tbuckley/cabot-search huggingface dataset:
Meta-analysis of Hypertension Trials in Diabetic Patients: Response to Parving and Rossing
Authors: Marco Pahor, Bruce M. Psaty, Michael H. Alderman, Curt D. Furberg
Journal: Diabetes Care (2001)

Methodological and statistical reasons may explain why the U.K. Prospective Diabetes Study (UKPDS) was considered an outlier when compared with the other reviewed studies. Study design, report, and conduct weaknesses limit the conclusions of the UKPDS (1). Several of these weaknesses have been discussed in published articles (2,3). These weaknesses are as follows: 1 ) the UKPDS hypertension study was not blind, but open label; 2 ) the dosing regimens for captopril may not have been adequate (captopril was given twice per day; for the treatment of hypertension captopril should be given three times per day [4]); 3 ) the trial was not powered to detect differences in drug effects on cardiovascular events; 4 ) none of the blood pressure goals in the tight blood pressure control group (150/85 mmHg) or in the less tight blood pressure control group (initially 200/105 mmHg and recently 180/105 mmHg) are currently recommended according to U.S. or U.K. guidelines for the treatment of hypertension in patients with or without diabetes (5,6); 5 ) in the less tight blood pressure control group the first-line agent was furosemide, a diuretic not recommended for treatment of hypertension, according to the current guidelines (5,6); and 6 ) patients randomized to atenolol were significantly more likely to dropout of …
Modification of the cardiac action potential by intracellular injection of adenosine triphosphate and related substances in guinea pig single ventricular cells.
Authors: J Taniguchi, A Noma, H Irisawa
Journal: Circulation Research (1983)

Effects of varying the intracellular adenosine triphosphate level on both the action potential and the membrane current were studied in single ventricular cells isolated from the guinea pig heart, using collagenase. Intracellular injection of adenosine triphosphate elevated the plateau potential level and prolonged the action potential duration. Similar results were obtained by injecting adenosine diphosphate, adenosine monophosphate, or creatine phosphate, i.e., substances considered to increase the intracellular concentration of adenosine triphosphate. In contrast, the action potential was depressed by procedures which could reduce the intracellular adenosine triphosphate level, such as an injection of creatine, superfusion of glucose-free Tyrode's solution containing 5.4 mM cyanide ion, or an injection of adenosine monophosphate into the cyanide-superfused cell. When the membrane current was recorded under the voltage clamp, it was found that the injection of adenosine triphosphate increased the amplitude of the slow inward current, whereas the superfusion of cyanide ion did not significantly decrease the slow inward current, although the action potential became considerably shorter. It was also found that the adenosine monophosphate injection decreased the amplitude of the net outward membrane current at the plateau level and increased it at around -40 mV, and thus intensified the N-shape of the isochronal 0.3-second current-voltage curve. The cyanide ion superfusion produced the opposite effect; in response to depolarizing clamp pulses more positive to the plateau level, the membrane current increased significantly with cyanide ion, but increased only slightly with adenosine triphosphate. These results suggest that intracellular adenosine triphosphate modifies the membrane currents at the plateau potential range, thus altering the action potential duration.
The Epidemiology of Pain During the Last 2 Years of Life
Authors: Alexander K. Smith, Irena Stijacic Cenzer, Sara J. Knight, Kathleen A. Puntillo, Eric Widera, Brie A. Williams, W. John Boscardin, Kenneth E. Covinsky
Journal: Annals of Internal Medicine (2010)

Background: The epidemiology of pain during the last years of life has not been well described. Objective: To describe the prevalence and correlates of pain during the last 2 years of life. Design: Observational study. Data from participants who died while enrolled in the Health and Retirement Study were analyzed. The survey interview closest to death was used. Each participant or proxy was interviewed once in the last 24 months of life and was classified into 1 of 24 cohorts on the basis of the number of months between the interview and death. The relationship between time before death and pain was modeled and was adjusted for age, sex, race or ethnicity, education level, net worth, income, terminal diagnosis category, presence of arthritis, and proxy status. Setting: The Health and Retirement Study, a nationally representative survey of community-living older adults (1994 to 2006). Participants: Older adult decedents. Measurements: Clinically significant pain, as indicated by a report that the participant was "often troubled" by pain of at least moderate severity. Results: The sample included 4703 decedents. Mean age (SD) of participants was 75.7 years (SD, 10.8); 83.1% were white, 10.7% were black, 4.7% were Hispanic; and 52.3% were men. The adjusted prevalence of pain 24 months before death was 26% (95% CI, 23% to 30%). The prevalence remained flat until 4 months before death (28% [CI, 25% to 32%]), then it increased, reaching 46% (CI, 38% to 55%) in the last month of life. The prevalence of pain in the last month of life was 60% among patients with arthritis versus 26% among patients without arthritis (P < 0.001) and did not differ by terminal diagnosis category (cancer [45%], heart disease [48%], frailty [50%], sudden death [42%], or other causes [47%]; P = 0.195). Limitation: Data are cross-sectional; 19% of responses were from proxies; and information about cause, location, and treatment of pain was not available. Conclusion: Although the prevalence of pain increases in the last 4 months of life, pain is present in more than one quarter of elderly persons during the last 2 years of life. Arthritis is strongly associated with pain at the end of life. Primary Funding Source: National Institute on Aging, National Center for Research Resources, National Institute on Musculoskeletal and Skin Diseases, and National Palliative Care Research Center.
Doctors are vulnerable to managers
Authors: P. Harrison
Journal: BMJ (1993)

the newly appointed ombudsman of the International Association of Infant Food Manufacturers; or with the health authorities of the countries concerned, whose ultimate responsibility it is to monitor the implementation of the international code.Nothing further was heard from Ms Rundall until the claims in Baby Milk Action's propagandarepeated in Lausanne, and in the BMJ-that the complaints had not been answered.Nestle and other responsible manufacturers have every interest in seeing the introduction of transparent, impartial, and effective procedures for monitoring the code in every country.Activist groups like that led by Ms Rundall can play a useful part in reporting alleged violations of the code, but they cannot be allowed to represent themselves as supranational arbiters of the code.
203 THE IMPACT OF THE TIPS PROCEDURE PRE-LIVER TRANSPLANT IN THE OUTCOME POST-TRANSPLANT
Authors: G.P. Guerrini, M. Pleguezuelo, S. Maimone, V. Calvaruso, E. Xirouchakis, P. Manousou, D. Patch, N. Rolando, G. Fusai, D. Sharma, B. Davidson, K. Rolles, A.K. Burroughs
Journal: Journal of Hepatology (2008)
A cell surface interaction network of neural leucine-rich repeat receptors
Authors: Christian Söllner, Gavin J Wright
Journal: Genome biology (2009)

Abstract Background The vast number of precise intercellular connections within vertebrate nervous systems is only partly explained by the comparatively few known extracellular guidance cues. Large families of neural orphan receptor proteins have been identified and are likely to contribute to these recognition processes but due to the technical difficulty in identifying novel extracellular interactions of membrane-embedded proteins, their ligands remain unknown. Results To identify novel neural recognition signals, we performed a large systematic protein interaction screen using an assay capable of detecting low affinity extracellular protein interactions between the ectodomains of 150 zebrafish receptor proteins containing leucine-rich-repeat and/or immunoglobulin superfamily domains. We screened 7,592 interactions to construct a network of 34 cell surface receptor-ligand pairs that included orphan receptor subfamilies such as the Lrrtms, Lrrns and Elfns but also novel ligands for known receptors such as Robos and Unc5b. A quantitative biochemical analysis of a subnetwork involving the Unc5b and three Flrt receptors revealed a surprising quantitative variation in receptor binding strengths. Paired spatiotemporal gene expression patterns revealed dynamic neural receptor recognition maps within the developing nervous system, providing biological support for the network and revealing likely functions. Conclusions This integrated interaction and expression network provides a rich source of novel neural recognition pathways and highlights the importance of quantitative systematic extracellular protein interaction screens to mechanistically explain neural wiring patterns.
A study of swallowing difficulties in first degree relatives of patients with achalasia.
Authors: J F Mayberry, M Atkinson
Journal: Thorax (1985)

Of 167 patients with achalasia asked to provide details of swallowing difficulties among their first degree relatives, 159 completed the survey (95% response rate). One thousand and twelve first degree relatives were identified, and 14 were reported to have dysphagia including two with reported achalasia. Review of the case notes of these 14 relatives showed, however, that in none was achalasia confirmed. Heartburn affected 54 (5%) of the relatives, an incidence similar to that in the general population. These findings suggest that adult achalasia is not inherited in an autosomal recessive manner and that environmental factors during early life do not play an important aetiological part.
Actinomyces Hepatic Abscess with Cutaneous Fistula
Authors: Mustafa Saad, Jonathan Moorman
Journal: New England Journal of Medicine (2005)

This 64-year-old man with a history of colonic resection for adenocarcinoma presented with abdominal discomfort. Hypodense lesions involving the liver appeared to cross the capsule and peritoneal membrane. A specimen was obtained by fine-needle aspiration of a liver lesion.
Familial distal renal tubular acidosis is associated with mutations in the red cell anion exchanger (Band 3, AE1) gene.
Authors: L J Bruce, D L Cope, G K Jones, A E Schofield, M Burley, S Povey, R J Unwin, O Wrong, M J Tanner
Journal: Journal of Clinical Investigation (1997)

All affected patients in four families with autosomal dominant familial renal tubular acidosis (dRTA) were heterozygous for mutations in their red cell HCO3-/Cl- exchanger, band 3 (AE1, SLC4A1) genes, and these mutations were not found in any of the nine normal family members studied. The mutation Arg589--> His was present in two families, while Arg589--> Cys and Ser613--> Phe changes were found in the other families. Linkage studies confirmed the co-segregation of the disease with a genetic marker close to AE1. The affected individuals with the Arg589 mutations had reduced red cell sulfate transport and altered glycosylation of the red cell band 3 N-glycan chain. The red cells of individuals with the Ser613--> Phe mutation had markedly increased red cell sulfate transport but almost normal red cell iodide transport. The erythroid and kidney isoforms of the mutant band 3 proteins were expressed in Xenopus oocytes and all showed significant chloride transport activity. We conclude that dominantly inherited dRTA is associated with mutations in band 3; but both the disease and its autosomal dominant inheritance are not related simply to the anion transport activity of the mutant proteins.
Frequency and causes of early hospital readmission for chest pain after contemporary coronary stent implantation
Authors: Dusan Knezevic, Jeffrey Moses, Zoran Lasic, Yan Li, Roberta Maida, Vladimir Ilic, David Bolon, Maja Zaric, Asu Rustemli, All Aboufares, Neil Coplan, George Dangas, Issam Moussa
Journal: Journal of the American College of Cardiology (2002)
CO-OPERATIVE WORK IN REGISTRATION METHODS AND VITAL STATISTICS.
Authors: W. A. KING
Journal: JAMA (1903)

The subject of vital statistics, or rather of mortality statistics, which is the only branch discussed in this paper, is perhaps more interesting to members of this Association than to any other class, inasmuch as in certain particulars they are responsible for the returns on which these statistics are based, and because such statistics furnish the means by which progress in medical science is measured. To accurately serve this and other purposes, however, it is necessary that all statistics of this kind—national, state and local—shall be compiled under a definite system of general application, and that the data shall be collected under a similarly definite system, having direct reference to the exact statistical and other uses for which they are designed. Many systems of collecting the data have been experimented with, but to all persons of extended practical experience it has become a settled principle that no adequate results can
Carbon Tetrachloride Toxicity Potentiated by Isopropyl Alcohol
Authors: David S. Folland
Journal: JAMA (1976)

Fourteen workers in an isopropyl alcohol packaging plant became ill after accidental exposure to carbon tetrachloride. In four, renal failure or hepatitis developed. Isopropyl alcohol potentiation of carbon tetrachloride toxicity has been shown previously only in rats. Acetone, a product of isopropyl alcohol metabolism, is a major potentiator of carbon tetrachloride toxicity. Workers had elevated levels of acetone in samples of expired alveolar gas and thus were metabolically predisposed to carbon tetrachloride injury. Stricter limits for industrial carbon tetrachloride exposure should be established where concomitant isopropyl alcohol use occurs.
High risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross sectional population database analysis in Scottish general practice
Authors: B. Guthrie, C. McCowan, P. Davey, C. R. Simpson, T. Dreischulte, K. Barnett
Journal: BMJ (2011)

To examine the prevalence and patterns of high risk prescribing, defined as potentially inappropriate prescribing of drugs to primary care patients particularly vulnerable to adverse drug events.Cross sectional population database analysis.General practices in Scotland.315 Scottish general practices with 1.76 million registered patients, 139 404 (7.9%) of whom were defined as particularly vulnerable to adverse drug events because of age, comorbidity, or co-prescription.How reliably each of 15 indicators-four each for non-steroidal anti-inflammatory drugs, co-prescription with warfarin, and prescribing in heart failure, two for dose instructions for methotrexate, and one for antipsychotic prescribing in dementia-and a composite of all 15 could distinguish practices in terms of their rates of high risk prescribing; and characteristics of patients and practices associated with high risk prescribing in a multilevel model.19 308 of 139 404 (13.9%, 95% confidence interval 13.7% to 14.0%) patients had received at least one high risk prescription in the past year. This composite indicator was a reasonably reliable measure of practice rates of high risk prescribing (reliability >0.7 for 95.6% of practices, >0.8 for 88.2%). The patient characteristic most strongly associated with high risk prescribing was the number of drugs prescribed (>11 long term prescribed drugs v 0; odds ratio 7.90, 95% confidence interval 7.19 to 8.68). After adjustment for patient characteristics, rates of high risk prescribing varied by fourfold between practices, which was not explained by structural characteristics of the practices.Almost 14% of patients defined as particularly vulnerable to adverse drug events were prescribed one or more high risk drugs. The composite indicator of high risk prescribing used could identify practices as having above average or below average high risk prescribing rates with reasonable confidence. After adjustment, only the number of drugs prescribed long term to patients was strongly associated with high risk prescribing, and considerable unexplained variation existed between practices. High risk prescribing will often be appropriate, but the large variation between practices suggests opportunities for improvement.
Drug points: Severe hypotension associated with netilmicin treatment
Authors: T Rygnestad
Journal: BMJ (1997)

Cardiovascular side effects from aminoglycosides are rarely reported,1 which might be the result of underreporting. I report a case of severe hypotension associated with netilmicin treatment in a critically ill patient.

A 50 year old woman with pharyngeal cancer had an emergency tracheotomy. At operation she had no other known disease. She developed pneumonia and was artificially ventilated. Streptococcus milleri was found in cultures from the operation wound. She was …
Cytology in Early Diagnosis
Authors: Rudolf O. K. Schade
Journal: JAMA (1974)

THE TITLE of this paper immediately poses the question, "What kind of lesion is representative of an early cancer?" Obviously, the answer varies from observer to observer. A small tumor that is diagnosed radiologically may show an advanced, widely infiltrating neoplasm on microscopic examination. Cytodiagnosis should aim at the detection of cancer in its earliest stage when other diagnostic techniques fail. Cytologic diagnosis foretells only the presence of a neoplasm; it is not capable of defining its histological type, its extent, or the location of the lesion. In the absence of positive radiologic or gastroscopic findings, one can hope to uncover a carcinoma in situ or a superficial intramucosal carcinoma, carcinomata that promise a reasonable prognosis after excision. Histologic studies have shown that the growth of a gastric cancer passes through the same phases as cancer in other situations. We recognize, therefore, a carcinoma in situ that is confined to
A Novel, Highly Sensitive Antibody Allows for the Routine Detection of<i>ALK</i>-Rearranged Lung Adenocarcinomas by Standard Immunohistochemistry
Authors: Mari Mino-Kenudson, Lucian R. Chirieac, Kenny Law, Jason L. Hornick, Neal Lindeman, Eugene J. Mark, David W. Cohen, Bruce E. Johnson, Pasi A. Jänne, A. John Iafrate, Scott J. Rodig
Journal: Clinical Cancer Research (2010)

Approximately 5% of lung adenocarcinomas harbor an EML4-ALK gene fusion and define a unique tumor group that may be responsive to targeted therapy. However ALK-rearranged lung adenocarcinomas are difficult to detect by either standard fluorescence in situ hybridization or immunohistochemistry (IHC) assays. In the present study, we used novel antibodies to compare ALK protein expression in genetically defined lung cancers and anaplastic large cell lymphomas.We analyzed 174 tumors with one standard and two novel monoclonal antibodies recognizing the ALK protein. Immunostained tissue sections were assessed for the level of tumor-specific ALK expression by objective quantitative image analysis and independently by three pathologists.ALK protein is invariably and exclusively expressed in ALK-rearranged lung adenocarcinomas but at much lower levels than in the prototypic ALK-rearranged tumor, anaplastic large cell lymphoma, and as a result, is often not detected by conventional IHC. We further validate a novel IHC that shows excellent sensitivity and specificity (100% and 99%, respectively) for the detection of ALK-rearranged lung adenocarcinomas in biopsy specimens, with excellent interobserver agreement between pathologists (kappa statistic, 0.94).Low levels of ALK protein expression is a characteristic feature of ALK-rearranged lung adenocarcinomas. However, a novel, highly sensitive IHC assay reliably detects lung adenocarcinomas with ALK rearrangements and obviates the need for fluorescence in situ hybridization analysis for the majority of cases, and therefore could be routinely applicable in clinical practice to detect lung cancers that may be responsive to ALK inhibitors.
Acute Unilateral Hearing Loss as an Early Symptom of Lateral Cerebral Sinus Venous Thrombosis
Authors: Sankalp Gokhale
Journal: JAMA Neurology (2013)

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Painless Thyroiditis and Transient Hyperthyroidism Without Goiter
Authors: STEVEN G. DORFMAN
Journal: Annals of Internal Medicine (1977)

Eight women had painless thyroiditis, transient thyrotoxicosis, and low radioactive iodine uptakes but were without goiter; they constituted 15% of all thyrotoxicosis cases that we saw during the past year. Standard antithyroid antibody tests by tanned erythrocyte hemagglutination, complement fixation, and colloid and microsomal fluorescence, if present initially, were only weakly positive and became negative by 9 months. However, human antithyroglobulin antibody levels by a sensitive radioimmunoassay were elevated initially in all patients. In general, these radioimmunoassayable antibody levels fell, but they had not returned to normal by 9 months. Serial thyroid function tests and standard antithyroid antibody tests were most compatible with subacute thyroiditis. However, the persistence of radioimmunoassayable antithyroglobulin antibodies and recent reports of histologic evidence of lymphocyte thyroiditis in similar patients with goiter leaves open the possibility that this is a previously unrecognized presentation of chronic lymphocytic thyroiditis. Neither the cause nor the ultimate course of this syndrome is known.
Antihistamines: do they work? Further well‐controlled trials involving larger samples are needed
Authors: F. Fumagalli, I. Baiardini, M. Pasquali, E. Compalati, L. Guerra, P. Massacane, G. W. Canonica
Journal: Allergy (2004)

Histamine is one of the most important steps in the phlogistic allergic reaction. Its activity is due to the link to specific receptors on the cellular surface. H1‐receptors of second generation are the most currently prescribed drugs in allergic diseases for their high selectivity, little or no central sedative effect, rapid onset of action and long half lives. Antihistamines can modulate part of immunological mechanisms involved in the pathogenesis of allergic inflammation reducing mediator release and expression of adhesion molecules, regulating the release of cytokines, chemokines and consequently inflammatory cells recruitment. The anti‐inflammatory effects of cetirizine, desloratadine and levocetirizine are reviewed. Quality of life is considered too, as a main parameter in a global evaluation of the antihistamine's effects.