tbuckley/cabot-search huggingface dataset:
Observations on the Blood Pressure of Tibetans
Authors: A. K. SEHGAL, IQBAL KRISHAN, R. P. MALHOTRA, H. D. GUPTA
Journal: Circulation (1968)

Observations on the blood pressure of a group of 660 displaced male Tibetans revealed striking dissimilarities in regard to the mean systolic and diastolic figures as compared to those reported for Europeans and Americans. The average Tibetan figures are lower than those of Western populations; however, a comparable variability after the fourth decade and a parallel spread of values with age and weight were found in the Tibetan data. The socioeconomic status and height bore no relation to the blood pressure levels. The results obtained from this survey on the Tibetans are compared with those of other Mongolian groups. It is suggested that the differences of blood pressure among related Mongolian groups and populations studied in the West are largely determined by environment.
Effect of Natural Oxygen Enrichment at Low Altitude on Oxygen-Dependent Patients with End-Stage Lung Disease
Authors: Mordechai R. Kramer
Journal: Annals of Internal Medicine (1994)

Objective: To assess the effect of lowering altitude to that of the lowest place on earth (Dead Sea) on arterial oxygenation and exercise performance in patients with hypoxemia and end-stage lung disease. Design: A cohort of 10 patients. Setting: Pulmonary function laboratories in Jerusalem, Israel, and at the Dead Sea. Patients: 10 patients with end-stage lung disease who were receiving long-term oxygen therapy. The 4 males and 6 females were 12 to 77 years old. Four patients had chronic obstructive pulmonary disease; 2 had cystic fibrosis; 3 had pulmonary fibrosis; and 1 had pulmonary hypertension (thromboembolic). Mean forced vital capacity was 1.54 L (54% of predicted value) and mean forced expiratory volume in 1 second was 0.85 L (35% of predicted value). Measurements: Spirometry, blood gas analysis, progressive exercise testing, and sleep oximetry were done in Jerusalem (altitude, 800 m above sea level; barometric pressure, 696 mm Hg); the same measurements were done 6 days after arrival at the Dead Sea (altitude, 402 m below sea level; barometric pressure, 800 mm Hg) and then 7 to 14 days later in Jerusalem. Results: Arterial oxygenation increased from a median partial pressure of arterial oxygen of 51.6 mm Hg in Jerusalem to 67.0 mm Hg at the Dead Sea, an increase of 15.2 mm Hg (95% CI of paired difference, 4.1 to 20.4 mm Hg; P = 0.001). Partial pressure of arterial carbon dioxide increased from a median of 43.2 to 45.9 mm Hg, an increase of 2.7 mm Hg (CI, 0.5 to 6.4 mm Hg; P = 0.004), with a borderline significant change in the alveolar-arterial gradient. Arterial oxygen saturation increased from a median of 87.7% to 92.8%, a change of 4.8% (CI, 1.9% to 9.8%; P = 0.003). Exercise performance also improved as maximum oxygen uptake increased from a median of 827 mL/min to 1056 mL/min, an increase of 203 mL/min (CI, 54 to 388 mL/min; P = 0.006). Sleep oximetry also improved as median arterial oxygen saturation measured during sleep increased from 85% to 90%, a change of 5% (CI, 2% to 7%; P = 0.005), and percentage of sleep time with an oxygen saturation rate of 90% or more increased from a median of 24% to 73%, a change of 49% (CI, 20% to 87%; P = 0.02). No change in spirometry was noted. All patients felt less dyspneic and reported improved functional capacity with reduced need for oxygen. Conclusion: Descent to low altitude can improve arterial oxygenation, exercise performance, and sleep oximetry and consequently the quality of life in patients with hypoxemia and advanced lung disease.
Immunologic Deficiency in Ataxia Telangiectasia
Authors: A. H. Eisen, G. Karpati, T. Laszlo, F. Andermann, J. P. Robb, H. L. Bacal
Journal: New England Journal of Medicine (1965)

IMMUNOLOGIC abnormalities, including hypogammaglobulinemia, abnormalities of gamma1A globulin, poor homograft rejection and structural abnormalities of the thymus gland, have recently been reported in patients with ataxia telangiectasia.1 2 3 4 We have had an opportunity to study 5 patients with this syndrome. All have the clinical features of telangiectasia of the bulbar conjunctiva, cerebellar ataxia, choreoathetosis, masklike facies, recurrent sinopulmonary infections and stunted growth. Their ages range from six to fourteen years, and 2 of the patients are siblings. A detailed clinical and genetic study of these patients has been done and will be presented elsewhere. This report deals with the . . .
New Tobacco Industry Strategy to Prevent Local Tobacco Control
Authors: Michael P. Traynor
Journal: JAMA (1993)

We examined the tobacco industry's new strategy to defeat and then repeal tobacco control ordinances in California and the efforts of health professionals to pass and defend these ordinances. Case studies were conducted in California communities in 1991 and 1992, using published reports, public documents, attendance at public meetings, and interviews. The tobacco industry is spending millions of dollars to intervene in California communities to oppose legislation protecting nonsmokers from secondhand smoke. The tobacco industry has moved beyond organizing smokers to use professional public affairs and political campaign firms to defeat or weaken local tobacco control ordinances. The industry used front groups to conceal its involvement because public knowledge of the industry's involvement increases support for legislation controlling smoking. Some firms closely monitor developing ordinances, while others actively organize and direct local opposition. If these efforts do not weaken or defeat an ordinance, the tobacco industry initiates a referendum petition drive to suspend it to pressure local elected officials to repeal or weaken it. If this tactic fails, the industry often finances an election campaign to repeal the ordinance by popular vote. Although the tobacco industry's new strategy has hindered the passage of some local tobacco control ordinances, when health professionals and elected officials remained active and committed, the industry's efforts have failed and the ordinances have been upheld.
Pulmonary Gas Exchange Improves in the Prone Position with Abdominal Distension
Authors: MARGARETA MURE, ROBB W. GLENNY, KAREN B. DOMINO, MICHAEL P. HLASTALA
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Arterial blood oxygenation in patients with adult respiratory distress syndrome is often improved in the prone position. Critically ill patients often have abdominal distension and whether similar improvements in gas exchange occur with the prone position is not known. We therefore studied the effect of posture on gas exchange in eight ketamine-anesthetized pigs with abdominal distension. A rubber balloon, placed in the abdominal cavity, was filled with water to increase intra-abdominal pressure. The animals were mechanically ventilated with Fi O2 = 0.4, and PaCO2 was kept constant. Gas exchange was measured in the supine and prone positions, with and without abdominal distension, in random order, using the multiple inert gas elimination technique (MIGET). When the abdomen was normal, the prone position increased PaO2 by 16 ± 21 mm Hg (p < 0.05), accompanied by a small, but statistically insignificant, decrease in aaPo 2 (p = 0.08) and no change in ventilation/perfusion (V˙ a/Q˙) heterogeneity measured by MIGET. In the presence of abdominal distension, the prone position increased Pa O2 by 26 ± 18 mm Hg (p < 0.01) and decreased aaPo 2 (p < 0.05) and V˙ a/Q˙ heterogeneity as measured by the log standard deviation of the perfusion distribution (p < 0.01) and the arterial-alveolar difference area (p < 0.05). In addition, intragastric pressure was lower in the prone position (p < 0.01). We conclude that in anesthetized, mechanically ventilated pigs, the prone position improves pulmonary gas exchange to a greater degree in the presence of abdominal distension than when the abdomen is normal.
Genotype-phenotype correlations in hypertrophic cardiomyopathy. Insights provided by comparisons of kindreds with distinct and identical beta-myosin heavy chain gene mutations.
Authors: L Fananapazir, N D Epstein
Journal: Circulation (1994)

BACKGROUND We have previously described two distinct mutations in the beta-myosin heavy chain gene with markedly different clinical presentations and outcome: The 908Leu--&gt;Val mutation was associated with a low disease penetrance and a benign prognosis. In contrast, the 403Arg--&gt;Gln mutation in a Caucasian kindred was associated with a 100% disease penetrance and high incidence of sudden cardiac death. Recently, another mutation, 606Val--&gt;Met, has been reported to be associated with "near normal survival" and offered as evidence for the benign nature of neutral charge substitutions. METHODS AND RESULTS We report (1) a large kindred (245 family members at risk of inheriting the disease gene) with a 256Gly--&gt;Glu mutation characterized by a similar disease penetrance in adults and in children (56% and 60%, respectively) and a cumulative sudden cardiac death rate of only 2% at 50 years of age, (2) a kindred with the 606Val--&gt;Met mutation with four sudden cardiac deaths in eight affected individuals, and (3) a Korean kindred with the 403Arg--&gt;Gln mutation. Although the disease occurred early and was associated with a high prevalence of myocardial ischemia in both of our kindreds with the 403Arg--&gt;Gln mutation, no sudden cardiac death or syncope has occurred in the Korean kindred. Furthermore, in the Caucasian kindred, all patients had nonobstructive hypertrophic cardiomyopathy, but most of the patients in the Korean kindred had left ventricular outflow obstruction. CONCLUSIONS The conclusions are as follows: (1) Although several sudden cardiac deaths are sufficient to establish that a mutation is malignant, study of a large kindred is necessary to be certain that a mutation is benign. To date, only the 908Leu--&gt;Val and the 256Gly--&gt;Glu mutations satisfy this requirement. (2) The 256Gly--&gt;Glu mutation demonstrates that not all mutations that result in a charge change are malignant. (3) Conversely, the 606Val--&gt;Met mutation is malignant in some kindreds; hence, despite the absence of a charge change, minor substitutions in critical regions of beta-myosin heavy chain protein may also have serious consequences. (4) The diverse ethnic origins of the two 403Arg--&gt;Gln kindreds provide evidence suggesting that the identical mutation occurred independently and was associated with different genetic backgrounds. Their distinct phenotypes underline the importance of modifying genes and nongenetic factors.
CARDIAC REHABILITATION REFERRAL AND ATTENDANCE IN WOMEN: A HIGH-RISK POPULATION WITH TWO STRIKES AGAINST IT
Authors: Jillian Colbert, Billie-Jean Martin, Trina Hauer, Mark Haykowsky, Leslie Austford, Ross Arena, Merril Knudtson, Don Meldrum, Sandeep Aggarwal, James Stone
Journal: Journal of the American College of Cardiology (2013)
1032-127 Regression of hypertrophy in remote myocardium after percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: A magnetic resonance imaging follow-up study
Authors: Willem G van Dockum, Marco J.W Gotte, Aernout M Beek, Folkert J ten Cate, Jurrien M ten Berg, Mark B.M Hofman, Cees A Visser, Albert C van Rossum
Journal: Journal of the American College of Cardiology (2004)
Conflict of interest problems in new NHS have not been solved, regulator says
Authors: M. Limb
Journal: BMJ (2011)

The government has still not clarified how new NHS commissioning reforms will prevent GPs getting into conflicts of interest, according to a leading health service regulator.

David Bennett, the chair and interim chief executive of Monitor, told a BMJ /King’s Fund debate that ministers had yet to make “important decisions” regarding commissioning groups that might want to provide services themselves. Until that happened, Monitor’s own role in this area couldn’t be determined, he said.

“It’s not yet entirely clear how all this is going to work,” he said. He said the issue of “self supply” by GPs was complex. “Our starting point will be very simple. Whatever a GP does, as a commissioner or provider, they need to demonstrate it’s …
Cancer chemotherapy--the first twenty-five years.
Authors: R. B. Scott
Journal: BMJ (1970)

A production trial in the San Joaquin Valley of California was conducted where canopy microclimate of Syrah 05/SO4 grapevines was altered through three pruning systems and two leaf removal treatments arranged factorially to rejuvenate vineyards with declining productivity. Vines were either pruned by hand to 44 nodes each, mechanically box-pruned to a 10 cm hedge, or cane-pruned by hand to six 8-node canes arranged in opposing directions of the row with horizontal canopy separation. Outer surface layer of leaves were either removed mechanically 20 days postbloom on the east side of the canopy in a 45 cm zone above the cordon in the fruit zone or not removed. Yields from spur- and mechanically box-pruned vines were considered too low for the study area, and leaf removal had no effect on yield components. Spur-pruned vines reached 24 Brix earlier than mechanically box-pruned and cane-pruned vines in each year. Leaf removal had no effect on fruit composition of Syrah at harvest. Berry skin phenolics were not consistently affected by treatments applied. Cane pruning resulted in 3.8 leaf layers, with 32 shoots per 30 cm of row, 7.77 kg/kg Ravaz index, and consistently ripened 22 tons/ha to 24 Brix and should therefore be used in the San Joaquin Valley to improve yields in vineyards with declining productivity. The study identified a pruning system for vineyards in warm climates that can sustain yields and provides management information for growers on how to rejuvenate vines that have declined in productivity.
Electrostatic modifications of the human leukocyte antigen‐DR P9 peptide‐binding pocket and susceptibility to primary sclerosing cholangitis
Authors: Johannes R. Hov, Vasilis Kosmoliaptsis, James A. Traherne, Marita Olsson, Kirsten M. Boberg, Annika Bergquist, Erik Schrumpf, Andrew J. Bradley, Craig J. Taylor, Benedicte A. Lie, John Trowsdale, Tom H. Karlsen
Journal: Hepatology (2011)

The strongest genetic risk factors for primary sclerosing cholangitis (PSC) are found in the human leukocyte antigen (HLA) complex at chromosome 6p21. Genes in the HLA class II region encode molecules that present antigen to T lymphocytes. Polymorphisms in these genes are associated with most autoimmune diseases, most likely because they contribute to the specificity of immune responses. The aim of this study was to analyze the structure and electrostatic properties of the peptide-binding groove of HLA-DR in relation to PSC. Thus, four-digit resolution HLA-DRB1 genotyping was performed in 356 PSC patients and 366 healthy controls. Sequence information was used to assign which amino acids were encoded at all polymorphic positions. In stepwise logistic regressions, variations at residues 37 and 86 were independently associated with PSC ( P = 1.2 × 10−32 and P = 1.8 × 10−22 in single-residue models, respectively). Three-dimensional modeling was performed to explore the effect of these key residues on the HLA-DR molecule. This analysis indicated that residue 37 was a major determinant of the electrostatic properties of pocket P9 of the peptide-binding groove. Asparagine at residue 37, which was associated with PSC, induced a positive charge in pocket P9. Tyrosine, which protected against PSC, induced a negative charge in this pocket. Consistent with the statistical observations, variation at residue 86 also indirectly influenced the electrostatic properties of this pocket. DRB1*13:01, which was PSC-associated, had a positive P9 pocket and DRB1*13:02, protective against PSC, had a negative P9 pocket. Conclusion: The results suggest that in patients with PSC, residues 37 and 86 of the HLA-DRβ chain critically influence the electrostatic properties of pocket P9 and thereby the range of peptides presented. (HEPATOLOGY 2011;)
The Postthrombophlebitic Syndrome
Authors: Edward A. Edwards
Journal: JAMA (1962)

A feature of this book is its complete coverage of historical aspects and theories of causation of this disorder. Unfortunately, no new evidence is presented to give any weight to one or another explanation of pathogenesis. Moreover, there is a certain ambiguity in quoted material, as when a majority of all adults are said to be suffering from varicose veins, or when, on some pages, lymphatic obstruction is said to play a major role in the syndrome, whereas this role is denied on other pages. Since Dr. Popkin is an internist, non-operative therapy is covered most comprehensively. Most surgeons would probably find the insistence on a lifelong regime of rest for the patient, as advocated by Luke, at variance with their own philosophy of treatment. The author devotes but little space to surgical treatment, suggesting reference to standard texts on this important aspect of treatment.
Combination immunotherapy with oncolytic vaccinia virus and checkpoint inhibitor following local tumor irradiation
Authors: Boris Minev, Holbrook Kohrt, Mehmet Kilinc, Nanhai Chen, Audrey Feng, Maysam Pessian, Ulrike Geissinger, Erik Haefner, Desislava Tsoneva, Kliment Bozhilov, Idit Sagiv-Barfi, Xing Zhao, Narendiran Rajesekaran, Ronald Levy, Aladar Szalay
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Oncolytic virotherapy is safe and clinically active in solid tumors, however its efficacy in hematologic malignancies as well as in combination with checkpoint inhibitors and radiation is unexplored. To simulate advanced lymphoma, A20 cells were injected subcutaneously on
Hormone receptors in breast cancer.
Authors: J Appelbaum
Journal: BMJ (1978)

Juel-Jensen's syndrome ?) ?Perhaps this explains the lack of concern about the un- palatability of heavily chlorinated water.I still maintain that flavouring is "very well worth while" when trying to force fluids into an anorexic, nauseated, uncooperative, delirious, and dehydrated patient.May I also thank Dr D L Child and his colleagues (14 October, p 1086) for their suggestions, which I accept?A parenteral form of chloroquine should have been included and its omission was a transcription error on my part.Chloramphenicol is undoubtedly useful, though I am less sure of co-trimoxozole in patients who have taken Streptotriad prophylactically.Finally, I would prefer to prescribe Nystaform-HC (nystatin, iodochlorhydroxyquin, and hydrocortisone) to clotrimazole, since the former rapidly alleviates the common allergic component of candidiasis, but this is a quibble.
[362] OPTIMIZATION OF BETA-GLYCOLIPID STRUCTURE FOR SUPPRESSION OF HEPATOCELLULAR CARCINOMA IN MICE: A ROLE FOR THE SPHINGOSINE CHAIN LENGTH IN ALTERING NKT LYMPHOCYTE-ASSOCIATED ANTI-TUMOR EFFECT
Authors: G. Lalazar, A. Ben-Ya'acov, M. Harati, Y. Ilan
Journal: Journal of Hepatology (2007)
Diagnostic and therapeutic technology assessment. Transjugular intrahepatic portosystemic shunt (TIPS)
Authors: R. Miller-Catchpole
Journal: JAMA (1995)

<h3>Objective.</h3> —To provide clinicians with a technology assessment of the safety and effectiveness of the use of a transjugular intrahepatic portosystemic shunt (TIPS) for reducing portal hypertension and its associated complications of esophageal varices and ascites. <h3>Participants.</h3> —A literature review and a Diagnostic and Therapeutic Technology Assessment (DATTA) survey questionnaire were mailed to 72 physicians with expertise in gastrointestinal or abdominal surgery or interventional radiology and a special interest in liver disease or esophageal varices. These panelists had been nominated to the DATTA panel by appropriate specialty societies and medical schools. A total of 54 panelists (75%) responded. <h3>Evidence.</h3> —Assessment was based on the expert opinion of the panelists, as well as on published scientific literature (available as of January 2, 1995). Published studies were identified by a MEDLINE search using the terms<i>transjugular intrahepatic portosystemic shunt, TIPS</i>, and<i>transjugular</i>and by review of the references cited in these primary sources. <h3>Consensus Process.</h3> —The respondents completed a DATTA survey questionnaire; the survey results were tabulated, analyzed, and interpreted by an American Medical Association staff physician. <h3>Conclusions.</h3> —The safety of TIPS was considered to be established in the acute control of bleeding from esophageal varices in patients who had failed sclerotherapy. The safety of TIPS was considered to be promising for long-term control of bleeding from esophageal varices. In patients with end-stage liver disease and esophageal varices who are liver transplant candidates, the use of TIPS was considered to be an established therapy. The effectiveness of TIPS was considered to be (1) established in the acute control of bleeding in patients who failed sclerotherapy; (2) promising for long-term control of bleeding from esophageal varices; and (3) established in patients with end-stage liver disease and esophageal varices who are candidates for liver transplants. (<i>JAMA</i>. 1995;273:1824-1830)
Moving beyond Parity — Mental Health and Addiction Care under the ACA
Authors: Colleen L. Barry, Haiden A. Huskamp
Journal: New England Journal of Medicine (2011)

Enactment of the Mental Health Parity and Addiction Equity Act in 2008 improved insurance coverage for mental health and addiction treatment. Now, the Affordable Care Act could affect the financing and delivery of such care even more profoundly.
Inhibin: from Hypothesis to Clinical Application
Authors: William J. Bremner
Journal: New England Journal of Medicine (1989)

WE are used to thinking of the gonads as sites for the production of steroid hormones, spermatozoa, and ova. It is now clear that the testes and ovaries produce many other substances, some of which, such as growth factors, may be important in controlling physiologic functions within the gonads themselves, whereas others, such as inhibin and activin, may have important hormonal roles. These substances could be important in the development of new methods to control human fertility and treat infertility. The measurement of inhibin in serum is likely to assume clinical importance as an indicator of gonadal function and, as . . .