tbuckley/cabot-search huggingface dataset:
Beta agonists and ventilation.
Authors: A E Tattersfield, P Wilding
Journal: Thorax (1993)

Agonists and ventilationAcute treatment with a high dose of f, agonist can cause an increase in oxygen uptake (Vo2), carbon dioxide out- put (Vco2), and ventilation of the order of 20-50%.1In this issue of Thorax Amoroso et al5 describe a dose dependent increase in oxygen uptake and CO2 output with smaller doses of inhaled salbutamol (up to 1200 pg in 10 normal subjects).The changes were maximal at the time of the initial measurement five minutes after inhalation of salbutamol and the increase in CO2 output of about 30% was then greater than the increase in oxygen uptake.This caused an increase in the ratio of Vco2 toVo2 (the respiratory exchange ratio (R)) from 0-85 to 0 93.Output of CO2 subsequently fell more rapidly than oxygen uptake so that by 30 minutes the respiratory exchange ratio was marginally lower after salbutamol than after placebo.In a companion paper6 the group compared the change in Vo2 and Vco2 after 800 ,ug of salbutamol eight to 10 hours after completing 10 days of treatment with placebo or salbutamol (200 jug four times a day) in a crossover study.An acute increase inVo2 and Vco2 was seen after 800 ,ig salbutamol after 10 days of placebo but not after 10 days of regular salbutamol.These papers raise questions about the mechanisms underlying the change in oxygen uptake and CO2 output with the acute administration of a ,B agonist, the clinical relevance of the findings, and, once again, the question of tolerance or tachyphylaxis.Before discussing these questions some points about nomenclature need to be clarified.The group measured oxygen uptake, CO2 output, and respiratory exchange ratio (R) at the mouth with indirect calorimetry.Subjects rested for 30 minutes before the first measurement so baseline values should reflect steady state conditions and hence CO2 production and oxygen consump- tion in the tissues and the ratio of these, the respiratory quotient (RQ).7After salbutamol steady state conditions may not pertain and the increase in CO2 output at the mouth, for example, may reflect a reduction in CO2 stores rather than an increase in CO2 production.Although described as a change in RQ in both papers the authors are in fact describing change in R, the respiratory exchange ratio-that is, change in the ratio of CO2 out- put and oxygen intake at the mouth.The changes they
Nocebos contribute to host of ills
Authors: R. Voelker
Journal: JAMA (1996)

HERBERT BENSON, MD, still recalls the time a patient nearly made him sick.  The incident happened during his internship, as Benson was about to examine an Asian man. When the patient came into the examining room, Benson says he absolutely panicked. In a cold sweat, his heart racing, the physician performed the exam. But afterward, he told the patient of his unusual reaction.  The patient's response? Ha, ha, ha, Yank. Now you die! he exclaimed, recreating his Tokyo Joe film role from World War II—era movies. Just the sight of the character actor evoked in Benson a response similar to how he had felt while watching those films.  Wired in me was this fear. When I saw him, although I couldn't identify the fear, it expressed itself, explains Benson, now president of the Mind & Body Medical Institute at Harvard Medical School, Boston, Mass.  Benson's anecdote illustrates a little-recognized aspect
US House passes bill that would defund Affordable Care Act
Authors: M. McCarthy
Journal: BMJ (2013)

In a 230-189 vote the Republican dominated House of Representatives passed a stopgap spending bill on Friday 20 September that would strip all funding for the Affordable Care Act.

Funding for the federal government runs out on 30 September, the end of the fiscal year. Unless a funding package is passed by both chambers of Congress and signed into law by then, much of the US government will have to shut down the next day.

The House speaker, John Boehner, an Ohio Republican, called the vote “a victory …
Enhancement of thrombolysis with tissue-type plasminogen activator by pretreatment with heparin.
Authors: B Cercek, A S Lew, H Hod, J Yano, N K Reddy, W Ganz
Journal: Circulation (1986)

The effect of pretreatment with heparin on lysis of arterial thrombi by tissue-type plasminogen activator (rt-PA) was studied in 19 dogs. Copper coil-induced carotid artery thrombi were weighed, inserted into the femoral arteries, and exposed to a 15 min infusion of rt-PA at 10 micrograms/kg/min either with (n = 6 thrombi) or without pretreatment with a 200 unit/kg bolus of heparin (n = 6 thrombi). The infusion of rt-PA without pretreatment reduced the thrombus weight by 27.6 +/- 7.4%, while infusion of rt-PA with pretreatment reduced it by 79.1 +/- 12.3% (p less than .0001). To test the hypothesis that heparin enhanced thrombolysis by preventing continued incorporation of new fibrin into the thrombus during thrombolysis we repeated the experiments using pretreatment with 8 U/kg of ancrod, which rapidly depletes fibrinogen. Pretreatment with ancrod (n = 6 thrombi) depleted fibrinogen and enhanced the lytic effect of rt-PA to a similar degree as pretreatment with heparin, resulting in a 67.6 +/- 12.3% (NS) decrease in thrombus weight. We conclude that heparin significantly enhances the thrombolytic effect of rt-PA, probably by preventing new fibrin formation and its incorporation into the thrombus during lysis.
Right Atrial Myxoma
Authors: MARTIN S. BELLE
Journal: Circulation (1959)

A case of myxoma of the right atrium with physiologic, surgical, and angiocardiographic findings has been presented together with a review of 6 other published cases. Several findings have been emphasized that may call attention to the possible diagnosis of right atrial myxoma: right-sided heart failure; intracardiac calcification of the right heart; enlargement of the right ventricle and right atrium; electrocardiographic findings of a prominent P wave and low voltage over right precordium simulating that found in Ebstein's anomaly and marked variation in heart rate not related to any physiologic event or change in rhythm; use of intracavitary electrode catheter to rule out Ebstein's anomaly; and finally, analysis of the right atrial curve may lead one to suspect that other than valvular stenosis is present. Angiocardiography gives a definitive diagnosis. Cure may now be obtained with surgical removal of myxomas; therefore, it is important that they be detected during life.
Fatty acid inhibition of glucose-stimulated insulin secretion is enhanced in pancreatic islets from insulin-resistant rats
Authors: N.-G. Chen, G.M. Reaven
Journal: Metabolism (1999)

A study was initiated to test two hypotheses. The first was the postulate that glucose-stimulated insulin secretion would be enhanced in pancreatic islets isolated from normal non-obese rats made insulin-resistant by dietary means. The second, related hypothesis was that glucose-stimulated insulin secretion by pancreatic islets isolated from insulin-resistant rats would be more vulnerable to inhibition following culture in the presence of fatty acids. For this purpose, insulin resistance was induced in normal Sprague-Dawley rats by feeding fat-enriched and fructose-enriched diets. The results indicate that islets isolated from either fat-fed or fructose-fed rats secreted significantly more insulin at a glucose concentration of 2.5 to 10.0 mmol/L. In addition, the mean maximal glucose (27 mmol/L)-stimulated insulin secretion rate was significantly lower (15.3 +/- 2.5 ng/islet/h) in islets from fructose-fed rats versus chow-fed rats (25.2 +/- 3.1 ng/islet/h) following culture for 48 hours in the presence of palmitate (0.125 micromol/L). These results support the view that glucose-stimulated insulin secretion is enhanced in islets from insulin-resistant rats, and that these islets are more vulnerable to the inhibitory effects of free fatty acid (FFA) on insulin secretion.
Endocytoscopie in vivo dans la maladie coeliaque
Authors: T Matysiak-Budnik, E Coron, M Le Rhun, H Inoue, JP Galmiche
Journal: Endoscopy (2008)

Introduction: L'Endocytoscopie (EC) est une nouvelle technique endoscopique, basée sur la microscopie optique, permettant de visualiser la muqueuse digestive à l'échelle microscopique in vivo. A ce jour, l'EC a été principalement utilisée pour étudier des lésions néoplasiques de l'œsophage et du colon. Sa valeur potentielle dans le diagnostic des lésions non-néoplasiques n'est pas établie. Notre but a été d'utiliser l'EC pour étudier in vivo la muqueuse duodénale chez les patients atteints d'une maladie coeliaque (MC).
Use of anti-inflammatory drugs by patients admitted with small or large bowel perforations and haemorrhage.
Authors: M J Langman, L Morgan, A Worrall
Journal: BMJ (1985)

The intake of anti-inflammatory drugs by 268 patients with colonic or small bowel perforation or haemorrhage was compared with that by a group of patients, matched for age and sex, with uncomplicated lower bowel disease. Patients with perforation or haemorrhage were more than twice as likely to be takers of anti-inflammatory drugs, but no association was detected with the intake of other types of drugs, particularly cardiovascular drugs. The association between complicated lower bowel disease and intake of anti-inflammatory drugs may be causal.
TB or not TB, That Is the Question
Authors: Heidi M. Jolson
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Based on a cross-sectional analysis comparing prevalence rates of tuberculin positivity in seropositive and seronegative intravenous drug users, Graham et al<sup>1</sup>conclude that "induration 5 mm or greater in diameter... significantly underestimates the 'true' infection rate" among seropositive individuals and advocate using 2-mm induration as the cutoff for isoniazid prophylaxis. The final cross-sectional sample included 17.3% (109/630) eligible seropositive individuals and 11.2% (151/1347) eligible seronegative individuals, recruited from an initial cohort of 2921 subjects. Importantly, a documented history of a positive tuberculin skin test or a previous tuberculosis (TB) diagnosis were among study exclusion criteria. Without additional information on reasons for nonparticipation and a description of nonparticipants, differential enrollment based on prior tuberculin positivity or prior disseminated disease offers an alternative explanation for the apparent difference in rates of tuberculin positivity. Plausible reasons for differential enrollment include (1) more rigorous screening of seropositive individuals for TB
Illustrated Manual of Neurologic Diagnosis
Authors: Thomasina Blissard
Journal: JAMA (1962)

Recognizing the student's and often the nonspecialist's difficulty in dealing confidently with neurological disorders, the author, a neurologist, has presented "a simplified approach" to diagnosis in this branch of medicine. The manual is no substitute for a standard text, nor is it purported to be. Some readers may criticize the volume for appearing to advocate a "recipe" for handling patients with neurological symptoms. The majority of readers will, however, welcome the steps suggested for working up such patients. The method is predicated on the belief that determination of the anatomical location of the lesion is fundamental to establishing a diagnosis. Data presented in several tables correlate neuroanatomy with clinical examination techniques, signs, and symptoms. The manual contains "anatomic profiles" of 97 neurological diseases. Color illustrations with shaded areas indicating affected structures are supplied for each disorder. Accompanying the illustrations are the common clinical signs and symptoms, as well as a
Guide to diagnosing sexual abuse of children is published
Authors: Clare Dyer
Journal: BMJ (2008)

A new report is calling for changes in the conduct of clinical trials in the United States to reduce disparities of age, sex, race, and comorbidity.The goal is to give a more representative picture of the benefits and risks of a treatment across the entire population but particularly among those who bear the greatest burden of the morbidity.The eliminating disparities in clinical trials (EDICT) initiative was conducted over two years by the Baylor College of Medicine in Houston and the Intercultural Cancer Council.It is part of an ongoing four year project to reduce barriers to participation in trials.The report of the initiative was released on 1 April in Washington, DC.The report describes itself as a "nationwide call to action . . .that removes the barriers to clinical trial participation and advances education and information sharing [as] a critical step to improving the health status of all Americans."Recommendations include harmonising the Food and Drug Administration's regulations on trial design and conduct with those of the National Institutes of Health requiring diversity; increasing collaboration between government and industry in trials; and fostering community involvement in all phases of trial design and implementation.It calls on journals to require researchers to include an analysis of how their trial participants match the population that bears the greatest burden of that condition.It also seeks better education of institutional review boards on their ethical responsibilities and of the general public about the trials process.Calls for better education of review boards and the public are likely to draw little opposition.But other recommendations are likely to require an increase in the size of a trial to provide sufficient numbers for subgroup analysis according to sex, race, age, and comorbidity.This will increase the cost of trials and could delay the introduction of new drugs to the marketplace.Information on EDICT is available at www.bcm.edu/edict. Trial participants need to represent patients betterUK NEWS Wakefield tells GMC he was motivated by concern for autistic children, p 738 World NEWS Australian drug firms give details of sums spent courting doctors, p 742 bmj.com reducing inequalities in health will need a long timeframe, MPs are told
Miliary Crohn's disease.
Authors: K W Heaton, C F McCarthy, R E Horton, J S Cornes, A E Read
Journal: Gut (1967)

COMMENT This paper draws attention to an important manifestation of Crohn's disease with miliary peritoneal nodules resembling tuberculosis.It is likely that Crohn's disease may not be considered.The differentiation is essential to enable correct treatment to be given.It is generally accepted that Crohn's disease (regional enteritis) is an inflammatory process affecting the bowel, in which all layers of the wall are involved.Usually this results in the characteristic 'hose-pipe' appearance, easily recognized at laporotomy, in which the wall of the affected segment is thickened, indurated, and reddened or dusky in colour (Crohn and Yarnis, 1958).Occasionally, on the serosal surface of the intestine, there are seen many tiny pale nodules, resembling the tubercles of miliary tuberculosis.These were noted in some of the earliest descriptions of the disease (Crohn, Ginsburg, and Oppenheimer, 1932; Blackburn, Hadfield, and Hunt, 1939), but they have seldom been commented on in recent discussions of the pathology of regional enteritis (Morson, 1965).When mention has been made of serosal tubercles it has been implied, if not explicitly stated, that they are only found on the surface of obviously diseased bowel (van Patter, Bargen, Dockerty, Feldman, Mayo, and Waugh, 1954; Warren and Sommers, 1954;Pollock, 1958;Avery Jones and Gummer, 1960).Moreover this aspect of Crohn's disease is not referred to at all in standard textbooks of surgery.The purpose of this paper is to describe three cases in which, at laparotomy, miliary tubercles were the most striking or even the only manifestation of Crohn's disease, with the result that in each case the first diagnosis to be considered was tuberculosis.CASE REPORTS CASE 1 R.W., a schoolboy aged 15, was admitted to hospital in May 1965 with an eight-month history of intermittent diarrhoea.The admission was precipitated by the bursting of an unsuspected ischio-rectal abscess.This was explored and drained and a biopsy was taken from the wall of the abscess.Histology showed non- caseating granulomas containing multinucleate giant cells and no acid-fast bacilli.Crohn's disease was diag-CASE 2 S.J., a 53-year-old schoolmistress, was admitted to hospital in October 1959 with a three-month history of mild diarrhoea, weight loss, abdominal discomfort, and tiredness.Physical examination and blood count
D-dimer to guide the duration of anticoagulation in patients with venous thromboembolism: a management study
Authors: Gualtiero Palareti, Benilde Cosmi, Cristina Legnani, Emilia Antonucci, Valeria De Micheli, Angelo Ghirarduzzi, Daniela Poli, Sophie Testa, Alberto Tosetto, Vittorio Pengo, Paolo Prandoni
Journal: Blood (2014)
Abstract 1077: Galectin-1 is implicated in G1/S-checkpoint control following irradiation - possible explanation of Galectin-1 mediated radioresistance
Authors: Alexander Huebner, James Perry, Michael Siedow, Min Zhang, Arnab Chakravarti, Tim Lautenschlaeger
Journal: Cancer Research (2010)

Abstract Purpose: The purpose of the conducted study was to examine a possible therapeutic relevance of Galectin 1 (Gal-1), a beta-galactoside binding protein. Gal-1 is overexpressed in high grade gliomas and leads to increased radioresistance in glioma cell culture models. Inhibition of Gal-1 increases radiosensitivity and thus is a potential therapeutic target for radiation sensitization. P53 has been shown to negatively regulate Gal-1, hence radiosensitivity could possibly be cell cycle mediated. Experimental Design: We used flow cytometry based cell cycle analysis to investigate cell cycle distribution of LN 229 glioma cells following irradiation. LN229 control cell lines and shRNA mediated Gal-1 knockdown LN 229 cell line were exposed to 6 Gy of irradiation and cell cycle analysis was performed. Furthermore Western blot analysis was carried out, probing for multiple proteins implicated in cell proliferation. The phosphorylation status of a variety of phosphorylation sites of p53, Chk1/2 and AKT were examined. Additionally p53-Gal-1 double-knockdown cell lines were created and clonogenic survival assays as well as AnnexinV apoptosis assays were conducted to analyze the influence on radiation sensitivity. Results: The results of the flow cytometry based cell cycle analysis show significant differences between the LN 229 control cell line and the Gal-1 knockdown cell line after irradiation. 24 h after irradiation 77 % of the control line cells are in G1 whereas only 60 % of the Gal-1 knockdown cells are in G1. Previous data has identified differences in the phosphorylation status of Akt in control vs. Gal-1 knockdown glioma cell lines. Phosphorylation of Akt is induced after irradiation. Western blot analysis indicates a reduction of phosphorylated Chk1/2 in Gal1 knockdown cell lines after irradiation. The phosphorylation state of the p53 phosphorylation site, correlating with Chk1/2 activity, exhibit anticipated results. P53-Gal-1 double-knockdown cell lines demonstrate significantly reduced clonogenic survival compared to control cell lines. Conclusions: The finding that less Gal-1 knockdown cells are in G1 phase after irradiation and that there is a reduction in phosphorylated Chk1/2 leads to the conclusion that Gal-1 knockdown abrogates G1 arrest through a Chk1/2 mediated pathway. That means in reverse that Gal-1 can mediate cell cycle arrest, thus potentially can explain Gal-1 mediated radioresistance. Further analysis of Chk1/2 independent phosphorylation sites of p53 is going to be conducted. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1077.
America's Oldest Student Medical Society
Authors: Newton E. Hyslop
Journal: New England Journal of Medicine (1961)

In the winter of 1842–3, on the resignation of the President, I became (as Vice-President) the sole representative of the Boylston Medical Society of Harvard University. There were then no members and the Society's records could not be found! For several years the President had tried and failed to obtain the assistance of a sufficient number of students to carry on even a nominal meeting, and he had addressed the students of that year on the subject without avail. The prospect seemed gloomy enough, nevertheless the cause appeared worthy of another trial. By the aid of three or four acquaintances . . .
Health Literacy Among Medicare Enrollees in a Managed Care Organization
Authors: Julie A. Gazmararian
Journal: JAMA (1999)

Elderly patients may have limited ability to read and comprehend medical information pertinent to their health.To determine the prevalence of low functional health literacy among community-dwelling Medicare enrollees in a national managed care organization.Cross-sectional survey.Four Prudential HealthCare plans (Cleveland, Ohio; Houston, Tex; south Florida; Tampa, Fla).A total of 3260 new Medicare enrollees aged 65 years or older were interviewed in person between June and December 1997 (853 in Cleveland, 498 in Houston, 975 in south Florida, 934 in Tampa); 2956 spoke English and 304 spoke Spanish as their native language. MAIN OUTCOME MEASURE; Functional health literacy as measured by the Short Test of Functional Health Literacy in Adults.Overall, 33.9% of English-speaking and 53.9% of Spanish-speaking respondents had inadequate or marginal health literacy. The prevalence of inadequate or marginal functional health literacy among English speakers ranged from 26.8% to 44.0%. In multivariate analysis, study location, race/language, age, years of school completed, occupation, and cognitive impairment were significantly associated with inadequate or marginal literacy. Reading ability declined dramatically with age, even after adjusting for years of school completed and cognitive impairment. The adjusted odds ratio for having inadequate or marginal health literacy was 8.62 (95% confidence interval, 5.55-13.38) for enrollees aged 85 years or older compared with individuals aged 65 to 69 years.Elderly managed care enrollees may not have the literacy skills necessary to function adequately in the health care environment. Low health literacy may impair elderly patients' understanding of health messages and limit their ability to care for their medical problems.
Quality and Equity in Dialysis and Renal Transplantation
Authors: Norman G. Levinsky
Journal: New England Journal of Medicine (1999)

The Medicare End Stage Renal Disease (ESRD) Program began in 1973. Over the past 26 years, it has illustrated both the benefits of modern, high-technology medicine and the problems associated with it. Life of good quality has been extended for hundreds of thousands of people. However, the cost of the program has increased far beyond original estimates. In 1997, Medicare spent approximately $11.76 billion on the ESRD program, and total spending by all insurers was estimated to be about $15.64 billion.1 The increase in cost came about mostly because long-term dialysis, originally intended for relatively young patients without systemic illnesses, . . .