tbuckley/cabot-search huggingface dataset:
Role of Endogenous Adenosine as a Modulator of Syncope Induced During Tilt Testing
Authors: Alain Y. Saadjian, Samuel Lévy, Fréderic Franceschi, Ibrahim Zouher, Franck Paganelli, Régis P. Guieu
Journal: Circulation (2002)

Background — Previous reports that used head-up tilt testing and adenosine administration have suggested that adenosine may be an important endogenous mediator that may trigger a vasovagal response in susceptible patients. However, little is known regarding endogenous adenosine plasma levels (APLs) during vasovagal syncope provoked by tilt testing. The aim of this study was to determine whether APLs differ in patients with a positive head-up tilt test compared with those with a negative test and whether APLs are modified during tilt-induced vasovagal syncope. Methods and Results — APLs (mean±SEM) were measured during head-up tilt test in 26 patients who presented with unexplained syncope. In the 15 patients with a negative test, APLs were 0.39±0.03 μmol/L at baseline, 0.22±0.03 μmol/L immediately after tilting, and 0.44±0.03 μmol/L after 45 minutes. APLs were significantly higher in the 11 patients with a positive test (2.66±0.67 μmol/L at baseline and 3.22±0.85 μmol/L immediately after tilting) than in those with a negative test. During tilt testing–induced syncope, APLs increased to reach 4.03±0.66 μmol/L (ie, a 52% increase compared with baseline levels; P &lt;0.02). Furthermore, we observed that the higher the APL during syncope, the shorter the time to appearance of symptoms. Conclusions — This study showed that APLs were higher in patients with a positive tilt test than in patients with a negative test and that they increased during tilt testing–induced syncope. These observations suggest that adenosine release may be involved in the triggering mechanism of syncope induced during tilt testing.
Patient Satisfaction with Bronchoscopy
Authors: Noah Lechtzin, Haya R. Rubin, Peter White, Mollie Jenckes, Gregory B. Diette
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

We conducted a cohort study to characterize patient satisfaction with flexible bronchoscopy (FB) and to determine patient characteristics, care factors, and patient evaluations of bronchoscopy that are associated with a patient's willingness to return for repeat FB. Physicians and patients completed surveys between February 1997 and June 1998. Data from 481 patients were analyzed. Over 80% of the patients rated physicians as very good or excellent, but they were least satisfied with the information that they were provided about FB, waiting time before and after FB, and the FB environment. Seventy-one percent of the patients would definitely return, and 22% would probably return for a repeat FB. Better health status (odds ratio [OR] 1.4; 95% confidence interval [CI], 1.1–1.7), not being bothered by scope insertion (OR 2.0; 95% CI, 1.2–3.3), better rating of information quality (OR 1.2; 95% CI, 1.0–1.3), and better rating of physician quality (OR 1.1; 95% CI, 1.0–1.2) were associated with patients reporting that they would definitely return for a repeat FB. Although patient satisfaction with providers is high, there are specific patient and process of care factors that should be improved. Sicker patients may be at a risk of dissatisfaction with FB. Process of care measures that could improve satisfaction with FB include providing better information to patients and optimizing the experience of bronchoscope insertion.
Depression but Not Anxiety Is a Significant Predictor of Physicians’ Assessments of Medical Status in Physically Ill Patients
Authors: Thomas Meyer, Heike Klemme, Christoph Herrmann
Journal: Psychotherapy and Psychosomatics (2000)

In a cross-sectional study we investigated associations between self-ratings of anxiety and depression, physical factors and physicians' assessments of patients' medical status.Hospital inpatients (n = 574) consecutively admitted to internal medical wards were evaluated for the presence of anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS). Physicians were asked for their perception of psychiatric problems in their patients and for their assessments of patients' severity of illness, functional impairment and 1-year prognosis on 3-point ranking scales. Detailed somatic data including comorbidity and accepted risk factors were taken from the patients' records.Almost two thirds of all patients with abnormal HADS scores (65.2%) were not identified by their attending physicians as suffering from psychiatric problems. Using multiple-regression models, HADS scores for depression, but not for anxiety, proved to be an independent predictor for the clinicians' judgements of disease severity [exp(beta) = 1.08; 95% confidence interval (CI) 1. 03-1.13; p < 0.01] and functional impairment [exp(beta) = 1.11; 95% CI 1.05-1.17; p < 0.01]. The estimation of prognosis, however, was only related to physical predictors and showed no association with depressive symptoms or other psychosocial factors.Our data demonstrate that internists' ratings of severity of illness and functional impairment, but not prognosis, are associated with HADS depression scores, whereas there is no such association with self-rated anxiety.
Observations on the maturation of thyroid function in early fetal life
Authors: Arnold H. Greenberg, Paul Czernichow, Richard C. Reba, John Tyson, Robert M. Blizzard
Journal: Journal of Clinical Investigation (1970)

Serum samples were obtained from 21 normal human fetuses after therapeutic abortion for psychiatric indications. Fetal crown-rump length ranged from 5.2 to 22.5 cm, corresponding to the gestational age of 65-168 days.Serum thyroxine, assayed by a modification of the Murphy-Pattee method, was identified in the second smallest fetus examined at 78 days gestation. Thereafter it increased rapidly, maintaining a significant linear correlation with crown-rump length until term (r = 0.800, P < 0.001). Free thyroxine (FT4) also increased in a linear relation to gestational age (r = 0.908, P < 0.001), but reached term levels by 18-20 wk. Radioimmunoassayable thyroid-stimulating hormone (TSH) was detected at 78 days gestation. Levels increased rapidly with advancing gestation, so that by 16 wk almost all were within the range of term infants. After 16 wk gestation, levels were usually greater than 4.0 muU/cc, higher than that seen in normal children. No correlation was demonstrated between the serum TSH levels and total thyroxine. TSH and FT4, however, increased in a parallel manner with a significant positive correlation. This suggested that fetal TSH secretion was responsive to FT4 levels from very early in gestation, possibly as early as 11 wk.Thyroxine-binding globulin (TBG) was detected in a fetus of 78 days gestation (1.4 mug/100 ml). Levels increased rapidly, paralleling the rise in serum thyroxine and maintaining a linear correlation with crownrump length (r = 0.864, P < 0.001). Thyroxine-binding prealbumin binding capacity (TBPA) in fetuses 14-24 wk gestation was comparable with that seen at term. When examining the distribution of tracer amounts of thyroxine-(131)I (T4-(131)I) between the thyroxine-binding proteins, it was found that a major fraction was bound to TBPA and albumin during the early part of gestation. This decreased linearly with maturation of the fetus as the fraction bound to TBG increased. By 20 wk gestation fetal TBG was able to bind 78% of tracer despite a TBG capacity of only 7.7 mug/100 ml. This appeared to be the result of relatively low concentrations of TBPA and albumin during this period of gestation. The theoretical association constant calculated for fetal and newborn TBG was found to be similar to that estimated for normal adult males and females.
1029-180 Impact of protein kinase C-epsilon for myocardial hypertrophy after chronic pressure overload: In-vivo study in protein kinase C-epsilon knockout mice
Authors: Gunnar G Klein, Dagmar Oppermann, Arnd Schaefer, Martin Fuchs, Denise Hilfiker, Michael Niehaus, Michael Leitges, Helmut Drexler
Journal: Journal of the American College of Cardiology (2004)
Ageism in cancer care
Authors: M. Lawler, P. Selby, M. S. Aapro, S. Duffy
Journal: BMJ (2014)

<h3>Abstract</h3> Pre-mRNA splicing is executed by the spliceosome, which has eight major functional states each with distinct composition. Five of these eight human spliceosomal complexes, all preceding exon ligation, have been structurally characterized. In this study, we report the cryo-electron microscopy structures of the human post-catalytic spliceosome (P complex) and intron lariat spliceosome (ILS) at average resolutions of 3.0 and 2.9 Å, respectively. In the P complex, the ligated exon remains anchored to loop I of U5 small nuclear RNA, and the 3'-splice site is recognized by the junction between the 5'-splice site and the branch point sequence. The ATPase/helicase Prp22, along with the ligated exon and eight other proteins, are dissociated in the P-to-ILS transition. Intriguingly, the ILS complex exists in two distinct conformations, one with the ATPase/helicase Prp43 and one without. Comparison of these three late-stage human spliceosomes reveals mechanistic insights into exon release and spliceosome disassembly.
Parathyroid Angiography: A Review of Current Knowledge and Guidelines for Clinical Application*
Authors: L. E. MALLETTE, L. GOMEZ, R. G. FISHER
Journal: Endocrine Reviews (1981)

IN THE YEARS since the first localization (1) and visualization (2) of parathyroid lesions by arteriography, there has accumulated a large body of knowledge about the anatomical basis of parathyroid angiography, the proper and safe application of these techniques, and the subtilities of their interpretation. This information is now widely scattered in the radiographic, surgical, and internal medicine literature. This review is undertaken to provide the internist with a concise summary of this knowledge, in order to facilitate the optimum application of these techniques. We will review the pertinent facts about parathyroid embryology, vascular anatomy, and blood flow patterns. We will outline the goals, risks and interpretation of arteriography and venous sampling. Tentative guidelines are presented to aid in the selection of patients who are most likely to benefit from these techniques. Arterial Anatomy and Embryology Accurate performance and interpretation of parathyroid angiographic studies requires an understanding of regional vascular anatomy and blood flow patterns.
Cladribine Therapy in Refractory Celiac Disease With Aberrant T Cells
Authors: Abdulbaqi Al–toma, Marije S. Goerres, Jos W.R. Meijer, B. Mary E. von Blomberg, Peter J. Wahab, Jo A.M. Kerckhaert, Chris J.J. Mulder
Journal: Clinical Gastroenterology and Hepatology (2006)
IgG2 Deficiency in Ataxia-Telangiectasia
Authors: Vivi-Anne Oxelius, A. Izzet Berkel, Lars Å. Hanson
Journal: New England Journal of Medicine (1982)

ATAXIA-telangiectasia is a genetically linked multisystem degenerative disease with abnormalities in both humoral and cellular immune responses. IgA deficiency is common in this disorder1; IgE deficiency occurs,2 as does low IgG.3 , 4 We previously found that three patients with ataxia-telangiectasia had IgG2 deficiency.5 This investigation concerns IgG-subclass determinations in serum samples from 22 patients with ataxia-telangiectasia, 10 of whom had IgA deficiency.An imbalanced IgG-subclass pattern was noted. Very low or borderline-low serum IgG2 values were found in all 22 patients, serum IgG4 was undetectable in 19 of the 22, and the IgG1 levels were significantly increased (P<0.001 by Student's . . .
Information Dissemination to Health Care Practitioners and Policymakers: Annotated Bibliography
Authors: Hannah L. Hedrick
Journal: JAMA (1992)

Promising mechanisms for ensuring that findings from medical treatment effectiveness programs and clinical practice and decision making are included in the new 79-page<i>Information Dissemination to Health Care Practitioners and Policymakers: Annotated Bibliography</i>, published by the Agency for Health Care Policy and Research (AHCPR). The continuing medical education community, in particular, should welcome the abstracts on research pertinent to the acceptance, inculcation, and use of clinical and other health-related information disseminated to practitioners and policymakers. Descriptions of selected conceptual and empirical research on diffusion of information and innovations and technology are also presented. The clinical practice guidelines the AHCPR has been charged with developing are another important source of medical education. The guidelines, in areas such as acute pain management, pressure ulcers in adults, and urinary incontinence, consist of a compact document and an abbreviated quick reference for health care providers and a patient's guide pamphlet. For information about other
Gastrointestinal complications of the Ehlers-Danlos syndrome
Authors: P. H. Beighton, J. L. Murdoch, T. Votteler
Journal: Gut (1969)

The gastrointestinal abnormalities encountered in 125 patients with the Ehlers-Danlos syndrome have been described. Spontaneous perforation of the intestine and massive gastrointestinal haemorrhage are uncommon but potentially lethal complications of the Ehlers-Danlos syndrome. Less dangerous abnormalities, such ;as external hernia, hiatus hernia, eventration of the diaphragm, intestinal diverticula, and rectal prolapse were all encountered in patients in the series. Abdominal surgery in affected patients may be made difficult by fragility of tissues and a bleeding tendency. In the postoperative period, tearing out of sutures and wound dehiscence may occur.
Quinine induced photosensitivity: clinical and experimental studies
Authors: J. FERGUSON, H.A. ADDO, B.E. JOHNSON, W. FRAIN-BELL
Journal: British Journal of Dermatology (1987)

Quinine induced photosensitivity, an infrequently described adverse effect, is reported in four patients. The clinical presentation and distribution was that of a light exposed site eruption characterized by oedema and erythema in three patients, and by lichen planus in the fourth. Monochromator phototesting demonstrated abnormal delayed erythema responses in the UVB, UVA and visible wavebands. The clinical features suggested a phototoxic effect but laboratory studies indicated that the molecular mechanisms involved are unusual. Clinical and phototest evidence of abnormal photosensitivity persisted for some months after stopping quinine. Broad spectrum sunscreens are advised for the management of such patients and, where possible, cessation of quinine administration.
Haemoglobinuria in a Case of Cholera
Authors: S. N. De, K. P. Sengupta, N. N. Chanda
Journal: BMJ (1952)

RETRODISPLACEMENT OF THE UTERUS Bmorn (e) The various laboratory methods for detecting the function of the liver and bile can be either positive or nega- tive in the presence of the hepatogenic syndrome, and they may or may not correspond to the clinical picture, which aiso may or may not be quite evident.(f) In cases where the above laboratory tests are positive, they may become negative after ventrofixation.(g) Where a retrodisplacement is associated with a hepato- genic syndrome clinically evident and proved by laboratory tests, mastopathy may often be present, the content of oestro- gens is usually above normal, and endometrial biopsy mainly reveals metropathia.These conditions disappear in most cases after ventrofixation with no additional treatment.(h) In our experience the incidence of retrodisplacement is very high among patients suffering from hepatocholecystopathy.(i) The hepatogenic syndrome may or may not be associ- ated with retrodisplacement, and vice versa; also, retrodis- placement, as known, does not necessarily always cause back- ache, lower abdominal pains, and menstrual disorders. ConclusionsRetrodisplacement may very often cause the hepato- genic syndrome.Ventrofixation will in most cases cure the hepatogenic syndrome if this is due only to retro- displacement.If retrodisplacement is not associated with the hepatogenic syndrome ventrofixation alone will either restore periods to normal or assist in the subse- quent treatment with oestrogens.Clinical symptoms are to our knowledge more demon- strative than laboratory tests, which, besides endometrial biopsy, cannot safely assist the diagnosis.
Perturbed Equilibrium of Myosin Binding in Airway Smooth Muscle and Its Implications in Bronchospasm
Authors: JEFFREY J. FREDBERG, DAVID S. INOUYE, SRBOLJUB M. MIJAILOVICH, JAMES P. BUTLER
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

In asthma, the mechanisms relating airway obstruction, hyperresponsiveness, and inflammation remain rather mysterious. We show here that regulation of airway smooth muscle length corresponds to a dynamically equilibrated steady state, not the static mechanical equilibrium that had been previously assumed. This dynamic steady state requires as an essential feature a continuous supply of external mechanical energy (derived from tidal lung inflations) that acts to perturb the interactions of myosin with actin, drive the molecular state of the system far away from thermodynamic equilibrium, and bias the muscle toward lengthening. This mechanism leads naturally to the suggestion that excessive airway narrowing in asthma may be associated with the destabilization of that dynamic process and its resulting collapse back to static equilibrium. With this collapse the muscle undergoes a phase transition and virtually freezes at its static equilibrium length. This mechanism may help to elucidate several unexplained phenomena including the multifactorial origins of airway hyperresponsiveness, how allergen sensitization leads to airway hyperresponsiveness, how hyperresponsiveness can persist long after airway inflammation is resolved, and the inability in asthma of deep inspirations to relax airway smooth muscle.
"Human right to health" needs clarifying, experts agree
Authors: N. Siva
Journal: BMJ (2009)

Experts in philosophy, law, and medicine at a conference in London on 14 and 15 May, have said that a multidisciplinary approach is needed to determine what a human right to health might entail. 

The conference, organised by University College London and The Lancet, was dedicated to looking at the issues concerning the human right to health.

“At the moment there is some vagueness about how to best understand the content of the human right to health, and this needs much further development,” said Jonathan Wolff, of the, University of College London’s Department of Philosophy, who helped organise the conference. 

“An interdisciplinary approach is needed to try to understand …
Early-life cockroach allergen and polycyclic aromatic hydrocarbon exposures predict cockroach sensitization among inner-city children
Authors: Matthew S. Perzanowski, Ginger L. Chew, Adnan Divjan, Kyung Hwa Jung, Robert Ridder, Deliang Tang, Diurka Diaz, Inge F. Goldstein, Patrick L. Kinney, Andrew G. Rundle, David E. Camann, Frederica P. Perera, Rachel L. Miller
Journal: Journal of Allergy and Clinical Immunology (2013)
[423] THE INFLUENCE OF HEPATITIS B SURFACE ANTIGEN LEVELS AND SEQUENCES ON THE ASSEMBLY EFFICIENCY OF HEPATITIS D VIRUS AND ITS CLINICAL IMPLICATIONS
Authors: J.C. Wu, H.H. Shih, K.S. Teng, Y.H. Huang, C.W. Su, P.T. Chiang, I.J. Sheen, S.D. Lee
Journal: Journal of Hepatology (2007)
Effect of Saline Infusions on Aldosterone Secretion and Electrolyte Excretion in Normal Subjects and Patients with Primary Aldosteronism
Authors: E. A. Espiner, J.R. Tucci, P. I. Jagger, D. P. Lauler
Journal: New England Journal of Medicine (1967)

IT is well established that aldosterone secretion in man is determined in part by the sodium content of the diet1 , 2 and that the administration of large amounts of sodium to normal subjects, in contrast to patients with primary aldosteronism,3 leads to a decrease in aldosterone excretion4 , 5 or secretion.6 However, there is less information on the amount and rate of salt administration necessary to suppress aldosterone secretion in normal subjects, nor has the time sequence of this response been well defined. Apart from its physiologic interest, a more precise definition of the normal response to salt loading may help to distinguish . . .
Professor to face GMC over his claim to have seen full trial data
Authors: C. Dyer
Journal: BMJ (2009)

The former research dean of Sheffield University’s medical school is to face a General Medical Council hearing over accusations that he falsely signed a declaration that he had seen all the data in a study of an osteoporosis treatment.

Richard Eastell, who heads the bone research unit at Sheffield University, was research director of Sheffield Teaching Hospitals NHS Foundation Trust at the time that the study, of which he was the lead investigator, was submitted to the Journal of Bone and Mineral Research .

The GMC hearing later this year will be the latest development in a research ethics case that saw the other named investigator, Aubrey Blumsohn, who raised questions about the data, take a financial settlement to leave his job …
Pre–B cell colony–enhancing factor inhibits neutrophil apoptosis in experimental inflammation and clinical sepsis
Authors: Song Hui Jia, Yue Li, Jean Parodo, Andras Kapus, Lingzhi Fan, Ori D. Rotstein, John C. Marshall
Journal: Journal of Clinical Investigation (2004)

Pre–B cell colony-enhancing factor (PBEF) is a highly conserved 52-kDa protein, originally identified as a growth factor for early stage B cells. We show here that PBEF is also upregulated in neutrophils by IL-1β and functions as a novel inhibitor of apoptosis in response to a variety of inflammatory stimuli. Induction of PBEF occurs 5–10 hours after LPS exposure. Prevention of PBEF translation with an antisense oligonucleotide completely abrogates the inhibitory effects of LPS, IL-1, GM-CSF, IL-8, and TNF-α on neutrophil apoptosis. Immunoreactive PBEF is detectable in culture supernatants from LPS-stimulated neutrophils, and a recombinant PBEF fusion protein inhibits neutrophil apoptosis. PBEF is also expressed in neutrophils from critically ill patients with sepsis in whom rates of apoptosis are profoundly delayed. Expression occurs at higher levels than those seen in experimental inflammation, and a PBEF antisense oligonucleotide significantly restores the normal kinetics of apoptosis in septic polymorphonuclear neutrophils. Inhibition of apoptosis by PBEF is associated with reduced activity of caspases-8 and -3, but not caspase-9. These data identify PBEF as a novel inflammatory cytokine that plays a requisite role in the delayed neutrophil apoptosis of clinical and experimental sepsis.