tbuckley/cabot-search huggingface dataset:
Functional Disorders of the Digestive Tract
Authors: Ann Ouyang
Journal: JAMA (1984)

This book is reported to be the result of an international symposium on "Functional Disorders of the Digestive Tract," and an aspiration was voiced that the text would become "a cornerstone for future research concerning this challenging clinical problem." One of the major problems with the book is its title. Which disorders constitute a "functional disorder" and even the definition of a functional disorder are areas of considerable controversy. This controversy is never addressed in the book. Dr Almy makes an attempt to define these disorders as having "an apparent absence of structural changes of the gut itself" (p 7), and this might be acceptable as the broadest definition. Included in the book, however, are chapters on intestinal pseudo-obstruction in which structural abnormalities of myenteric nerves or smooth muscle have been clearly demonstrated. The major portion of the book is a summary of the physiology and neuroanatomy applicable to intestinal
Fatigue in Obstructive Sleep Apnea: Driven by Depressive Symptoms Instead of Apnea Severity?
Authors: Wayne A. Bardwell, Polly Moore, Sonia Ancoli-Israel, Joel E. Dimsdale
Journal: American Journal of Psychiatry (2003)

Obstructive sleep apnea is a common and frequently devastating illness that often includes significant fatigue. Fatigue is also a hallmark depressive symptom. The authors wondered if depressive symptoms in patients with obstructive sleep apnea would account for some of the fatigue beyond that explained by obstructive sleep apnea severity.Sixty patients with obstructive sleep apnea-i.e., score >/=15 on the respiratory disturbance index (mean score=49; range=15-111)-underwent polysomnography and completed the Center for Epidemiological Studies Depression Scale (CES-D Scale), Profile of Mood States (POMS), and Medical Outcomes Study surveys. Data were analyzed by using hierarchical regression, with POMS fatigue score as the dependent variable (step 1, forced entry of apnea severity variables; step 2, forced entry of CES-D Scale score).Whereas score on the respiratory disturbance index and the percent of time oxygen saturation was <90% together accounted for 4.2% of variance in scores on the POMS fatigue scale, the CES-D Scale score accounted for 10 times the variance (i.e., an additional 42.3%) in POMS fatigue scale score.After obstructive sleep apnea severity was controlled, higher levels of depressive symptoms were dramatically and independently associated with greater levels of fatigue. Assessment and treatment of mood symptoms-not just treatment of the disordered breathing itself-might reduce the fatigue experienced by patients with obstructive sleep apnea.
A Controlled Trial of Teaching Critical Appraisal of the Clinical Literature to Medical Students
Authors: Kathryn J. Bennett
Journal: JAMA (1987)

We carried out a controlled trial of teaching the critical appraisal of clinical literature among final-year clinical clerks. Tutors at two of four teaching hospitals were offered a short course in the critical appraisal of clinical articles that describe diagnostic tests and treatments and were assisted in identifying and appraising specialty-specific articles that described those diagnostic tests and treatments that clinical clerks were sure to encounter during their clerkship tutorials. Tutors and clerks at the other two hospitals received no special intervention and served as controls. Experimental and control clinical clerks completed pretests and posttests of their ability to take and defend a stand on whether to apply specific diagnostic tests and treatments in specific clinical situations. Experimental clerks demonstrated both statistically and "clinically" significant increases in their critical appraisal skills, improving 37% on the diagnostic test exercise and 8% on the treatment exercise; control students' scores deteriorated for both. (<i>JAMA</i>1987;257:2451-2454)
Prematurity-Associated Neurologic and Developmental Abnormalities and Neonatal Thyroid Function
Authors: Thomas Vulsma, Joke H. Kok
Journal: New England Journal of Medicine (1996)

The first complete description of transient hypothyroxinemia in low-birth-weight infants dates from 1981,1 and there has since been much speculation about the causes of the phenomenon. The hypothyroxinemia may be caused by a special type of nonthyroidal illness, although an association with the severity of prenatal or postnatal illness has never been demonstrated, by a metabolic adaptation of the preterm infant to extrauterine life, especially to the impaired oxygenation caused by the respiratory distress syndrome, or by incomplete maturation of the hypothalamic–pituitary–thyroid axis. This transient hypothyroxinemia is seldom called hypothyroidism, because most authors believe that thyroxine therapy is not justified. . . .
Children's accidents
Authors: J A Davis
Journal: BMJ (1982)

<h3>Abstract</h3> Fragile X Syndrome (FXS) is the leading known monogenic form of autism and the most common form of inherited intellectual disability. FXS results from silencing the <i>FMR1</i> gene during embryonic development, leading to loss of Fragile X Mental Retardation Protein (FMRP), an RNA-binding protein that regulates mRNA transport, stability, and translation. FXS is commonly thought of as a disease of synaptic dysfunction; however, FMRP expression is lost early in embryonic development, well before most synaptogenesis occurs. Recent studies suggest that loss of FMRP results in aberrant neurogenesis, but neurogenic defects have been variable. We investigated whether FMRP affects neurogenesis in <i>Xenopus laevis</i> tadpoles that express a homolog of <i>FMR1</i>. We used <i>in vivo</i> time-lapse imaging of neural progenitor cells and their neuronal progeny to evaluate the effect of acute loss or overexpression of FMRP on neurogenesis in the developing optic tectum. We complimented the time-lapse studies with SYTOX labeling to quantify apoptosis and CldU labeling to measure cell proliferation. Animals with increased or decreased levels of FMRP have significantly decreased neuronal proliferation and survival. They also have increased neuronal differentiation, but deficient dendritic arbor elaboration. The presence and severity of these defects was highly sensitive to FMRP levels. These data demonstrate that FMRP plays an important role in neurogenesis and suggest that endogenous FMRP levels are carefully regulated. These studies show promise in using <i>Xenopus</i> as an experimental system to study fundamental deficits in brain development with loss of FMRP and give new insight into the pathophysiology of FXS.
Medical centre recalls potentially infected body parts
Authors: D. Josefson
Journal: BMJ (2002)

A Texas medical centre has issued a recall of body parts it sent out to some 60 research centres across the United States, warning that it cannot ensure that the tissues were properly tested for infectious diseases such as HIV and hepatitis.

The recall affects cadaveric unembalmed body parts donated to the University of Texas's medicalbranch at Galveston under its willed body programme between November 2000 and …
Multicenter trial of L-carnitine in maintenance hemodialysis patients. II. Clinical and biochemical effects
Authors: Suhail Ahmad, H. Thomas Robertson, Thomas A. Golper, Marsha Wolfson, Paul Kurtin, Lois A. Katz, Raimund Hirschberg, Robert Nicora, Donald W. Ashbrook, Joel D. Kopple
Journal: Kidney International (1990)
Palliative care in severe COPD: how and when?
Authors: A. Moore
Journal: Thorax (2011)

Palliative care in chronic obstructive pulmonary disease (COPD) is an area that needs development. Existing palliative care models for cancer and chronic diseases such as heart failure do not seem to fit well with problems encountered by patients with COPD. This study obtained qualitative data about living and dying with COPD from serial interviews with 21 patients with end-stage …
Gene and Stem Cell Therapies
Authors: Eugene H. Kaji
Journal: JAMA (2001)

Gene and stem cell therapies hold promise for the treatment of a wide variety of inherited and acquired human diseases. Identification of genes involved in human disease and development of novel vectors and devices for delivering therapeutic genes to different tissues in vivo have resulted in significant progress in the area of gene therapy. Isolation of stem cells from organs formerly thought to have no regenerative potential, the demonstration of stem cell plasticity, and the creation of human embryonic stem cells clearly demonstrate the feasibility of human stem cell therapy. Much additional work remains to be done in the areas of vector development and stem cell biology before the full therapeutic potential of these approaches can be realized. Of equal importance, the ethical issues surrounding gene- and cell-based therapies must be confronted.
A painful right leg
Authors: L.-J. E. Smith, S. M. Murphy, P. Holmes, M. M. Reilly, L. Reiniger, M. Thom, M. P. Lunn
Journal: BMJ (2011)

A 68 year old man was referred for assessment of a painful right leg. The symptoms had started three years previously with intermittent pain on the lateral aspect of the right calf. The pain had gradually become more persistent and spread to the sole of the foot, the back of the leg, and the buttock. Within six months the painful area had become numb, and within one year he noticed onset of right leg weakness, which was progressive. The pain was severe, worse when lying down, and he required considerable doses of opiates, which did not fully relieve the pain. He had longstanding constipation, but no recent change in bladder or sexual function.

He had a history of Gleason grade 3+3 prostatic carcinoma, for which he had undergone radical prostatectomy four years earlier. This had been followed by radiotherapy to the prostate bed, and he was being treated with ongoing goserelin injections. His prostate specific antigen level was 8.17 µg/L when first seen; however, when repeated it was 3.14 µg/L. He also had a history of well controlled non-insulin dependent diabetes and hypertension.

On examination the patient was in pain. He had wasting of the right gluteus maximus and hamstrings, without fasciculations. Tone was normal. Hip flexion and knee extension power was Medical Research Council grade 5/5; however, there was weakness of hip extension to 4/5, knee flexion to 3/5, and ankle dorsiflexion and plantarflexion to 0/5. Reflexes were initially absent in the right leg with reinforcement; however, when the patient’s pain was under better control the knee jerk was present but ankle jerk remained absent. He had sensory loss to pinprick in the distribution of L5 to S3 dermatomes on the right, whereas perianal sensation was intact (S4 and S5). There was impaired proprioception and vibration sense to the …
Multiple spontaneous ruptures of tendons in renal transplant recipient.
Authors: Y Pirson, J Ghysen, J P Squifflet, G P Alexandre, C van Ypersele de Strihou
Journal: BMJ (1984)

the same fault (Dr R D Turner, 25 February, p 643).In reply the authors defend their questions in the same way that I supported mine.2They admit they do not know of a perfect questionnaire.Perhaps bias, like beauty, lies in the eye of the beholder.Even the apparently neutral question "Would you like a cup of tea ?" could be construed as being biased against coffee.Two disturbing matters arise.Firstly, Dr Pringle and others found even more patients than I did who have worries about computerisation of medical records-31 % com- pared with 19% on the issue of medical confidentiality-although their sample is admittedly much smaller.It is astonishing therefore that they conclude in their discussion that "patients have few worries concerning computerisation of their medical records."Secondly, they say that "measures taken to avoid this threat [to confidentiality] may reduce the value of computers in medicine."What is paramount: the value of computers or the patients themselves ?Discussion should now be directed away from argument over "biased" questionnaires and towards those patients' fears that have been clearly expressed.Just how are general practitioners using, or intending to use, computers going to deal with them ?
India to introduce death penalty for peddling fake drugs
Authors: G. Mudur
Journal: BMJ (2003)

India plans to introduce the death penalty for the sale and manufacture of fake and counterfeit medicines that cause grievous harm. The move follows widespread concern that existing regulations pose little deterrence to unscrupulous drug vendors.

An expert committee last week recommended stiffer penalties for violating the drug laws and improvements in the nation's drug regulatory infrastructure. India's health minister Sushma Swaraj pledged that she would accelerate the process of enacting the changes.

“Profiting from spurious drugs that might harm or kill innocent people is equivalent to mass murder,” said Mrs Swaraj, after receiving an interim …
Inhibition of Insulin Release in Infants Undergoing Deep Hypothermic Cardiovascular Surgery
Authors: David Baum, David H. Dillard, Daniel Porte
Journal: New England Journal of Medicine (1968)

Plasma immunoreactive insulin and glucose levels were studied in infants undergoing deep hypothermic cardiovascular surgery. In six receiving glucose infusions, marked hyperglycemia developed when body temperature was lowered below 30°C. With cooling, plasma immunoreactive insulin levels fell or remained low despite the development of hyperglycemia. On rewarming, plasma insulin concentrations rose markedly, and glucose levels fell despite continued glucose administration. In three infants given saline infusions rather than glucose, plasma glucose and immunoreactive insulin levels remained relatively stable during cooling. Five of these patients were studied when unanesthetized and at normal temperatures. Similar glucose infusions produced much smaller increases in plasma glucose levels, and yet circulating immunoreactive insulin levels increased. These observations indicate that reduction of exogenous glucose uptake is associated with a marked reversible inhibition of insulin release in infants undergoing deep hypothermic cardiovascular surgery.
Indian schoolchildren to undergo fitness tests amid fears of rising levels of obesity
Authors: M. Kachhap
Journal: BMJ (2012)

Schoolchildren in India will face twice yearly fitness tests in a bid to tackle the rising tide of obesity and boost fitness levels, in plans unveiled by the government.1

The plans have been drawn up by India’s sports minister Ajay Maken to motivate schoolchildren to take part in exercise as well as to evaluate their fitness.

Schoolchildren from class V onwards (from age 9) will take part in eight tests, the details of which have not been specified, assessing six criteria. These are cardiorespiratory endurance; muscular strength; muscular endurance; flexibility; explosive strength; and percentage of body fat. The Sports Authority of India …
IMPACT OF BIVALIRUDIN USE ON BODY MASS INDEX AND PERI-PROCEDURAL BLEEDING AFTER PERCUTANEOUS CORONARY INTERVENTION
Authors: Cedric Delhaye, Loic Belle, Kohei Wakabayashi, Gabriel Maluenda, Itsik Ben-Dor, Manuel A. Gonzalez, Michael A. Gaglia, Nicholas N. Hanna, Sara D. Collins, Asmir I. Syed, Rebecca Torguson, Zhenyi Xue, William O. Suddath, Lowell F. Satler, Kenneth M. Kent, Joseph Lindsay, Augusto D. Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2010)
Anticoagulants and Intrauterine-Device Insertion
Authors: Adolf Singer
Journal: JAMA (1979)

<h3>To the Editor.—</h3> The article "Anticoagulation: A Contraindication to Intrauterine-Device Insertion" (240: 1515, 1978) cannot be allowed to pass without comment. I note that in the entire case presentation, there is no mention whatever of a prothrombin time or of any other clotting tests. Therefore, it is impossible to say whether the bleeding was related to the insertion of the intrauterine device primarily or to the level of anticoagulation. As a vascular surgeon, I have performed a considerable volume of surgeries on patients who were receiving anticoagulant treatment, and I have had only minor problems. I have also been involved in the care of several pregnancies and deliveries for women with phlebitis and pulmonary embolus and had similarly no serious problems from anticoagulants. The title of the article may therefore be inappropriate. Incidentally, if emergency surgery has to be performed on a patient bleeding from warfarin sodium treatment, the administration
Bioelectronics: Nanovesicle-Based Bioelectronic Nose for the Diagnosis of Lung Cancer from Human Blood (Adv. Healthcare Mater. 3/2014)
Authors: Jong Hyun Lim, Juhun Park, Eun Hae Oh, Hwi Jin Ko, Seunghun Hong, Tai Hyun Park
Journal: Advanced Healthcare Materials (2014)

A human nose-mimetic diagnosis system that can distinguish the odor of a lung cancer biomarker is developed by Seunghun Hong, Tai Hyun Park, and team on page 360. Nanovesicles containing human olfactory receptors are combined with carbon nanotubes in order to smell the biomarker from human blood plasma sensitively and selectively without any pretreatment processes.
Survival Plans for Biomedical Research
Authors: Joseph C. Hinsey
Journal: New England Journal of Medicine (1973)

University health centers, with their component schools, hospitals and other units, are experiencing difficult times in the light of the sudden cutbacks in federal funds that have flowed rather freely in recent years. It has been estimated that about 1/2 the funds in the budgets of our medical schools come from federal sources. Some are struggling to stay aliye and out of bankruptcy. Dean Robert H. Ebert (p. 348) has analyzed present biomedical research policy and has made recommendations for modification and changes. These points deserve careful consideration and evaluation. Now is the time to take stock and ascertain how . . .
Identification of a ribavirin-resistant NS5B mutation of hepatitis C virus during ribavirin monotherapy
Authors: Kung Chia Young, Karen L. Lindsay, Ki Jeong Lee, Wen Chun Liu, Jian Wen He, Susan L. Milstein, Michael M.C. Lai
Journal: Hepatology (2003)

Ribavirin (RBV), a guanosine analogue, has been suggested to exert an antiviral action against hepatitis C virus (HCV) by causing lethal mutations and suppressing RNA polymerase in vitro, but the mechanism of its clinical therapeutic effects is currently unknown. To test the hypothesis that RBV could act both as an RNA mutagen and inhibit viral RNA synthesis in vivo, we studied the evolution of the nucleotide sequences of HCV RNA at the nonstructural (NS) 5B region in patients receiving RBV, placebo, or interferon alfa (IFN-α) monotherapy. The RBV group showed a slightly more accelerated evolution rate of HCV RNA quasispecies than either the IFN-α or placebo group. RBV caused preferentially A-to-G and U-to-A mutations. Interestingly, an NS5B amino acid 415 Phe-to-Tyr (F415Y) mutation emerged in all (5 of 5) patients infected with HCV genotype 1a during the RBV treatment. Subsequently, the parental 415F strain reemerged in some patients after the treatment was discontinued. The effect of the amino acid substitution at NS5B415 on HCV RNA replication was then investigated using an HCV subgenomic replicon in Huh7 cells. We showed that treatment of replicon cells with RBV reduced the HCV RNA level of NS5B415F replicon, but not NS5B415Y, in a dose-dependent manner. Thus, NS5B F415Y mutation represents an RBV-resistant variant. The 3-dimensional modeling and structure analysis of NS5B protein revealed that the 415th amino acid is located at the P helix region of the thumb subdomain, which may interact with the minor groove of the template-primer duplex in the putative RNA-binding cleft. In conclusion, RBV could work as a weak mutagen for HCV RNA in HCV-infected patients. Furthermore, the selection of an RBV-resistant variant with a single amino acid substitution in NS5B suggested that RBV may directly interact with HCV RNA polymerase, thus interfering with its enzymatic activity. (Hepatology 2003;38:869–878).
Relaxation of tetanised smooth muscle of canine saphenous vein
Authors: N. L STEPHENS, V. A CLAES, D. L BRUTSAERT
Journal: Cardiovascular Research (1981)

Since vascular filling depends on the cross-sectional area of the venous bed and since this is determined by the state of relaxation of the mural smooth muscle, we have studied load bearing capacity during relaxation of the smooth muscle of canine saphenous vein. The effect of load on the time course of relaxation was analysed either by comparing afterloaded contractions against various loads or by imposing abrupt alterations in load (load clamps). Unlike mammalian cardiac muscle in which relaxation was reported sensitive to loading conditions, relaxation in the smooth muscle of the saphenous vein was largely independent of loading conditions. In this it resembled frog heart muscle. This type of relaxation, which is not influenced by manipulation of loading conditions, has been termed "inactivation-dependent" relaxation. It appears to operate in muscle tissue in which the calcium sequestering apparatus is poorly developed and sequestration or some process downstream to it appears to be the rate limiting step during relaxation.
Safety of chloral.
Authors: R. H. Mindham
Journal: BMJ (1968)

Last week we made a necropsy of a boy of 15 years, and previous to this the ages of the patients were 19, 20, 21, 30, and 31.Al- together we have, since 1949, made necropsies on 101 asthmatic people of various ages who have died suddenly and often unexpectedly.This series will be published shortly.The clinical and necropsy findings lead to the in- escapable conclusion that death in most of these was due to ventricular fibrillation.The possible role of inhaled drugs remains to be elucidated.This letter is to reinforce the view of others' that the excessive use of self- administered palliative drugs might instigate fatal cardiac dysrhythmia.-Weare, etc.,
Preferential expression of human Fc gamma RIIIPMN (CD16) in paroxysmal nocturnal hemoglobinuria. Discordant expression of glycosyl phosphatidylinositol-linked proteins.
Authors: J C Edberg, J E Salmon, M Whitlow, R P Kimberly
Journal: Journal of Clinical Investigation (1991)

The isoform of Fc gamma RIII (CD16) expressed on PMN has a GPI membrane anchor, and in paroxysmal nocturnal hemoglobinuria (PNH) there is a deficiency in Fc gamma RIII expression on PMN. Contrary to expectation, however, CD16 expression is preserved (albeit at reduced levels) in all affected PNH PMN that completely lack the GPI-anchored proteins DAF (CD55) and CD59. Fc gamma RIII negative PMN are not observed in any of the six PNH patients examined in this study. Analysis of the molecular weight of both glycosylated and deglycosylated Fc gamma RIII from PMN with reduced Fc gamma RIII expression indicates no variations in size relative to normal donor Fc gamma RIIIPMN. Indeed, the Fc gamma RIII expressed at intermediate levels is phosphatidylinositol-specific phospholipase C (PI-PLC)-sensitive. Thus, there is no evidence suggestive of expression of a transmembrane isoform and all data indicate that Fc gamma RIIIPMN on affected cells in PNH is a GPI-linked isoform. With Fc gamma RIIIPMN expression preserved at reduced levels on affected cells in PNH, PMN from PNH patients retain the capacity to internalize the Fc gamma RIIIPMN-specific probe E-ConA (at reduced levels) as well as IgG-opsonized erythrocytes. Reduced expression of GPI-anchored molecules on PNH PMN is not restricted to Fc gamma RIIIPMN since intermediate levels of CD59 were observed in the PNH PMN that were decay-accelerating factor (DAF)-negative and Fc gamma RIIIPMN intermediate. In addition, discordant expression of GPI-linked molecules in individual cells is not restricted to PMN since DAF+/CD14- monocytes were observed in one PNH patient. These data suggest that, when analyzed on an individual cell level, the GPI anchor defect in PNH is not absolute and must involve either a hierarchy of access of different protein molecules to available GPI anchors, distinct anchor biochemistries for the different proteins, or differential regulation of protein-anchor assembly.