tbuckley/cabot-search huggingface dataset:
Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments)
Authors: A F Connors, N V Dawson, C Thomas, F E Harrell, N Desbiens, W J Fulkerson, P Kussin, P Bellamy, L Goldman, W A Knaus
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

In order to describe the outcomes of patients hospitalized with an acute exacerbation of severe chronic obstructive pulmonary disease (COPD) and determine the relationship between patient characteristics and length of survival, we studied a prospective cohort of 1,016 adult patients from five hospitals who were admitted with an exacerbation of COPD and a PaCO2 of 50 mm Hg or more. Patient characteristics and acute physiology were determined. Outcomes were evaluated over a 6 mo period. Although only 11% of the patients died during the index hospital stay, the 60-d, 180-d, 1-yr, and 2-yr mortality was high (20%, 33%, 43%, and 49%, respectively). The median cost of the index hospital stay was $7,100 ($4,100 to $16,000; interquartile range). The median length of the index hospital stay was 9 d (5 to 15 d). After discharge, 446 patients were readmitted 754 times in the next 6 mo. At 6 mo, only 26% of the cohort were both alive and able to report a good, very good, or excellent quality of life. Survival time was independently related to severity of illness, body mass index (BMI), age, prior functional status, PaO2/FI(O2), congestive heart failure, serum albumin, and the presence of cor pulmonale. Patients and caregivers should be aware of the likelihood of poor outcomes following hospitalization for exacerbation of COPD associated with hypercarbia.
Erythrocyte pyruvate kinase (PK): The variable significance of “nucleotide specificity” in the characterization of mutant variants
Authors: W. N. Valentine, D. E. Paglia, M. Nakatani, R. A. Brockway
Journal: American Journal of Hematology (1987)

The half-saturation constant (K0.5s) phosphoenolpyruvate (PEP) for red cell pyruvate kinase (PK) with co-factors UDP and GDP is less than one-half that with ADP with or without additions of the allosteric modifier, fructose-1, 6-dephosphate (F-1, 6-P2) to the assay. The Vmax is markedly greater with ADP than with UDP or GDP, but with (PEP) at 0.5 mM, activity with all co-factors is about equal and at lower concentrations greater with UDP and GDP. With high K0.5s (PEP) mutant enzymes, and at the usual test concentration (lmM) for PEP when nucleotide specificity is assessed, the abnormally low saturation of variant enzymes may result in higher activity with UDP and GDP than with ADP--the opposite of the "normal situation." The apparent aberration in nucleotide specificity may thus be illusory and secondary to the abnormal K0.5s (PEP) of the mutant. Example data are recorded. Variations in K0.5s (PEP) may also be introduced during enzyme preparation for assay, particularly when partial purification is employed.
P472Atherosclerosis insight by matrix assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI)
Authors: M Martin-Lorenzo, B Balluff, AS Maroto, F De La Cuesta, LF Lopez-Almodovar, LR Padial, MG Barderas, LA Mcdonnell, G Alvarez-Llamas, F Vivanco
Journal: Cardiovascular Research (2014)

Purpose: Two-dimensional mapping of arterial tissue by MALDI-MSI for in-situ visualization of proteins, metabolites and lipids. Methods: Human pathological arteries and healthy mammary arteries were obtained from patients subjected to carotid endarterectomy and from patients admitted for coronary artery bypass surgery, respectively. An early model of atherosclerosis was performed by feeding rabbits with regular diet (control group) and with cholesterol-rich diet (pathological group). Following histological characterization, specific methods for visualization of metabolites, proteins and lipids in their original locations inside the different arterial layers (intima, media) were set-up. Aortic tissue from both animal groups was dissected and comparatively analyzed by MALDI-MSI, using sinapinic acid, 2,5-dihidroxybenzoic acid and 9-aminoacridine as matrix for proteins, lipids and metabolites respectively. Experiments were performed in an UltrafleXtreme MALDI-ToF/ToF and a Solarix FT-ICR (BrukerDaltonik) instruments. Results: Protein evaluation resulted in 15 m/z values defining media or intima layers. From them six are significant altered between control and pathological animals. Two of them are localized in the media layer and the other four in the intima. There are 8 m/z values of metabolites identifying lipids. All of them are localized in the intima layer and are significantly altered when comparing control and atherosclerotic tissue. Lipids analysis show 11 masses (m/z) defining intima, 8 of them specifically localized in the plaque region. A couple of them are varied with significance. Conclusions: A novel protein MALDI-MSI protocol for human atherosclerotic lesions and healthy arteries has been developed and successfully applied. A panel of 15 m/z consisting in proteins, metabolites and lipids are here described to be significant involved in atherosclerosis and, importantly, its identification goes together with their localization, helping enormously in the study of underlying mechanism of atherosclerosis.
Hypertrophied Non-Failing Rat Heart: PARTIAL BIOCHEMICAL CHARACTERIZATION
Authors: Charles H. Dart, John O. Holloszy
Journal: Circulation Research (1969)

Cardiac hypertrophy was induced in rats by constructing an arteriovenous fistula. Heart weights approximately doubled in 7.5 weeks. The levels of activity, expressed per gram of heart, of a variety of enzymes of the mitochondrial respiratory chain and of the citric acid cycle, as well as the concentrations of cytochrome c and of mitochondrial protein, were the same in the hypertrophied and control hearts. Similarly, the capacity of whole heart homogenate to oxidize pyruvate was unaltered in hypertrophy. There was also no change in the levels of activity of cytochrome oxidase and malate dehydrogenase, or in the concentration of cytochrome c in early hypertrophy (3 to 10 days after construction of an A-V fistula). These results suggest that cardiac mitochondria increase in parallel with the other components of the myocardial cell. The levels of activity, per gram of heart, of creatine phosphokinase and adenylate kinase, and of the rate-limiting enzymes of glycolysis and glycogenolysis, were the same in the hypertrophied and the control hearts. The above findings suggest that the capacity, per gram of heart, for regenerating ATP, both aerobically and anaerobically, is unchanged in the non-failing, hypertrophied heart.
The messianic cockroaches of sexual health
Authors: Mary E Black
Journal: BMJ (2013)

Sexually transmitted diseases will always be with us. We have only one antibiotic left to hold multi-resistant gonorrhoea at bay. Every three cases of HIV infection we prevent will save the NHS a million pounds in the cost of treatment. Within living memory, lack of access to contraception and backstreet abortions devastated women’s health in the UK, and this is still the case in some parts of the world.⇑

Sexual health providers and advocates are like messianic cockroaches: you just cannot get rid of them and they will …
Selective Serotonin Reuptake Inhibitors and Myocardial Infarction
Authors: William H. Sauer, Jesse A. Berlin, Stephen E. Kimmel
Journal: Circulation (2001)

Background Depression is an independent risk factor for myocardial infarction (MI). Selective serotonin reuptake inhibitors (SSRIs) may reduce this risk through attenuation of serotonin-mediated platelet activation in addition to treatment of depression itself. Methods and Results A case-control study of first MI in smokers 30 to 65 years of age was conducted among all 68 hospitals in an 8-county area during a 28-month period. Cases were patients hospitalized with a first MI. Approximately 4 community control subjects per case were randomly selected from the same geographic area using random digit dialing. Detailed information regarding use of antidepressant medication as well as other clinical and demographic data were obtained by telephone interview. A total of 653 cases of first MI and 2990 control subjects participated. After adjustment, using multivariable logistic regression, for age, sex, race, education, exercise, quantity smoked per day, body mass index, aspirin use, family history of MI, number of physician encounters, and history of coronary disease, diabetes, hypertension, or hypercholesterolemia, the odds ratio for MI among current SSRI users compared with nonusers was 0.35 (95% CI 0.18, 0.68; P &lt;0.01). Non-SSRI antidepressant users had a nonsignificant reduction in MI risk with wide confidence intervals (adjusted odds ratio 0.48, CI 0.17, 1.32; P =0.15). However, analysis of this group was limited by the small number of exposed subjects. Conclusions The use of SSRIs may confer a protective effect against MI. This could be attributable to the inhibitory effect SSRIs have on serotonin-mediated platelet activation or possibly amelioration of other factors associated with increased risk for MI in depression.
MPs warn government over wasting aid money in fragile states
Authors: A. Gulland
Journal: BMJ (2012)

MPs have commended the UK government for donating money to countries emerging from years of conflict but have warned that ministers must reduce the cost of delivering aid programmes.

MPs on the select committee on international development stated in a report that they support the UK government’s decision to increase the amount of money it spends in fragile states, from £1.8bn (€2.2bn; $2.8bn) in 2010-11 to £3.4bn in 2014-15. However, the report warns that “money can easily be wasted” in such countries.

It adds, “It is more risky and more costly to deliver programmes in fragile and conflict-affected states. The Department for International Development (DFID) must be open about these risks and open about the costs. However, we want to see evidence that DFID …
Genetic variants in human leukocyte antigen/DP-DQ influence both hepatitis B virus clearance and hepatocellular carcinoma development
Authors: Lingmin Hu, Xiangjun Zhai, Jibin Liu, Minjie Chu, Shandong Pan, Jie Jiang, Yixin Zhang, Hua Wang, Jianguo Chen, Hongbing Shen, Zhibin Hu
Journal: Hepatology (2011)

Recent genome-wide association studies showed that four single-nucleotide polymorphisms (SNPs) in human leukocyte antigen (HLA)-DP (rs3077 and rs9277535) and HLA-DQ (rs2856718 and rs7453920) were associated with chronic hepatitis B virus (HBV) infection in Japanese populations. More than 75% of hepatocellular carcinoma (HCC) patients are attributable to persistent infection of hepatitis B virus (HBV), especially in China. We genotyped these four SNPs in 1,300 HBV-positive HCC patients, 1,344 persistent HBV carriers, and 1,344 persons with HBV natural clearance from Southeast China to further test the associations of HLA-DP/DQ variants and with risk of both HBV clearance and HCC development. Logistic regression analyses showed that HLA-DQ rs2856718 significantly decreased host HCC risk, whereas three SNPs were associated with HBV clearance (HLA-DP rs9277535 as well as HLA-DQ rs7453920 and rs2856718). In addition, HLA-DP rs3077 showed an approaching significant effect on susceptibility to HBV persistent infection and HCC development when considering multiple testing adjustments. Taken together, we report, for the first time, that genetic variants in the HLA-DP and HLA-DQ loci may be marker SNPs for risk of both HBV clearance and HCC development.
Reviews: Clinical Diagnosis and Management of Alzheimer's Disease
Authors: David O. Staats
Journal: Annals of Internal Medicine (1997)

Medical Writings15 January 1997Reviews: Clinical Diagnosis and Management of Alzheimer's DiseaseDavid O. StaatsDavid O. StaatsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-2-199701150-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Gauthier S; ed. 372 pages. Boston: Butterworth-Heinemann; 1996. $125.00. ISBN 0750698454. Order phone 800-366-2665.Field of medicine: Geriatrics.Format: Hardcover book.Audience: Geriatricians, internists, and neurologists.Purpose: To give health professionals current details on many aspects of Alzheimer disease.Content: A multiauthor, international description of current work in and the state of knowledge about Alzheimer disease.Highlights: This book gives a broad look at Alzheimer disease, touching on everything from molecular biology to staging the illness to treatment issues. It features pertinent references and is well illustrated. Useful tables summarizing main points are dispersed throughout the chapters.Limitations: Some of ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1997Volume 126, Issue 2Page: 175-176KeywordsAlzheimer diseaseGeriatricsMolecular biology ePublished: 15 August 2000 Issue Published: 15 January 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Organelle pathology in ulcerative and Crohn's colitis with special reference to the lysosomal alterations.
Authors: C O'Morain, P Smethurst, A J Levi, T J Peters
Journal: Gut (1984)

Rectal biopsy specimens from control subjects, patients with either active or quiescent ulcerative colitis, and patients with Crohn9s colitis were examined histologically and assayed for marker enzymes associated with tissue organelles. They were catalase (peroxisome); neutral alpha-glucosidase (endoplasmic reticulum); alkaline phosphatase (plasma membrane); malate dehydrogenase (mitochondria); lactate dehydrogenase (cytosol). There was no significant change in these enzyme activities in patient samples compared with controls. Activities of three acid hydrolases (lysosomal enzymes), beta-glucuronidase, acid phosphatase, and N-acetyl-beta-glucosaminidase, were also assayed in the biopsy samples. Decreased activities of all three enzymes were noted in ulcerative colitis, particularly in active disease. Normal values were obtained in Crohn9s colitis. Measurement of lysosomal integrity by assays of latent N-acetyl-beta-glucosaminidase activity revealed similar results in control and colitic subjects. It is suggested that the lysosomal changes reflect a specific tissue release of enzyme and may be implicated in the pathogenesis of the tissue damage.
Disparity in Blood Pressure Between Arms
Authors: Walter P. Zmyslowski
Journal: JAMA (1977)

<h3>To the Editor.—</h3> While the consultants in QUESTIONS AND ANSWERS (237:1871, 1977) are correct in stating that the most common cause of dissimilar blood pressure readings in the arms of a 77-year-old man is arteriosclerotic occlusion of the subclavian artery, they make no mention of alternative explanations that may be responsible or contributory. Asymmetrical sphygmomanometric recordings can occur with the scalenus anticus syndrome, a cervical rib, or other forms of the thoracic outlet syndrome. Adson's test is usually positive in these cases.<sup>1</sup> Anesthesiologists as myself occasionally give anesthesia to these patients for unrelated surgery, and often positioning them on the operating table can incur a spurious hypotension in the affected arm. Contralateral normalrange Korotkoff sounds delineate the discrepancy, and repositioning amends it. Unilaterally diminished arterial pulsations may also be seen status after open heart surgery or cardiac catheterization. Checking the blood pressure in both arms is worthwhile not only
Current topics in nutrition and disease: vol 12. Absorption and malabsorption of mineral nutrients
Authors: M. Case
Journal: Gut (1985)

included even though the journal is clearly aimed at clinicians.Two choices then, to help the overworked clinician to keep up.My personal preference is for the American book, which gives the impression of being the distillation of a great deal of hard and critical work; it seems to me that the editors have found precisely the right balance between summarising the work of others, and seasoning it with their own opinions.On the other hand, Current opinion covers more ground (or will have done so within the year) for less money, but in less detail so that access to original sources in a library is still required.There is room for both of these in the market, and on the shelves of the moderately affluent.
Southall is cleared by GMC but faces new charges
Authors: Owen Dyer
Journal: BMJ (2004)

Professor David Southall, one of Britain's best known paediatricians, has been cleared by the General Medical Council of conducting neonatal research without proper consent but still faces GMC hearings relating to two separate investigations.

The GMC's preliminary proceedings committee found no grounds to pursue complaints that Professor Southall had acted without consent, or had forged patients' signatures, when conducting research on a new type of ventilator at the University Hospital of North Staffordshire in Stoke on Trent between …
WHAT CAN HEALTH DEPARTMENTS DO TO CONTROL SCARLET FEVER?
Authors: C. HAMPSON JONES
Journal: JAMA (1910)

My attention was first attracted to the question by observing the marked contrast in the tracings of the cases and deaths due to scarlet fever and diphtheria in Baltimore. The record of cases reported of such diseases was available for only a few years, commencing with the year 1891 and ending with the year 1909, making a period of nineteen years. Previous to 1891, the death-record alone gives us any information, and this has been reproduced in the tracings for the two diseases as far back as 1875, when our burial law requiring death certificates to be filed at the health department went into effect. <h3>DIPHTHERIA</h3> If, now, we consider the tracing for diphtheria (including croup) we find the number of deaths in 1875 was 238, which increased almost steadily to 929 in 1882. Then the number decreased year by year until the low number 206 was reached in 1889.
Jury of My Peers: A Surgeon's Encounter With the Malpractice Crisis
Authors: Miles J. Gullickson
Journal: JAMA (1989)

This well-written chronicle of the author's arduous personal experience with a malpractice trial, while serving a minor role as emotional catharsis, is primarily a polemic for removal of medical malpractice questions from decisional solution by our jury system.  The narrative can be conveniently divided into three parts. The book begins with a brief description of the emotional and psychological suffering of three of the author's acquaintances, who even after acquittal of unjust charges of medical malpractice, continued to agonize over potential future litigational trauma that might occur owing to their high-risk practices, and eventually ceased part or all of their medical practice. Elsewhere the author cites alarming figures on the serious loss to society by the refusal of many of our best practitioners to work in this malignantly litigational atmosphere, with those remaining being forced paradoxically to increase the cost of medical care by unnecessary procedures to avoid unjust malpractice
Historical pesticide exposure in California using pesticide use reports and land-use surveys: an assessment of misclassification error and bias.
Authors: Rudolph P Rull, Beate Ritz
Journal: Environmental Health Perspectives (2003)

We used California's Pesticide Use Report (PUR) and land-use survey data to conduct a simulation study evaluating the potential consequences of misclassifying residential exposure from proximity to agricultural pesticide application in health effect studies. We developed a geographic model linking the PUR with crop location data from land-use surveys to assess the impact of exposure misclassification from simpler exposure models based solely on PUR or land-use data. We simulated the random selection of population controls recruited into a hypothetical case-control study within an agricultural region. Using residential parcel data, we derived annual exposure prevalences, sensitivity, and specificity for five pesticides and relied on the PUR plus land-use model as the "gold standard." Based on these estimates, we calculated the attenuation of prespecified true odds ratios (ORs), assuming nondifferential exposure misclassification. True ORs were severely attenuated a) when residential exposure status was based on a larger geographic area yielding higher sensitivity but low specificity for exposure, in contrast to relying on a smaller area and increasing specificity; b) for less frequently applied pesticides; and c) with increasing mobility of residents among the study population. Considerable effect estimate attenuation also occurred when we used residential distance to crops as a proxy for pesticide exposure. Finally, exposure classifications based on annual instead of seasonal summaries of PUR resulted in highly attenuated ORs, especially during seasons when applications of specific pesticides were unlikely to occur. These results underscore the importance of increasing the spatiotemporal resolution of pesticide exposure models to minimize misclassification.
Fasting Glucose in Acute Myocardial Infarction
Authors: Doron Aronson, Haim Hammerman, Michael R. Kapeliovich, Abeer Suleiman, Yoram Agmon, Rafael Beyar, Walter Markiewicz, Mahmoud Suleiman
Journal: Diabetes Care (2007)

Elevation of blood glucose is a common metabolic disorder among patients with acute myocardial infarction (AMI) and is associated with adverse prognosis. However, few data are available concerning the long-term prognostic value of elevated fasting glucose during the acute phase of infarction.We prospectively studied the relationship between fasting glucose and long-term mortality in patients with AMI. Fasting glucose was determined after an >/=8 h fast within 24 h of admission. The median duration of follow-up was 24 months (range 6-48). All multivariable Cox models were adjusted for the Global Registry of Acute Coronary Events (GRACE) risk score.In nondiabetic patients (n = 1,101), compared with patients with normal fasting glucose (<100 mg/dl), the adjusted hazard ratio for mortality progressively increased with higher tertiles of elevated fasting glucose (first tertile 1.5 [95% CI 0.8-2.9], P = 0.19; second tertile 3.2 [1.9-5.5], P < 0.0001; third tertile 5.7 [3.5-9.3], P < 0.0001). The c statistic of the model containing the GRACE risk score increased when fasting glucose data were added (0.8 +/- 0.02-0.85 +/- 0.02, P = 0.004). Fasting glucose remained an independent predictor of mortality after further adjustment for ejection fraction. Elevated fasting glucose did not predict mortality in patients with diabetes (n = 462).Fasting glucose is a simple robust tool for predicting long-term mortality in nondiabetic patients with AMI. Fasting glucose provides incremental prognostic information when added to the GRACE risk score and left ventricular ejection fraction. Fasting glucose is not a useful prognostic marker in patients with diabetes.
The need for liver transplantation: a nationwide estimate based on consensus review
Authors: B Modan, O Shpilberg, E Anis, A Chetrit, O Luxenburg, E Rosenberg, N Rosenthol, S Sadetski, H Benaim, H Eckstein, Y Baruch, E Sikuler, Y Ashur, D Shouval
Journal: The Lancet (1995)
Israel tightens up hospital research procedures
Authors: Judy Siegel-Itzkovich
Journal: BMJ (2005)

Israel's health ministry is to issue new directives for closer scrutiny of studies on patients. The move comes after newspaper publicity about several alleged irregularities in clinical research.

Every hospital will have to appoint a “follow-up body,” comprising three members and headed by the institution's internal financial controller or legal adviser. This independent supervisory body will periodically report on its activities to …