in vitro hypoxic stress. Inhibiting both of these miRs blocked the protective effects of the exosomes.In summary, HIF1 can be used to modulate the host microenvironment for improving survival of transplanted cells. The exosomal transfer of miRs from host cells to transplanted cells represents a unique mechanism that can be potentially targeted for improving survival of transplanted cells.
A History and Theory of Informed Consent.
Authors: Fred M. Frohock
Journal: Annals of Internal Medicine (1986)

This volume provides a historical and conceptual review of informed consent with particular attention to the special conditions under which such consent is obtained.  Topics covered by the books 10 chapters are:  foundations in moral theory foundations in legal theory pronouncement and practice in clinical medicine the emergence of legal doctrine the development of consent requirements in research ethics the evolution of federal policy governing human research in the US the concept of autonomy the concepts of informed consent and competence standards of understanding and coercion manipulation and persuasion.  A distinction is made between 2 concepts of informed consent--informed consent defined in terms of the conditions of a particular kind of autonomous authorization and informed consent where the nature and acceptability of effective authorizations are established by operative informed consent rules in a particular policy system.  Required is a complex balancing of policy objectives moral considerations and the interests of various parties in the setting of consent requirements.
Felty's syndrome. Good response to adrenocorticosteroids: possible mechanism of the anaemia.
Authors: C. D. Pengelly
Journal: BMJ (1966)

Dialysmg Fluid-Longmore and Parsons BRrTrSH lence.The suction-hole for this small vortex-venturi unit is placed just below the cell of the electric conductivity meter and helps scour this of small bubbles and also ensures a good flow of fluid through it.
Transgenic approach to hepatitis B Virus liver damage
Authors: Jorge J. Gumucio, Michael W. McDonnell, Rebecca W. Van Dyke
Journal: Hepatology (1991)

This study investigates the role of the immune system in the pathogenesis of hepatic injury during hepatitis B virus infection. A transgenic mouse line containing the gene sequences for the hepatitis B virus envelope region (pre-S1, pre-S2, and HBs Ags) ligated to mouse albumin regulatory sequences was developed. Mice of this lineage did not contract spontaneous liver disease and were immunologically tolerant to pre-S and HBs Ags. Nontransgenic mice of the same lineage were immunized with a recombinant vaccinia virus containing the coding region for the HBs polypeptide. Spleen cells from immunized mice were transferred into the transgenic mice. The recipient transgenic mice exhibited prompt falls in serum HBsAg, appearance of serum anti-HBsAg and biphasic patterns of serum ALT elevation. The first rise in serum ALT (3 to 7 days after spleen cell transfer) appeared to be due to antibody-mediated cell injury because it could be reproduced by administration of serum from immunized, nontransgenic mice to transgenic mice. The second rise in ALT, at 14 to 21 days, occurred long after disappearance of serum HBsAg and was associated with histological evidence of liver cell necrosis and infiltration of the liver by lymphocytes. In other experiments, the pattern of delayed injury was reproduced by transfer of specific cytotoxic Lyt 2+ (CD8) T cells from immunized nontransgenic mice to transgenic mice, suggesting a role for cytotoxic T lymphocyte—mediated immune injury. Further studies using a cytotoxic T lymphocyte cell line specifically sensitized to HBsAg suggested that (a) cytotoxicity was specifically directed against cells that expressed a small region of the HBsAg; (b) cytotoxicity was major histocompatibility complex—restricted (i.e. cells expressing HBsAg but not identical major histocompatibility complex antigens were not killed); (c) cytotoxicity was enhanced if target cells were pretreated with γ-interferon, which presumably enhances expression of major histocompatibility complex antigens; and (d) cytotoxicity and liver cell injury could be reproduced in vivo by transfer of HBsAg-directed cytotoxic T cell lines back into transgenic mice (which express hepatitis B antigens). In summary, transgenic mice were raised that expressed HBV-encoded antigens at the hepatocyte surface in a form recognizable by both major histocompatibility complex class I—restricted cytotoxic T lymphocytes and envelope-specific antibodies. The resultant liver cell injury indicates that chronic HBV infection may be mediated by antigenspecific, cell-mediated responses. Finally, these studies also suggest a role (perhaps minor) for viral antibodies in hepatocyte injury.
The management of common metabolic bone disorders
Authors: S. Patel
Journal: Annals of the Rheumatic Diseases (1994)

Reviewsthat electromyography has little to offer in the mangement of spinal disease.Treatments both traditional and unconventional are all extensively reviewed and a lot of common sense advice on the management of neck pain is provided but, as one reads, it becomes very clear that, despite being a frequent source of pain, the cervical spine is a sadly neglected area in the field of research.Conclusion-an excellent browse and a good reference book to have in the department or library.
Smoking, lung function, and body weight.
Authors: B Nemery, N E Moavero, L Brasseur, D C Stanescu
Journal: BMJ (1983)

In a cross-sectional study of steelworkers aged 45-55 years, smokers (n = 105; mean weight 76.1 kg) were found to weigh significantly less than non-smokers (n = 54; 81.6 kg) and ex-smokers (n = 51; 82.6 kg). The lower weight of smokers was attributable to a group with airflow obstruction (n = 37; forced expiratory volume in one second/vital capacity (FEV1/VC) less than 66%), who weighed less (4.8 kg; p less than 0.05) than smokers with normal FEV1/VC (n = 68). In smokers, but not in ex-smokers or non-smokers, body mass index and FEV1/VC ratio were closely related (r = 0.34; p less than 0.001). This association was apparently not due to an effect of body weight on lung function. Weight loss in smokers may be the consequence of impaired lung function or reflect the effect of cigarette smoking on both the respiratory tract and metabolism in susceptible subjects.
Recognition of uridine diphosphate glucuronosyl transferases by LKM-3 antibodies in chronic hepatitis D Philipp T, Durazzo M, Trautwein C, Britta Alex B, Straub P, Lamb JG, Johnson EF, et al. Lancet 1994; 344: 578?581
Authors: F BONINO
Journal: Hepatology (1995)

Patients with chronic hepatitis D often have liver-kidney microsomal antibodies type 3 (LKM-3). These antibodies react with several microsomal antigens that have a molecular weight of 55 HDa and an isoelectric point of about 8. We studied the molecular nature of the antigen and, by immunoscreening a human liver cDNA expression library with KM-3 sera, found that uridine diphosphate glucuronosyl transferase (UGT) appeared as candidate antigens. We confirmed the identity of UGT as an antigen by reacting the sera with recombinant rabbit liver UGT proteins. Some sera reacted with rabbit UGT-2 proteins, but UGT-1 proteins were more sensitive and specific in detecting LKM-3 autoantibodies in patients sera. Anti-UGT-1 antibodies were detected in all LKM-3 positive sera from patients with hepatitis D and 1 out of 11 patients with autimmune hepatitis type 2. Sera from patients who had hepatitis B only did not react with UGT proteins.
The Influence of the Antecedent Diet upon Glucagon and Insulin Secretion
Authors: Walter A. Muller, Gerald R. Faloona, Roger H. Unger
Journal: New England Journal of Medicine (1971)

The effect of varying carbohydrate intake upon plasma insulin and glucagon was tested in five volunteers. One week of carbohydrate restriction lowered fasting insulin from 18 to 11 μU per milliliter, whereas fasting glucagon rose from 100 to 136 pg per milliliter, a decline in insulin-glucagon ratio (I/G) of 3.9 to 1.6. One week of isocaloric restoration of carbohydrate to the diet increased fasting insulin to 14 μU per milliliter, and glucagon declined to 65 pg per milliliter, a return of I/G to 4.4. A week of carbohydrate restriction changed the response of insulin and glucagon to protein, insulin rising only to 15 μU per milliliter, whereas glucagon rose from 126 to 218 pg per milliliter, I/G remaining unchanged. After one week of a carbohydrate-containing diet insulin rose to 38 μU, and glucagon to only 167 pg per milliliter, I/G rising from 4.35 to 8.2. The results support the key glucoregulatory role of the alpha and beta cells in influencing hepatic glucose production from both endogenous and ingested glucose precursors in accordance with need.
PROGNOSTIC VALUE OF ANEMIA IN CHRONIC GLOMERULAR NEPHRITIS
Authors: GEORGE E. BROWN
Journal: JAMA (1923)

Since the advent of recent methods for studying renal function, a great deal of additional information has been gained which aids in the diagnosis and prognosis of renal disease. The work of Myers1and his associates on the relationship of increased concentration of creatinin in the blood, and life expectancy in chronic nephritis, has been of great value in drawing accurate prognostic conclusions. These workers have shown that the maintenance of a high leyel of creatinin (5 mg. or more for each 100 c.c.) in the blood indicates a very grave prognosis, and that values from 2 to 5 mg. for each 100 c.c. are of serious import. These conclusions have been amply verified. A consistently high level of blood urea, or a continued low excretion (5 per cent, or less of phenolsulphonephthalein in the urine in two hours), also usually indicates a serious prognosis. Moreover, the ophthalmoscopic examination
(50) Ross' syndrome
Authors: I.H. Coulson, R.A. Marsden
Journal: British Journal of Dermatology (1985)

Journal Article (50) Ross' syndrome Get access I.H. Coulson, I.H. Coulson St George's Hospital, London SW17 Search for other works by this author on: Oxford Academic Google Scholar R.A. Marsden R.A. Marsden St George's Hospital, London SW17 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 113, Issue s29, 1 July 1985, Pages 96–97, https://doi.org/10.1111/j.1365-2133.1985.tb13065.x Published: 01 July 1985
US Justice Department brings charges in massive Medicare fraud scheme
Authors: F. Charatan
Journal: BMJ (2010)

The US Department of Justice has arrested and charged 28 people for allegedly operating a 25 state scheme to defraud Medicare, the federal health insurance programme for people aged 65 or over.

The fraudsters set up dozens of phoney clinics across the country and gained more than $35m (£22m; €25m) in concocted medical bills, the prosecutors say. …
BMJ set to sign with PubMed Central, JSTOR, and WorldSpace
Authors: T. Delamothe
Journal: BMJ (2000)

Within the next few weeks, the BMJ expects to join three separate initiatives, which together will make more of the journal available to many more people. It will be the first general medical journal to join PubMed Central, a project masterminded by the US National Institutes of Health to make the results of original research in the life sciences freely available to everyone via the internet (BMJ 1999;318:1637-8).

Electronic …
Real-Time Ultrasonography
Authors: P. L. Cooperberg, H. J. Burhenne
Journal: New England Journal of Medicine (1980)

We used high-resolution real-time ultrasonography to examine the gallbladder in patients with signs and symptoms suggestive of gallbladder disease. Using this noninvasive technique, the physician can examine the gallbladder and related anatomy thoroughly in less than five minutes. The technique is much easier to learn and perform than gray-scale ultrasonography. In 313 patients in whom gallstones were later confirmed at cholecystectomy or autopsy, the ultrasound examination achieved an accuracy of 96 per cent in the evaluation of cholelithiasis. Five examinations gave false-negative results, one a definite false-positive result, and two possible false-positive results; six examinations were inadequate. The sensitivity of the method was 98 per cent, and the specificity was between 93.5 and 97.7 per cent. In 124 patients evaluated prospectively by means of both ultrasound and oral cholecystography, the ultrasound study revealed calculi in five patients in whom calculi were not demonstrated on an adequate oral cholecystogram. No calculus detected with oral cholecystography was missed by ultrasound. We believe that ultrasound should replace oral cholecystography as the first technique in evaluation of the patient with suspected gallbladder disease.
Why Some Health Policies Don't Make Sense at the Bedside
Authors: David A. Asch
Journal: Annals of Internal Medicine (1995)

Cost-effectiveness analysis and other forms of decision analysis are becoming more common in the medical literature and are increasingly influential in the development of health policy. Nevertheless, many clinicians find it difficult to apply policies developed from these analyses to individual encounters with patients. We examine the assumptions behind these analyses and argue that the perspective they embody can make clinical strategies appear to be less risky in theory than they are at the bedside. We believe that this problem underlies the intuitive concern many physicians have about policy analyses and calls into question the value of these analyses in shaping clinical practice. These analyses aggregate the benefits and burdens of alternative interventions across different individual persons. Thus, overall population risk appears blunted, as it would in a diversified portfolio of stocks that react differently to financial forces or in a herd of cattle that react differently to veterinary interventions. The assumptions behind these analyses make sense if aggregate outcome is what matters, but not if one cares about each individual investment or animal. Because such aggregation tends to understate individual risk, when applied to human health policy, it may misrepresent the interests of patients and cannot be assumed to provide useful guidelines for decision making at the bedside.
Electrocardiographic Changes and Plasma Potassium Levels in Patients on Regular Haemodialysis
Authors: M. Papadimitriou, R. R. Roy, M. Varkarakis
Journal: BMJ (1970)

Two out of four patients who had severe ischaemic E.C.G. changes when first accepted on to the dialysis programme showed much improvement after six months. From an analysis of 40 electrocardiograms (20 before and 20 after dialysis) of a further 17 patients it was found that the height of the T wave is a good index of the plasma potassium level. The tolerance of higher plasma potassium levels by these patients compared with patients with acute renal failure may be explained by the fact that the former do not have a hypercatabolic process and have a lesser degree of acidosis.
Discordant Hepatic Uptake of Tc-99m HIDA and Tc-99m Colloid in a Patient with Segmental Biliary Obstruction
Authors: TAMIO ABURANO, MITSURU TANIGUCHI, KINICHI HISADA, YOSHIHARU MIYAZAKI, KAZUTO KAKUMA, MASAHIKO FUJIOKA
Journal: Clinical Nuclear Medicine (1988)

Discordant hepatic uptake between Tc-99m HIDA and Tc-99m colloid occurred in a 63-year-old female with segmental biliary obstruction due to cholangioma. Radiographic CT and a percutaneous transhepatic cholangiogram revealed the obstructed right hepatic duct as well as the dilated intrahepatic duct in the right lobe. At surgery this was confirmed, and a 2 cm mass encasing the right hepatic duct was identified. It should be included in the gamut of discordant hepatic uptake of Tc-99m IDA and Tc-99m colloid.