tbuckley/cabot-search huggingface dataset:
Lack of geographic variation in anonymous nuclear polymorphisms in the American oyster, Crassostrea virginica
Authors: J. H. McDonald, B. C. Verrelli, L. B. Geyer
Journal: Molecular Biology and Evolution (1996)

Comparing geographic variation of noncoding nuclear DNA polymorphisms, which presumably are neutral to natural selection, with geographic variation of allozymes is potentially a good way to detect the effects of selection on allozyme polymorphisms. A previous study of four anonymous nuclear markers in the American oyster, Crassostrea virginica, found dramatic differences in allele frequency between the Gulf of Mexico and the Atlantic Ocean. In contrast, 14 allozyme polymorphisms were fairly uniform in frequency between the two areas. This led to the conclusion that all of the allozyme polymorphisms were kept uniform in frequency by balancing selection. To test the robustness of this pattern, six additional anonymous nuclear DNA polymorphisms were surveyed in oysters from Panacea, Fla, and Charleston, S.C. on the Gulf and Atlantic coasts, respectively. Unlike the previously studied DNA markers, the six DNA polymorphisms examined here show geographic variation that is not significantly greater than that of allozymes. The reason for the discrepancy between the two sets of DNA polymorphisms is unclear.
Tryptase inhibitors block allergen-induced airway and inflammatory responses in allergic sheep.
Authors: J M Clark, W M Abraham, C E Fishman, R Forteza, A Ahmed, A Cortes, R L Warne, W R Moore, R D Tanaka
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Tryptase, a mast cell serine protease, has been implicated in the pathophysiology of allergic asthma, but formal evidence to support this hypothesis has been limited by the lack of specific inhibitors for use in vivo. Therefore, in this study we examined the effects of two inhibitors of tryptase, APC 366 [N-(1-hydroxy-2-naphthoyl)-L-arginyl-L-prolinamide hydrochloride] and BABIM [bis(5-amidino-2-benzimidazolyl)methane] on antigen-induced early and late responses, airway responsiveness as measured by carbachol provocation, microvascular permeability as measured by bronchoalveolar lavage (BAL) albumin concentrations, and tissue eosinophilia from biopsies in allergic sheep. APC 366 and BABIM were administered by aerosol in all experiments. In vehicle control trials, antigen challenge resulted in peak early and late increases in specific lung resistance (SRL) of (mean +/- SE, n = 6) 259 +/- 30% and 183 +/- 27% over baseline, respectively. Treatment with APC 366 (9 mg/3 ml H2O given 0.5 h before, 4 h after, and 24 h after antigen challenge) slightly reduced the peak early response (194 +/- 41%), but significantly inhibited the late response (38 +/- 6%, p < 0.05 versus control trials). Twenty-four hours after challenge, APC 366 also completely blocked the antigen-induced airway hyperresponsiveness to inhaled carbachol observed in the control trial.(ABSTRACT TRUNCATED AT 250 WORDS)
Hyperlipoproteinaemia in gout.
Authors: R Bluestone, B Lewis, I Mervart
Journal: Annals of the Rheumatic Diseases (1971)

<h3>ABSTRACT</h3> <h3>Background</h3> Diabetic nephropathy (DN) is a leading cause of end stage renal disease and renal replacement therapy worldwide. A pathophysiological hallmark of DN is glomerular basal membrane (GBM) thickening, whereas this feature is absent in minimal change disease. Theoretically, a thicker GBM will impede the diffusion of middle-molecules such as cystatin C, potentially leading to a lower estimated GFR (eGFR) from cystatin C compared to that of creatinine. Here we test the hypothesis that thickening of the glomerular filter leads to an increased diffusion length, and lower clearance, of cystatin C. <h3>Methods</h3> Twenty-nine patients with a kidney biopsy diagnosis of either DN (n=17) or minimal change disease (MCD) (n=12) were retrospectively included in the study. GBM thickness was measured at 20 separate locations in the biopsy specimen and plasma levels of cystatin C and creatinine were retrieved from health records. A modified two-pore model was used to simulate the effects of a thicker GBM on glomerular water and solute transport. <h3>Results</h3> The mean age of the patients was 52 years, and 38% were women. The mean eGFR<sub>cystatin C</sub>/eGFR<sub>creatinine</sub>-ratio was 74% in DKD compared to 98% in MCD (P &lt; 0.001). Average GBM thickness was strongly inversely correlated to the eGFR<sub>cystatin C</sub>/eGFR<sub>creatinine</sub>-ratio (Pearson’s r=-0.61, P &lt; 0.01). Two-pore modeling predicted a eGFR<sub>cystatin C</sub>/eGFR<sub>creatinine</sub>-ratio of 78% in DN. <h3>Conclusions</h3> We provide clinical and theoretical evidence suggesting that thickening of the glomerular filter, increasing the diffusion length of cystatin C, lowers the eGFR<sub>cystatin C</sub>/eGFR<sub>creatinine</sub>-ratio in DN. <h3>Significance statement</h3> Increased thickness of the glomerular basement membrane (GBM) is an early structural abnormality in diabetes, and has been identified as an independent risk factor for progression to diabetic nephropathy (DN). Increased GBM thickness will increase the diffusion length of mid-sized molecules like cystatin C across the renal filter, potentially leading to increased plasma concentrations and lower estimated GFR from cystatin C. The authors show theoretically that estimated GFR from cystatin C (eGFR<sub>cystatin C</sub>) is lower than that of creatinine (eGFR<sub>creatinine</sub>) in DN to a degree directly depending on GBM thickness. In line with theory, they provide clinical data showing a lower eGFR<sub>cystatin C</sub> in diabetic patients with the eGFR<sub>cystatin C</sub>/eGFR<sub>creatinine</sub>-ratio being inversely correlated to GBM thickness assessed from electron micrographs.
Evaluation of the Mobile Acute Care of the Elderly (MACE) Service
Authors: William W. Hung, Joseph S. Ross, Jeffrey Farber, Albert L. Siu
Journal: JAMA Internal Medicine (2013)

Older adults are particularly vulnerable to adverse events during hospitalization for acute medical problems. The Mobile Acute Care of the Elderly (MACE) service is a novel model of care delivered by an interdisciplinary team, designed to deliver specialized care to hospitalized older adults to improve patient outcomes.To evaluate the impact of the MACE service when compared with general medical service (usual care).Prospective, matched cohort study.The Mount Sinai Hospital, an urban tertiary acute care hospital.Patients aged 75 years or older admitted because of an acute illness to either the MACE service or usual care. Patients were matched for age, diagnosis, and ability to ambulate independently.Admission to the MACE service when compared with admission to usual care.Patient outcomes included incidence of adverse events, including falls, pressure ulcers, restraint use, and catheter-associated urinary tract infections, along with length of stay, rehospitalization within 30 days, functional status at 30 days, and patient satisfaction during care transitions, measured with the 3-item Care Transition Measure.A total of 173 matched pairs of patients were recruited. The mean (SD) age was 85.2 (5.3) and 84.7 (5.4) years in the MACE and usual-care groups, respectively. After adjustment for confounders, patients in the MACE group were less likely to experience adverse events (9.5% vs 17.0%; adjusted odds ratio, 0.11; 95% CI, 0.01-0.88; P = .04) and had shorter hospital stays (0.8 days, 95% CI, 0.7-0.9; P = .001) than patients receiving usual care. Patients in the MACE group were not less likely to have a lower rate of rehospitalization within 30 days than those in the usual-care group (odds ratio, 0.91; 95% CI, 0.39-2.10; P = .83). Functional status did not differ between the 2 groups. Care Transition Measure scores were 7.4 points (95% CI, 2.9-11.9; P = .001) higher in the MACE group.Admission to the MACE service was associated with lower rates of adverse events, shorter hospital stays, and better satisfaction. This model has the potential to improve care outcomes among hospitalized older adults.clinicaltrials.gov Identifier: NCT00927160.
Monitoring effects of oral anticoagulants during treatment with heparin.
Authors: P Thomas, A Fennerty, G Backhouse, D P Bentley, I A Campbell, P A Routledge
Journal: BMJ (1984)

pyrexia.This abated over 48 hours of treatment, which included tobramycin, and repeat endoscopic retrograde cholangiography showed a biliary tree free of stones.She made an uneventful recovery, and subsequently eight consecu- tive stool samples over a period of three months showed clearance of the salmonella. CommentThis patient was a chronic carrier of S eastbourne despite a cholecystectomy 18 years previously.This appeared to be resistant to appropriate antibiotics until a common bile duct stone was removed.Salmonella carriage was probably perpetuated by biliary stasis analogous to that caused by a stone filled gall bladder.We thank Dr J Partridge for his help in arranging analysis of stool samples.
In an ideal world minority associations would not be needed, but this isn't an ideal world
Authors: S Kumar
Journal: BMJ (1994)

In an ideal world, where there was fairness and equity at all levels, there would be no need for associations such as the BMA or the Overseas Doctors Association. Unfortunately, we do not live in an ideal world and therefore need representation in our social and professional lives.

The number of doctors from commonwealth countries coming to Britain for postgraduate training peaked during the 1950s to 1970s. The lack of organised training programmes meant that many of them ended …
Best books on genitourinary medicine: a personal choice
Authors: M R Fitzgerald
Journal: BMJ (1995)

Anyone exploring the sexually transmitted diseases section of one of Britain's few remaining medical bookshops will encounter a rampant overgrowth of publications on every aspect of HIV infection and AIDS but will be lucky to find more than a meagre selection of books about the rest of genitourinary medicine. Unfortunately, this reflects what is available. In particular, some of the better British reference and undergraduate books are currently out of print, so that my principal recommendations are all American. The differences between American and British practice are particularly apparent in the advice on management and the assumptions about microbiological support.

\***| Sexually Transmitted Diseases. 2nd edn. K K Holmes, P A Mardh, P F Sparling, P J Weisner. (pounds sterling89.50.) McGraw-Hill, 1989. ISBN 0 07 029677 4

* Sexually Transmitted Diseases. G W Csonka, J W Oates. (pounds sterling62.) Balliere Tindall, 1990. ISBN 0 7020 1258 0

* A Colour Atlas of Sexually Transmitted Diseases. A Wisdom. (pounds sterling24.50.) Wolfe, 1989. ISBN 0 7234 1592 7

** Work Roles and Responsibilities in Genitourinary Medicine Clinics. I Allen, D Hogg. (pounds sterling17.95.) Policy Studies Institute, 1993. ISBN 0 85374 570 6

With 1200 pages one can expect Holmes et al …
Thyroid Hormones and Protein-Bound Iodine
Authors: Jan D. Wiener
Journal: JAMA (1969)

To the Editor:—  Dr. Paul Starr ( 205 : 313, 1968) rightly stresses the importance of the triiodothyronine (T3) content of desiccated thyroid preparations. I am afraid, however, that the statement that T3 stimulates metabolism without representation in the PBI value may give rise to misunderstanding. Triiodothyronine is, in fact, included in the protein-bound iodine (PBI) value, but its concentration in the serum is very low, compared to that of thyroxine (T4). 1 Owing to the much shorter biologic half-life, much larger distribution space, and greater calorigenic potency of T3, however, a given serum concentration of T3 will be metabolically equivalent to about 25 times the same concentration of T4. 2   The statement in the last paragraph that T4  completely to the thyroxine binding globulin (TBG), and the T3 does not, should be understood to mean that T3 binds less completely, rather than not at all.  Finally, patients with high TBG
Neu differentiation factor upregulates epidermal migration and integrin expression in excisional wounds.
Authors: D M Danilenko, B D Ring, J Z Lu, J E Tarpley, D Chang, N Liu, D Wen, G F Pierce
Journal: Journal of Clinical Investigation (1995)

Neu differentiation factor (NDF) is a 44-kD glycoprotein which was isolated from ras-transformed rat fibroblasts and indirectly induces tyrosine phosphorylation of the HER-2/neu receptor via binding to either the HER-3 or HER-4 receptor. NDF contains a receptor binding epidermal growth factor (EGF)-like domain and is a member of the EGF family. There are multiple different isoforms of NDF which arise by alternative splicing of a single gene. To date, in vivo biologic activities have not been demonstrated for any NDF isoform. Since NDF, HER-2/neu, and HER-3 are present in skin, and other EGF family members can influence wound keratinocytes in vivo, we investigated whether NDF would stimulate epidermal migration and proliferation in a rabbit ear model of excisional wound repair. In this model, recombinant human NDF-alpha 2 (rhNDF-alpha 2), applied once at the time of wounding, induced a highly significant increase in both epidermal migration and epidermal thickness at doses ranging from 4 to 40 micrograms/cm2. In contrast, rhNDF-alpha 1, rhNDF-beta 1, and rhNDF-beta 2 had no apparent biologic effects in this model. rhNDF-alpha 2 also induced increased neoepidermal expression of alpha 5 and alpha 6 integrins, two of the earliest integrins to appear during epidermal migration. In addition, rhNDF-alpha 2-treated wounds exhibited increased neoepidermal expression of cytokeratin 10 and filaggrin, both epidermal differentiation markers. NDF alpha isoforms were expressed in dermal fibroblasts of wounded and unwounded skin, while both HER-2/neu and HER-3 were expressed in unwounded epidermis and dermal adnexa. In wounds, HER-2/neu expression was markedly decreased in the wound neoepidermis while neoepidermal HER-3 expression was markedly upregulated. Taken together, these results suggest that endogenous NDF-alpha 2 may function as a paracrine mediator directing initial epidermal migration during cutaneous tissue repair.
Scottish inquiry vindicates decision not to resuscitate baby
Authors: C. Dyer
Journal: BMJ (1997)

A paediatric registrar who decided not to resuscitate a baby born at 23 weeks' gestation was vindicated last week by a Scottish fatal accident inquiry. Sheriff Principal Robert Hay said that Dr Faisal al-Zidgali had acted reasonably and in the best interests of his patient, Rebecca Cassidy, who was born at Ayrshire Central Hospital on 7 September last year, weighing only 567 …
Determination of parameters effecting proton relaxation of hepatic and gallbladder biles in dogs
Authors: Douglas A. Bakan, James L. Barnhart
Journal: Hepatology (1988)

The parameters which are important in causing changes in the Tl and T2 proton magnetic relaxation times of dog bile were investigated. Three factors were found to be important in causing relaxation in bile: (i) total bile salt concentration; (ii) total protein concentration, and (iii) viscosity. The T1 and T2 values of hepatic and gallbladder biles were found to be independent of specific gravity, osmolarity and electrolyte concentrations. In vitro experiments were conducted with taurocholic acid, bovine serum albumin and porcine stomach mucin to examine the effects of intermolecular interactions on proton relaxation. Relative to each of the molecules alone, various combinations of the bile salt and proteins exhibit relaxation rates of 20 to 60% below theoretically expected values. This influence of in vitro molecular interactions on T1 and T2 is also likely to occur in hepatic and gallbladder biles in vivo . Thus, the effects of complex intermolecular interactions associated with the gallbladder microenvironment complicate but likely will not preclude direct assessment of physiologic data with magnetic resonance imaging.
An Evaluation of the Nitrous Oxide Method for the Quantification of Left-to-Right Shunts
Authors: RICHARD J. SANDERS, THEODORE COOPER, ANDREW G. MORROW
Journal: Circulation (1959)

Extensive clinical use has now been made of the nitrous oxide test for the detection and localization of left-to-right circulatory shunts. On theoretical grounds the magnitude of such a shunt should be related to the systemic and pulmonary arteriovenous differences in nitrous oxide content measured early in the period of inhalation. In order to determine the validity of the nitrous oxide method for the quantification of a left-to-right shunt, total pulmonary and shunt flows were directly measured in experimental animals as nitrous oxide tests were performed simultaneously.
Assessment of proliferation of squamous, Barrett's and gastric mucosa in patients with columnar lined Barrett's oesophagus.
Authors: S Y Iftikhar, R J Steele, S Watson, P D James, K Dilks, J D Hardcastle
Journal: Gut (1992)

There is no satisfactory biomarker yet available for predicting the likelihood of premalignant changes or carcinoma developing in Barrett9s or columnar lined oesophagus. In this study we have evaluated the proliferation of squamous epithelium, columnar epithelium from columnar lined oesophagus and gastric columnar epithelium from 23 Barrett9s patients using positive immunoreactivity with the mouse monoclonal antibody Ki67 (which recognises an antigen associated with proliferative cells) with a view to using this parameter as a biomarker. Squamous epithelium had significantly higher Ki67 immunostaining as compared with columnar epithelium from columnar lined oesophagus (when examining the tissue with greater than 15% cells staining positive for Ki67, Fisher9s exact test p = 0.004) but there was no difference found between the epithelium from the columnar lined oesophagus and gastric columnar epithelium. There was no correlation between histological inflammation and Ki67 immunoreactivity of Barrett9s mucosa, and the Ki67 immunostaining of two patients with dysplasia was no different from the rest of the group. There was, however, a significant correlation between the Ki67 immunoreactivity of columnar epithelium from columnar lined oesophagus and columnar epithelium from the stomach (correlation coefficient = 0.44, p = 0.03) suggesting that epithelium from columnar lined oesophagus behaves in a similar fashion to gastric epithelium.
Overuse of Emergency Departments
Authors: Thomas E. Cowling, Azeem Majeed
Journal: JAMA (2013)

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Academic Health Centers
Authors: Robert H. Ebert, Sarah S. Brown
Journal: New England Journal of Medicine (1983)

There are 123 academic health centers in the United States, and they are markedly diverse in organization and function. Some have large research programs, others emphasize the education of nurses and allied health professionals, but all have one characteristic in common--namely, the dominant role of the medical school-teaching hospital combination. Their evolution has been shaped to a great degree by four federal initiatives: funding of research and research training by the National Institutes of Health, legislation that permitted close relations between Veterans Administration hospitals and medical schools, health-manpower legislation, and Medicare and Medicaid. Although academic health centers were created to foster the integration of structure and function, federal funding has always been categorical in support of research, teaching, or patient care. No federal funding was ever intended to stabilize the overall academic health center as an institution. This mattered little during a period of expansion, but the future of academic health centers is now uncertain in a period of federal cutbacks, rising health-care costs, and worry about an oversupply of physicians. Academic health centers must enter a new phase of institutional planning for which they are ill equipped. Special interests must be submerged for the good of the whole, diversity must be encouraged, and each center should exploit its own special strengths.
Global Biventricular Dysfunction in Patients With Asymptomatic Coronary Artery Disease May Be Caused by Myocarditis
Authors: Andrea Frustaci, Cristina Chimenti, Attilio Maseri
Journal: Circulation (1999)

The causal role of asymptomatic critical coronary artery obstruction in patients presenting with severe global biventricular dysfunction but no evidence of myocardial infarction is uncertain.Among 291 patients aged >40 years undergoing a noninvasive (2-dimensional echocardiography) and invasive (catheterization, coronary angiography, and biventricular endomyocardial biopsy, 6 to 8 samples/patient) cardiac study because of progressive heart failure (New York Heart Association functional class III or IV) with global biventricular dysfunction and no history of myocardial ischemic events, 7 patients (2.4%; 7 men; mean age, 49+/-6.9 years) had severe coronary artery disease (3 vessels in 4 patients; 2 vessels in 1 patient, proximal occlusion of left anterior descending coronary artery in 2 patients). Left ventricular end-diastolic diameter and ejection fraction by 2-dimensional echocardiography were 73+/-10.5 mm and 23+/-6.5%, respectively, and right ventricular end-diastolic diameter and ejection fraction were 39+/-7 mm and 29+/-7.2%, respectively. Biopsy specimens showed extensive lymphocytic infiltrates with focal myocytolysis meeting the Dallas criteria for myocarditis in all patients (in 5 patients with and 2 patients without fibrosis). Cardiac autoantibodies were detected with indirect immunofluorescence in the serum of 2 patients with active myocarditis. The 2 patients with active inflammation received prednisone (1 mg. kg-1. d-1 for 4 weeks followed by 0.33 mg. kg-1. d-1 for 5 months) and azathioprine (2 mg. kg-1. d-1 for 5 months) in addition to conventional drug therapy for heart failure. At 8-month overall follow-up, cardiac volume and function improved considerably in immunosuppressed patients but remained unchanged in conventionally treated patients, of whom 1 died.Global biventricular dysfunction in patients with severe asymptomatic coronary artery disease and no evidence of previous myocardial infarction may be caused by myocarditis. Histologic findings may influence the treatment.