tbuckley/cabot-search huggingface dataset:
Flow modulates myogenic responses in isolated microperfused rabbit afferent arterioles via endothelium-derived nitric oxide.
Authors: L A Juncos, J Garvin, O A Carretero, S Ito
Journal: Journal of Clinical Investigation (1995)

Flow may be a physiological stimulus of the endothelial release of nitric oxide (NO) and prostaglandins (PGs). We tested the hypothesis that pressure-induced constriction of the glomerular afferent arteriole (Af-Art) is modulated by luminal flow via endothelial production of NO. We microdissected the terminal segment of an interlobular artery together with two Af-Arts, their glomeruli (GL) and efferent arterioles (Ef-Art). The two Af-Arts were perfused simultaneously from the interlobular artery, while one Ef-Art was occluded. Since the arteriolar perfusate contained 5% albumin, oncotic pressure built up in the glomerulus with the occluded Ef-Art and opposed the force of filtration, resulting in little or no flow through the corresponding Af-Art. Thus this preparation allowed us to observe free-flow and no-flow Af-Arts simultaneously during stepwise 30-mmHg increases in intraluminal pressure (from 30 to 120 mmHg). Pressure-induced constriction was weaker in free-flow than no-flow Af-Arts, with the luminal diameter decreasing by 11.1 +/- 1.7 and 25.6 +/- 2.3% (n = 30), respectively, at 120 mmHg. To examine whether flow modulates myogenic constriction through endothelium-derived NO and/or PGs, we examined pressure-induced constriction before and after (a) disruption of the endothelium, (b) inhibition of NO synthesis with NW-nitro-L-arginine methyl ester (L-NAME), or (c) inhibition of cyclooxygenase with indomethacin. Both endothelial disruption and L-NAME augmented pressure-induced constriction in free-flow but not no-flow Af-Arts, abolishing the differences between the two. However, indomethacin had no effect in either free-flow or no-flow Af-Arts. These results suggest that intraluminal flow attenuates pressure-induced constriction in Af-Arts via endothelium-derived NO. Thus flow-stimulated NO release may be important in the fine control of glomerular hemodynamics.
Combined Active and Passive Immunization against Diphtheria: II. Control of Epidemics in the Field
Authors: F. Fulton, A. Q. Wells, J. Taylor, G. S. Wilson
Journal: BMJ (1941)

In the previous paper (p. 717) evidence was brought to show that by means of combined active and passive immunization a degree of active immunity can be pro duced which, though slower in its development, is ulti mately not greatly inferior to that resulting from active immunization alone. Attention was drawn to the difficulty in practice of pro tecting children against diphtheria during the intermediate phase of relative susceptibility which, according to Gundel and Konig's (1938) experiments on guinea-pigs, probably occurs between the waning of passive immunity due to the injection of antitoxic serum and the development of active immunity due to inoculation with diphtheria pro phylactic. Information on the length and degree of this intermediate phase of relative susceptibility cannot be obtained in human beings by the direct experimental method, but the observations of Gierthmuhlen and Voges (1939) on children during an actual epidemic of diphtheria suggest that with doses of 0.3 to 0.5 c.cm. of A.P.T. and 1,000 units of antitoxin it is at its maximum between about three and six weeks after the first injection of A.P.T. and serum, and that it is considerably less in degree than the susceptibility of uninoculated children. Though this information was not available to us when we were conducting the observations about to be described, we were fully aware of the possible occurrence and danger of such an intermediate phase of relative susceptibility. It seemed to us, therefore, that, if an outbreak of diphtheria was to be brought under immediate and complete control, the only satisfactory way to prevent fresh cases from developing during the relatively susceptible phase was by protecting the children so far as possible from further risk of exposure to infection. This we proposed to do by detecting all carriers in the community and segregating them until the remaining children had acquired an adequate degree of active immunity.
Robert Boyle on Natural Philosophy: An Essay With Selections From His Writings
Authors: Lester S. King
Journal: JAMA (1965)

Robert Boyle is one of those great men more often talked about than read. One of the great figures in that century of genius, the 17th century—he is familiar to every schoolboy as the author of Boyle's law. But his great significance lies rather in the part he played in establishing modern science and the scientific method. His writings, in the early editions, have been excessively rare, and, until recent years, the only work currently available was the Skeptical Chymist . Very recently a facsimile edition of his Experiments and Considerations Touching Colour has been reprinted.  Dr. Marie Hall has long been an authority on Boyle and 17th-century physics and chemistry. In the present volume she has made a selection of his writings, classifying them among four categories dealing respectively with The New Learning, The Mechanical Philosophy, Chemistry, and Pneumatics. Boyle contributed greatly to the experimental approach, the scientific method, and
In at the deep end
Authors: Apul Parikh
Journal: BMJ (2004)

individual and healthcare systems (box).The model could also be applied outside the health arena-for example, to people in the criminal justice system. 1 Healthcare systems are social organisations, and their continuing health depends on members of society using a congruent model of illness and system of values to decide the rights and responsibilities associated with illness and the sick role, and how these are to be policed where individuals choose to take advantage of the role.We suggest that the use of our model might improve the delivery of better health more than any other change in healthcare organisation.It is time that the medical models underpinning health delivery were debated openly.Contributors and sources: DW has long experience of neurological rehabilitation that has always included a minority of patients with activity limitation not fully attributable to disease.PH has discussed such patients and has investigated some.Both authors have searched the literature, and have discussed models of illness and the process of rehabilitation with each other endlessly.DW is the guarantor.
Enteritis Necroticans (Pigbel) in a Diabetic Child
Authors: Toni M. Petrillo, Consuelo M. Beck-Sagué, J. Glenn Songer, Carlos Abramowsky, James D. Fortenberry, Lillian Meacham, Andrew G. Dean, Hanmin Lee, Dawn M. Bueschel, Steven R. Nesheim
Journal: New England Journal of Medicine (2000)

Enteritis necroticans (pigbel), an often fatal illness characterized by hemorrhagic, inflammatory, or ischemic necrosis of the jejunum, occurs in developing countries but is rare in developed countries, where its occurrence is confined to adults with chronic illnesses. The causative organism of enteritis necroticans is Clostridium perfringens type C, an anaerobic gram-positive bacillus. In December 1998, enteritis necroticans developed in a 12-year-old boy with poorly controlled diabetes mellitus after he consumed pig intestines (chitterlings). He presented with hematemesis, abdominal distention, and severe diabetic ketoacidosis with hypotension. At laparotomy, extensive jejunal necrosis required bowel resection, jejunostomy, and ileostomy. Samples were obtained for histopathological examination. Polymerase-chain-reaction (PCR) assay was performed on paraffin-embedded bowel tissue with primers specific for the cpa and cpb genes, which code for the alpha and beta toxins produced by C. perfringens.Histologic examination of resected bowel tissue showed extensive mucosal necrosis, the formation of pseudomembrane, pneumatosis, and areas of epithelial regeneration that alternated with necrotic segments--findings consistent with a diagnosis of enteritis necroticans. Gram's staining showed large gram-positive bacilli whose features were consistent with those of clostridium species. Through PCR amplification, we detected products of the cpa and cpb genes, which indicated the presence of C. perfringens type C. Assay of ileal tissue obtained during surgery to restore the continuity of the patient's bowel was negative for C. perfringens.The preparation or consumption of chitterlings by diabetic patients and other chronically ill persons can result in potentially life-threatening infectious complications.
Splenomegaly. An algorithmic approach to diagnosis
Authors: E. R. Eichner
Journal: JAMA (1981)

SPLENOMEGALY may be a presenting or dominant feature of certain diseases. Since the spleen enlarges in many conditions, a systematic approach may facilitate timely and costeffective diagnosis of the cause of splenomegaly. The algorithms herein attempt to present a rational, stepby-step diagnostic approach. They consider the causes of splenomegaly in the rough order of their frequency, and they stress clues from the history, physical examination, and routine laboratory test results.  Normal Functions of the Spleen  In many instances, the spleen enlarges as it performs its normal functions. The four most important normal functions of the spleen are (1) clearance of microorganisms and particulate antigens from the bloodstream; (2) synthesis of immunoglobulin and properdin factors; (3) destruction of effete or abnormal RBCs; and (4) embryonic hematopoiesis, which can reactivate as extramedullary hematopoiesis in certain diseases.  Mechanisms of Splenomegaly  There are six basic pathophysiological mechanisms of splenomegaly: (1) immune response work hypertrophy,
Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials
Authors: S. Bachmann, C. Finger, A. Huss, M. Egger, A. E. Stuck, K. M. Clough-Gorr
Journal: BMJ (2010)

To assess the effects of inpatient rehabilitation specifically designed for geriatric patients compared with usual care on functional status, admissions to nursing homes, and mortality.Systematic review and meta-analysis.Medline, Embase, Cochrane database, and reference lists from published literature. Review methods Only randomised controlled trials were included. Trials had to report on inpatient rehabilitation and report at least one of functional improvement, admission to nursing homes, or mortality. Trials of consultation or outpatient services, trials including patients aged <55, trials of non-multidisciplinary rehabilitation, and trials without a control group receiving usual care were excluded. Data were double extracted. Odds ratios and relative risks with 95% confidence intervals were calculated.17 trials with 4780 people comparing the effects of general or orthopaedic geriatric rehabilitation programmes with usual care were included. Meta-analyses of effects indicated an overall benefit in outcomes at discharge (odds ratio 1.75 (95% confidence interval 1.31 to 2.35) for function, relative risk 0.64 (0.51 to 0.81) for nursing home admission, relative risk 0.72 (0.55 to 0.95) for mortality) and at end of follow-up (1.36 (1.07 to 1.71), 0.84 (0.72 to 0.99), 0.87 (0.77 to 0.97), respectively). Limited data were available on impact on health care or cost. Compared with those in control groups, weighted mean length of hospital stay after randomisation was longer in patients allocated to general geriatric rehabilitation (24.5 v 15.1 days) and shorter in patients allocated to orthopaedic rehabilitation (24.6 v 28.9 days).Inpatient rehabilitation specifically designed for geriatric patients has the potential to improve outcomes related to function, admission to nursing homes, and mortality. Insufficient data are available for defining characteristics and cost effectiveness of successful programmes.
Endothelium-dependent vasodilation is independent of the plasma L-arginine/ADMA ratio in men with stable angina
Authors: Hamish A Walker, Elaine McGing, Ian Fisher, Rainer H Böger, Stefanie M Bode-Böger, Graham Jackson, James M Ritter, Philip J Chowienczyk
Journal: Journal of the American College of Cardiology (2001)
Basic Concepts of Early 18th-Century Animism
Authors: LESTER S. KING
Journal: American Journal of Psychiatry (1967)

The 18th-century mechanist physicians offered mechanical explanations for vital phenomena and paid special attention to bodily parts and to analysis. The 18th-century animists were principally concerned with integration and purposive goal activity. Mechanists either ignored goal activity or offered ad hoc explanations that depended on faith rather than demonstration. These explanations animists could readily show lacked cogency, but the animists themselves ignored specific details. The conflict centered around the problem, "Which facts will we attend to and which ones ignore?"
Leukoplakia of the Bladder
Authors: L. M. Zinck, H. S. Trafford
Journal: BMJ (1956)

Leukoplakia of the BladderLeukoplakia of the bladder, whether alone or associated with similar changes in the upper urinary tract, would appear to be rare enough to warrant comment whenever a case arises.CASE REPORT A man aged 59 was admitted to this hospital in April, 1950, with severe haematuria.He was anaemic-looking and had a blood pressure of 160/80 mm.Hg.The bladder was not palp1able abdominally, the kidneys did not appear clini- cally to be enlarged, and rectal examination suggested no abnormality of prostate or seminal vesicles.Neither was any abnormality found in other systems.A provisional diagnosis of vesical neoplasm was made.As his haemo- globin was only 530,,' a blood transfusion was given, and this was repeated twice in the subsequent few days.His Wassermann reaction was negative, and intravenous pyelography showed the kidneys to be normal.Ten days after admission he developed clot re- tention, and supra- pubic cystotomy was performed by one ofus (L.M. Z.).After evacuation of many clots no -~~~A. .~evidence of vesical neoplasm could be J.
Intramural Use of Extramural Examinations
Authors: John B. Hickam
Journal: JAMA (1965)

For the past four years the final examination in the junior year of medicine at Indiana University has been a recent National Board part 2 medicine test, supplied and graded by the National Board. This is the test usually taken by students who have completed the senior year of medicine. The National Board medicine test was selected for two reasons. It was believed to be a comprehensive, well-designed examination dealing with subjects of current medical interest. It would also enable us to compare our students with medical students throughout the country, not only in terms of their performance on the test as a whole but also on various subdivisions of medicine and even on individual test items. Although the test is designed for students a year more advanced, such a comparison was expected to be helpful in guiding the educational effort of the medical department year by year. At the
Bevacizumab: Finding its niche in the treatment of heart failure secondary to liver vascular malformations in hereditary hemorrhagic telangiectasia
Authors: Lawrence H. Young, Katharine J. Henderson, Robert I. White, Guadalupe Garcia-Tsao
Journal: Hepatology (2013)

Abstract Context: The only treatment available to restore normal cardiac output in patients with hereditary hemorrhagic telangiectasia (HHT) and cardiac failure is liver transplant. Anti-vascular endothelial growth factor treatments such as bevacizumab may be an effective treatment. Objectives: To test the efficacy of bevacizumab in reducing high cardiac output in severe hepatic forms of HHT and to assess improvement in epistaxis duration and quality of life. Design, Setting, and Patients: Single-center, phase 2 trial with national recruitment from the French HHT Network. Patients were 18 to 70 years old and had confirmed HHT, severe liver involvement, and a high cardiac index related to HHT. Intervention: Bevacizumab, 5 mg per kg, every 14 days for a total of 6 injections. The total duration of the treatment was 2.5 months; patients were followed up for 6 months after the beginning of the treatment. Main Outcome Measure: Decrease in cardiac output at 3 months after the first injection, evaluated by echocardiography. Results: A total of 25 patients were included between March 2009 and November 2010. Of the 24 patients who had echocardiograms available for reread, there was a response in 20 of 24 patients with normalization of cardiac index (complete response [CR]) in 3 of 24, partial response (PR) in 17 of 24, and no response in 4 cases. Median cardiac index at beginning of the treatment was 5.05 L/min/m2 (range, 4.1-6.2) and significantly decreased at 3 months after the beginning of the treatment with a median cardiac index of 4.2 L/min/m2 (range, 2.9-5.2; P = .001). Median cardiac index at 6 months was significantly lower than before treatment (4.1 L/min/m2; range, 3.0-5.1). Among 23 patients with available data at 6 months, we observed CR in 5 cases, PR in 15 cases, and no response in 3 cases. Mean duration of epistaxis, which was 221 minutes per month (range, 0-947) at inclusion, had significantly decreased at 3 months (134 minutes; range, 0-656) and 6 months (43 minutes; range, 0-310) ( P = .008). Quality of life had significantly improved. The most severe adverse events were 2 cases of grade 3 systemic hypertension, which were successfully treated. Conclusion: In this preliminary study of patients with HHT associated with severe hepatic vascular malformations and high cardiac output, administration of bevacizumab was associated with a decrease in cardiac output and reduced duration and number of episodes of epistaxis.
Blood Donors—Paid or Volunteer?
Authors: Guy C. Glenn
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Dr Allen, with characteristic zeal in the crusade for voluntary blood donation, has missed the point of our article (234:1051,1975) in his letter (235:1327, 1976). The objective of our article was to report our experience in changing from a paid to a volunteer blood donor program in compliance with the American Association of Blood Banks definition of a volunteer donor. Our results emphasize the problem with the definition of volunteer vs paid blood donor. Dr Allen apparently believes he can intuitively define paid and volunteer donor. If the definition were as clear as he implies, there would not have been such a variety of opinion on this subject expressed at the March 18, 1976, Food and Drug Administration public meeting on blood labeling. We have received inquiries concerning the actual number of cases of posttransfusion hepatitis identified as a result of blood transfusion from our volunteer and
Does Albuminuria Predict Cardiovascular Outcomes on Treatment With Losartan Versus Atenolol in Patients With Diabetes, Hypertension, and Left Ventricular Hypertrophy?
Authors: Hans Ibsen, Michael H. Olsen, Kristian Wachtell, Knut Borch-Johnsen, Lars H. Lindholm, Carl E. Mogensen, Björn Dahlöf, Steven M. Snapinn, Ying Wan, Paulette A. Lyle
Journal: Diabetes Care (2006)

OBJECTIVE—Our current aims were to investigate whether 1) baseline urinary albumin-to-creatinine ratio (UACR) predicted cardiovascular outcomes, 2) changes in UACR differed between treatments, 3) benefits of losartan were related to its influence on UACR, and 4) reduction in albuminuria reduced cardiovascular events. RESEARCH DESIGN AND METHODS—In 1,063 patients with diabetes, hypertension, and left ventricular hypertrophy, UACR was measured for a mean of 4.7 years. The primary composite end point included cardiovascular death, myocardial infarction, and stroke. Cox models were run including and excluding baseline and time-varying UACR. RESULTS—Increasing baseline albuminuria related to increased risk for cardiovascular events. Reductions in UACR at years 1 and 2 were ∼33% for losartan vs. 15% for atenolol (P &amp;lt; 0.001). Benefits of losartan seem to be most prominent in patients with the highest level of baseline UACR, although treatment by albuminuria interaction was only significant for total mortality. Approximately one-fifth of the superiority of losartan was explained by the greater reduction of albuminuria. Risk of the primary end point was related to the in-treatment UACR. CONCLUSIONS—Lowering of albuminuria in patients with hypertension and diabetes appears to be beneficial and should be the subject of additional study in future clinical trials.
Small cortical thymocytes are subject to positive selection.
Authors: K Lundberg, K Shortman
Journal: The Journal of Experimental Medicine (1994)

To determine the developmental stages at which positive selection can act to produce mature T cells, CD4+8+3lo thymocytes of large dividing type and of small nondividing type were sorted and transferred into the thymus of nonirradiated Thy-1 congenic recipient mice. In contrast to earlier studies, the small as well as the large thymocytes produced mature CD4+8-3hi and CD4-8+3hi progeny, although production was less efficient from the small cells. The relative efficiency of small cells was increased and was close to that of large cells when bcl-2/anti-HY T cell receptor (TCR) alpha beta transgenic donors were used to improve cell survival, overcome stress effects of the transfer process, and increase the frequency of selectable cells. The results from transferring small CD4+8+3lo thymocytes expressing a TCR transgene from a nonselecting to a selecting thymic MHC environment also confirmed that the small cells were capable of being selected and maturing. Thus the developmental window available for positive selection includes the small CD4+8+3lo thymocytes. The results also showed a striking difference in the kinetics of production of mature progeny from the transferred CD4+8+3lo precursors. CD4+8-3hi cells appeared several days before CD4-8+3hi cells, apparently because the CD4-8+ lineage cells spent several days in transit as CD4+8+3hi intermediates before losing CD4. Most CD4+8- lineage cells on the other hand, either passed very rapidly through this intermediate stage, or lost CD8 before increasing the expression of CD3.
List of 56 best interventions will help to reduce maternal and child deaths
Authors: Z. Kmietowicz
Journal: BMJ (2011)

A study has identified 56 essential interventions which are most likely to improve the health and safety of mothers, infants, and young children and help countries to meet Millennium Development Goals 4 and 5.

The list of evidence based interventions includes screening and treating pregnant women for anaemia and hypertension, preventing and managing post-partum haemorrhage, immediate thermal care for newborns, and antibiotics for the treatment of pneumonia in children.

Every year 358 000 women die during pregnancy and childbirth and 7.6 million children die before the age of 5, says the …