tbuckley/cabot-search huggingface dataset:
Pharmacologic and Physiologic Aspects of Anesthesiology
Authors: S. H. Ngai, Lester C. Mark, E. M. Papper
Journal: New England Journal of Medicine (1970)

DURING the six years since our last report of progress in the field of anesthesiology1 there have been important advances in the acquisition of scientific information and in the application of this knowledge to the clinical care of patients. A number of excellent reviews and symposia summarized some of these advances.2 3 4 5 6 7 8 9 Relevant and important progress in anesthesiology has been achieved through the efforts of basic scientists who are keenly interested in the anesthetic processes and of anesthesiologists who have the combined qualities of clinical insight and scientific skill. This kind of anesthesiologist is still in short supply despite intensive educational . . .
Fibulin-5: two for the price of one maintaining pelvic support
Authors: Gina M. Northington
Journal: Journal of Clinical Investigation (2011)

Pelvic organ prolapse (POP) is a disabling disorder in women characterized by a loss of pelvic floor support leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely involves multiple mechanisms, and available therapies are limited. In this issue of the JCI, Budatha et al. explore the dual role carried out by fibulin-5 in facilitating the assembly of normal elastic fibers and inhibiting MMP-9 activity, revealing a new mechanism critical to the maintenance of pelvic organ support.
Myocardial Ischemia and the Pains of the Heart
Authors: Julio A Panza
Journal: New England Journal of Medicine (2002)

Angina pectoris is usually caused by myocardial ischemia due to atherosclerotic narrowing of the epicardial coronary arteries, with or without local vasoconstriction or a superimposed thrombus, that limits the supply of blood to the myocardium. This leads to the stimulation of pain receptors that trigger the patient's perception of anginal symptoms (see Figure). Therefore, when a physician cares for a patient with chest pain whose coronary anatomy is unknown, the main question is whether the symptoms are due to coronary atherosclerosis. This question is relevant for two reasons. First, atherosclerotic heart disease is the chief cause of death in Western . . .
Actinic keratoses induced by use of sunbed
Authors: E L Speight, M G C Dahl, P M Farr
Journal: BMJ (1994)

EDITOR, - David Shuttleworth's editorial1 reminds doctors of the hazards of use of sunbeds, which were detailed by the British Photodermatology Group.2 Although many adverse effects may occur, neither non-melanoma skin cancer nor dysplasia has been reported. We report on a patient with a large number of dysplastic keratoses, which seem to have been induced by use of a sunbed.

A 38 year old woman who had been abroad only once (to Spain for a short holiday at the age …
A3.9 IGG subclasses of autoantibodies directed against the angiotensin receptor type 1 and the endothelin receptor type a and their clinical relevance
Authors: J. Günther, A Kill, M. Becker, E Siegert, H Heidecke, G Riemekasten
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background and Objectives</h3> IgG4-related diseases are often characterised by a generalised inflammatory fibrosis which is also present in patients suffering from systemic sclerosis (SSc). Recent findings indicate the importance of autoantibodies (Aabs) against the angiotensin II type-1 receptor (AT1R) and the endothelin type-A receptor (ETAR) in the pathogenesis of SSc. Therefore, we analysed the levels of anti-AT1R/ETAR IgG sublasses in patients with SSc to determine a possible role of IgG subclasses as markers for disease manifestations in SSc. <h3>Material and Methods</h3> Sera from 91 SSc patients, 59 patients suffering from systemic lupus erythematosus (SLE), and from 199 healthy donors were analysed for the levels of anti-AT1R and anti-ETAR Aabs as well as for the different anti-AT1R and anti-ETAR IgG subclasses by ELISA. The results were associated with clinical manifestations using Mann-Whitney test and correlated with the time since onset of disease manifestations by Spearman correlation test. <h3>Results</h3> IgG3 followed by IgG1 was found to show highest anti-AT1R/ETAR Aab levels in all analysed groups, in which SSc patients as well as SLE patients had higher IgG1 and IgG3 anti-AT1R/ETAR Aab levels as compared to healthy donors. Comparing SLE and SSc patients IgG1 and IgG3 showed slightly higher anti-AT1R/ETAR Aab levels in SLE. Within the SSc group patients with diffuse SSc had higher anti-AT1R/ETAR IgG3 levels as compared to those with limited disease or overlap forms. Correlation analysis with SSc-related clinical manifestations revealed that levels of anti- AT1R/ETAR IgG3 negatively correlated with time since onset of Raynaud's phenomenon, and with time since first detection of PAH. Of note, there were negative correlations between levels of anti-AT1R/ETAR IgG3 levels and diffusion capacity for carbon monoxide (DLCO) as well as between anti-AT1R/ETAR-IgG3 levels and forced vital capacity (FVC) values (p = 0.02/0.07 and p = 0.01/0.03, respectively). <h3>Conclusion</h3> Interestingly, not IgG4 but IgG3 showed highest anti-AT1R/ETAR Aab levels when compared to other IgG subclasses. However, in SSc patients, anti-AT1R/ETAR IgG3 levels are strongly correlated to certain disease manifestations, whereby high anti-AT1R/ETAR IgG3 levels are associated with low DLCO and FVC indicating deterioration of lung function. According to these findings high anti-AT1R/ETAR IgG3 levels could predict for lung function deterioration and represent a new marker for SSc complications.
Diabetes and Plasma Lipoproteins in Native Americans: Studies of the Pima Indians
Authors: Barbara V Howard
Journal: Diabetes Care (1993)

OBJECTIVE– To determine the effects of diabetes on plasma lipoproteins in Pima Indians, to identify metabolic determinants of these differences, and to examine the effects of various modes of diabetes therapy. RESEARCH DESIGN AND METHODS— A series of studies was performed including a population survey of lipoprotein concentrations, kinetic studies of VLDL and LDL metabolism, and studies of the effects of weight loss, sulfonylureas, and high carbohydrate diets. RESULTS— Population data established that diabetes was consistently associated with elevations in total and VLDL TGs and decreases in HDL cholesterol. Metabolic studies indicated multiple alterations in VLDL metabolism induced by NIDDM, including overproduction of VLDL TG, impaired clearance of VLDL TG and apoB, and decreases in adipose tissue lipoprotein lipase. Although changes in LDL concentrations accompanying NIDDM were minimal, the clearance of LDL appeared to be impaired and a higher proportion of VLDL was metabolized without conversion to LDL. There were significant changes in the flux of particles to the LDL compartment. Total and VLDL TG concentrations were found to be inversely related to rates of insulin-mediated glucose disposal, and HDL cholesterol concentrations were positively related to glucose disposal. These relationships between lipoproteins and insulin action were independent of adiposity and insulin, suggesting that insulin resistance may be involved with diabetes-induced changes in VLDL and HDL. Weight loss was associated with decreases in total and VLDL TG, decreases in total and LDL cholesterol, and improvements in the ratio of HDL to LDL cholesterol. Sulfonylurea therapy was associated with lower total and VLDL TGs and lower LDL cholesterol, but little change in HDL. Substitution of complex carbohydrates for saturated fat in the diet showed consistent and significant decreases in total and LDL cholesterol, no decreases in HDL cholesterol, or elevation of total or VLDL TG. CONCLUSIONS— Studies suggest that there are multiple changes in plasma lipoproteins accompanying NIDDM in Pima Indians, but that many of these may be reversed by current modes of hypoglycemic therapy.
Reciprocity and uncertainty
Authors: Yoella Bereby-Meyer
Journal: Behavioral and Brain Sciences (2012)

Abstract Guala points to a discrepancy between strong negative reciprocity observed in the lab and the way cooperation is sustained “in the wild.” This commentary suggests that in lab experiments, strong negative reciprocity is limited when uncertainty exists regarding the players' actions and the intentions. Thus, costly punishment is indeed a limited mechanism for sustaining cooperation in an uncertain environment.
Nursing Education in Evolution
Authors: Ruth Sleeper
Journal: New England Journal of Medicine (1964)

NURSING education, like other systems of education for the professions, has been shaped in its evolution by cultural and social change. Unlike most of the other systems, nursing education alone seems not to have moved from one distinct phase to the next, but to have retained the old patterns as each new phase emerged.An examination of the plan for the education of nurses in 1964 will show at least three systems for the registered nurse, each quite distinct and each appearing as the result of changes in general education, in hospitals, in medicine or in community health programs. Each . . .
Demon Doctors: Physicians as Serial Killers
Authors: Cameron Stark
Journal: BMJ (2002)

Kenneth V Iserson Galen Press, $28.95, pp 520 ISBN 1883620295 Rating: ![Graphic][1]</img>![Graphic][2]</img> See www.galenpress.com/ to order Iserson writes clearly, although with occasional overtones of melodrama: given the subject matter, this is probably hard to avoid. Herman Mudgett, for example, is thought to have killed more than 130 people in the United States in the 1880s and 1890s. A graduate of the University of Michigan Medical School, he already had a childhood history of torturing and killing animals. While a medical student, he stole corpses and used them in insurance frauds. Working as a pharmacist in Chicago, he used the proceeds of various other frauds to construct a rooming house built to his specification by teams of builders, none of whom knew the whole plan. Mudgett included sound proof and airtight rooms, a dissecting room, an industrial size … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif
Our Current Approach to Drug Abuse -- Progress, Problems, Proposals
Authors: H D Kleber
Journal: New England Journal of Medicine (1994)

Most drug-abuse experts and historians agree that we are in the declining phase of a drug epidemic that began about 30 years ago. Still, drug abuse remains one of the nation's critical domestic problems, linked to crime, neglect of children, family violence, incomplete education, homelessness, AIDS, high health care costs, urban decay, and diminished economic competitiveness. Until we reduce the current level of addiction and the experimentation that leads many people to that end, individual tragedies and profound social problems will continue to undermine the quality of our lives.Most people are poor judges of their own susceptibility to addiction. . . .
Inhibition of Enterovirus 71 in Virus-infected Mice by RNA Interference
Authors: Eng Lee Tan, Theresa May Chin Tan, Vincent Tak Kwong Chow, Chit Laa Poh
Journal: Molecular Therapy (2007)

Enterovirus 71 (EV71) is the main causative agent of hand, foot, and mouth disease (HFMD) in young children. It is often associated with neurological complications and has caused high mortality levels in recent outbreaks in the Asia Pacific region. Currently, there is no effective antiviral therapy against EV71 infections. In this study, we have evaluated and compared the efficacies of three different forms of small interfering RNAs (siRNAs) in inhibiting EV71 replication in a murine model. We have shown that both synthetic 19-mer siRNAs and plasmid-borne short hairpin RNAs (shRNAs) targeted at the conserved 3D(pol) region were able to inhibit EV71 infections in suckling mice when delivered with or without lipid carrier via the systemic route. The treated mice did not exhibit hind limb paralysis and weight loss, as was observed in untreated mice. EV71 replication was significantly reduced as revealed by real-time reverse transcription polymerase chain reaction (RT-PCR) and Western blot. In addition, no evidence of interferon (IFN) induction was detected in the intestinal tissues harvested from the mice as a result of siRNA administration. However, the chemically synthesized 29-mer shRNA did not protect the suckling mice from EV71 infections despite being more potent in the in vitro system. Our results indicate that RNA interference (RNAi) may be a promising therapeutic approach for fighting EV71 infections.
Mycosis Fungoides: Natural History and Relationship to Other Malignant Lymphomas.
Authors: J. B. Block
Journal: Annals of Internal Medicine (1962)

s1 April 1962Mycosis Fungoides: Natural History and Relationship to Other Malignant Lymphomas.J. B. Block, M.D., J. H. Edgcomb, M.D., A. Z. Eisen, M.D., E. J. Van Scott, M.D.J. B. Block, M.D.Search for more papers by this author, J. H. Edgcomb, M.D.Search for more papers by this author, A. Z. Eisen, M.D.Search for more papers by this author, E. J. Van Scott, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-693_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMycosis fungoides is considered to be a member of the group of malignant lymphomas. Because its earliest manifestations are cutaneous, mycosis fungoides is particularly suited to studies of natural history and pathogenesis which may have application to the lymphomas. Thirty-eight patients with mycosis fungoides, seen over an eight-year period, provide the case material of this study. In this group, 21 patients died, and 17 were autopsied.It was found that mycosis fungoides almost always began as a chronic benign dermatitis, and only rarely was cutaneous tumor the initial manifestation. Subsequently, all patients developed skin tumors which were histologically characteristic of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. B. Block, M.D.; J. H. Edgcomb, M.D.; A. Z. Eisen, M.D.; E. J. Van Scott, M.D.Affiliations: Bethesda, Md. (CS) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 693-693KeywordsLymphomaPathogenesis ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...
Correlation of environmental carbaryl measurements with serum and urinary 1-naphthol measurements in a farmer applicator and his family.
Authors: D B Shealy, J R Barr, D L Ashley, D G Patterson, D E Camann, A E Bond
Journal: Environmental Health Perspectives (1997)

In exposure or risk assessments, both environmental and biological measurements are often used. Environmental measurements are an excellent means for evaluating regulatory compliance, but the models used to estimate body burden from these measurements are complex. Unless all possible routes of exposure (i.e., inhalation, dermal absorption, ingestion) are evaluated, exposure to a toxicant can be underestimated. To circumvent this problem, measurements of the internal dose of a toxicant in blood, serum, urine, or tissues can be used singularly or in combination with environmental data for exposure assessment. In three separate laboratories, carbaryl or its primary metabolite, 1-naphthol, was measured in personal air, dermal samples, blood serum, and urine from farmer applicators and their families. The usefulness of both environmental and biological data has been demonstrated. For the farmer applicator, the environmental levels of carbaryl would have been sufficient to determine that an exposure had occurred. However, biological measurements were necessary to determine the absorbed dose of each member of the applicator's family. In addition, a correlation between serum and urinary 1-naphthol measurements has been shown; therefore, either matrix can be used to accurately evaluate occupational carbaryl exposure.
Time for a new approach to assessing the quality of hospitals in England
Authors: N. Black
Journal: BMJ (2013)

Managing quality is as important as financial management for trust boards

Politicians, clinicians, and the public are justified in questioning the ability and competence of the NHS to assess and monitor the quality of hospitals in England. Failures in managing quality have recently been reported at Stafford General, Furness General, and Tameside hospitals. Whatever the rights and wrongs of the claims and counterclaims about who was at fault, neither the mechanisms within the hospitals (clinical governance, trust board engagement) nor the external mechanisms for performance management (strategic health authorities until recently) and regulation (Care Quality Commission, professional regulators) have proved fit for purpose.1

Traditionally the NHS has assessed hospital quality in two ways: inspections and the use of statistical data. Each has its limitations. Although inspections helped to transform appalling conditions in nineteenth century workhouse infirmaries and, in the 1970s and 1980s, care in long stay institutions, their more recent impact is less clear.2 This reflects the shortcomings of inspections (such as the absence of experienced clinician inspectors, as occurred at Furness Hospital) and the failure of trust boards to act on the findings (as occurred at Mid Staffordshire NHS Foundation Trust).3

Meanwhile, statistical data have been …
SOME SOURCES OF FAILURE IN TREATING LACHRYMAL OBSTRUCTIONS.
Authors: LEARTUS CONNOR
Journal: JAMA (1898)

Accepted methods of treating lachrymal obstructions succeed in some cases but fail in others, for reasons not always apparent. Bearing on the sources of failure are the following suggestions, grouped under four heads: Constitutional disorder, eye strain, nasal disease and faulty technique. First. It is evident that if lachrymal obstruction be caused by a chronic constitutional disease, the best planned and most skillfully executed operation will come to naught, for surgery never cured syphilis, gout nor rheumatism, and yet observation shows that this obvious truth is not infrequently overlooked. Spyhilitic infection may diplace the puncta, obstruct the canaliculi, induce a dacryocystitis, locate a mucous patch about the mouth of the duct, cause a periostitis, endostitis or subperiosteal gumma, adjacent to, or necrosis of the bony wall of, the duct; or hyperplastic processes of the bones themselves. These lesions may be found in any stage, from insignificant to gravest, singly or
P502 SPONTANEOUS BACTERIAL PERITONITIS AND BACTEREMIA PREDICT MORTALITY IN CIRRHOSIS DESPITE PROPHYLACTIC MEASURES: A PROSPECTIVE MULTI-CENTER STUDY FROM NACSELD
Authors: S.W. Biggins, J.G. O'Leary, K.R. Reddy, F. Wong, P.S. Kamath, H.M. Patton, M.B. Fallon, G. Garcia-Tsao, R.M. Subramanian, P. Thuluvath, B. Maliakkal, D. Koch, R. Malik, L.R. Thacker, J.S. Bajaj
Journal: Journal of Hepatology (2014)
Atlas of Bedside Procedures
Authors: Ira R. Friedlander
Journal: JAMA (1981)

This large expensive paperback atlas presents 40 of the most necessary and important invasive procedures available to the modern physician. The editors have compiled an extensive selection of procedures. The authors present a specific approach to the performance of each, and also list major indications, complications, and materials necessary for each procedure, along with a pertinent discussion of each aspect. The schematic representations placed copiously throughout the book are frequently more than sufficient to demonstrate the method of each procedure. The procedures are also presented with a short bibliography on complications, alternate methods, and historical development. Intravenous cannulation, venous and arterial cutdown, nasogastric tube placement, and lumbar puncture are some of the less dramatic procedures presented. Sengstaken-Blakemore tube insertion, temporary transvenous pacemaker placement, passage of filiforms and followers, culdocentesis, and liver biopsy are only a few of the highly invasive and technically difficult procedures that find a place in this
Higher rates of venous thromboembolism for Black‐Americans are likely due to lower serum 25‐hydroxyvitamin D levels
Authors: William B. Grant
Journal: American Journal of Hematology (2010)

The recent paper on disparities of thromboembolism in the United States concluded that heritability may be important in the etiology of venous thromboembolism among Black-Americans [1]. That is correct but not in the manner considered by the authors. As Black-Americans have darker skin than White-Americans, they have lower serum 25-hydoxyvitamin D [25(OH)D] levels, with mean value of 16 ng/mL compared with 26 ng/mL for White-Americans [2]. Lower serum 25(OH)D levels are a risk factor for cardiovascular disease in general [3] and venous thrombotic events in particular [4], as well as Type 2 diabetes mellitus [3]. A recent review concluded that the disparities in serum 25(OH)D levels can account for most of the 25% higher mortality rates for Black-Americans compared with White-Americans [5]. If Black-Americans were to supplement with 2,000–5,000 IU/day of vitamin D3, which would raise serum 25(OH)D levels from a mean value of 16 ng/mL to 30–50 ng/mL, they would significantly reduce their risk of venous thromboembolism, other cardiovascular diseases, Type 2 diabetes mellitus, many types of cancer, and a number of bacterial and infectious diseases [3, 5].
Lymphatic Drainage Patterns on Early Versus Delayed Breast Lymphoscintigraphy Performed after Injection of Filtered Tc-99m Sulfur Colloid in Breast Cancer Patients Undergoing Sentinel Lymph Node Biopsy
Authors: Gildy V. Babiera, Ebrahim S. Delpassand, Tara M. Breslin, Merrick I. Ross, Frederick C. Ames, Sonja E. Singletary, Henry M. Kuerer, Barry W. Feig, Funda Meric???Bernstam, Kelly K. Hunt
Journal: Clinical Nuclear Medicine (2004)

The axillary lymph node status is the most important predictor of prognosis and aids in breast cancer treatment planning. Patients with breast cancer now frequently undergo sentinel lymph node (SLN) biopsy rather than axillary lymph node dissection to determine the status of the regional lymph nodes. However, the optimal timing of radionuclide injection relative to the timing of SLN biopsy remains controversial. The objective of this study was to compare the lymphatic drainage patterns on lymphoscintigraphy performed at 15 minutes to 4 hours and at 18 to 24 hours after injection of filtered Tc-99m sulfur colloid, and to determine whether, over time, radiocolloid migrates to second-echelon nodes that are not the SLNs. Fifteen women with breast cancer (mean age, 55 years; range, 38-78 years) were scheduled to undergo SLN biopsy after each received an injection of 18.5 MBq (0.5 mCi) filtered Tc-99m sulfur colloid into the breast parenchyma surrounding the tumor or biopsy cavity. Both early (15 minutes to 4 hours after radionuclide injection) and delayed (18-24 hours after radionuclide injection) lymphoscintigraphy was performed in each patient. SLN biopsy was performed, followed by completion axillary lymph node dissection and planned breast surgery. In each patient the patterns of distribution of the radionuclide in the lymph nodes were the same on early and delayed lymphoscintigrams. These findings, that the distributions of radionuclide in lymph nodes are identical on early and delayed images obtained after injection of filtered Tc-99m sulfur colloid, suggest that performing SLN biopsy on the day after injection does not diminish the accuracy of the technique in predicting the potential site of metastasis in the regional lymph nodes in patients undergoing this procedure for breast cancer.