tbuckley/cabot-search huggingface dataset:
The Troubled Dream of Life: Living With Mortality
Authors: Norman B. Levy
Journal: JAMA (1995)

This must have been a difficult book to write. It certainly was difficult to begin to read, but once started it flowed easily. The subject of getting a perspective on how one may best understand and live with the knowledge of one's mortality is among the most difficult issues to tackle. Callahan does the job well and is well qualified to take on such a task. He is director and cofounder of the Hastings Center and the author of two other books. He is well informed about the status of medical advances, is a well-known philosopher and ethicist, and is clearly a thoughtful and considerate person who writes simply and well.  The book tackles the issue of why the termination of treatment and the care of the dying have continued to be stormy issues despite intense reform efforts. Callahan gives us a historical view of dying and why death prior
Differences in Mitotic Activity May Explain Observed Differences in HIF-1α Response in Cancers and Stroma
Authors: Khush Mittal
Journal: PLoS Medicine (2006)

I read the paper by Chi et al. with interest.The authors found a greater hypoxia response gene expression in carcinomas than stromal cells grown in vitro, but were not sure of the underlying explanation (see Discussion in [1]).The underlying explanation may be the difference in mitotic activity and hence metabolic activity between these two cell types, such that hypoxia may be present within cancer cells, although the surrounding culture media may have similar oxygen levels as the stromal cultures.The differences in mitotic activity could also explain greater hypoxia-related gene expression in clear-cell carcinoma compared with chromophobe carcinoma, normal tissue, or oncocytoma, as clear-cell carcinomas are more active mitotically.Did the authors compare the hypoxia gene expression with mitotic activity in various tumors?
PTEN deficiency in mast cells causes a mastocytosis-like proliferative disease that heightens allergic responses and vascular permeability
Authors: Yasuko Furumoto, Nicolas Charles, Ana Olivera, Wai Hang Leung, Sandra Dillahunt, Jennifer L. Sargent, Kevin Tinsley, Sandra Odom, Eric Scott, Todd M. Wilson, Kamran Ghoreschi, Manfred Kneilling, Mei Chen, David M. Lee, Silvia Bolland, Juan Rivera
Journal: Blood (2011)
A CATALOGUE OF R.C.S.'s PORTRAITS
Authors: Z. Cope
Journal: BMJ (1960)

Trials of antiseizure medications involve static group assignments for treatments with pre-specified durations. We propose a response-adaptive crossover design using basic statistical assumptions regarding both seizure count and duration of treatment to determine when a participant can change group assignment. We modelled seizure frequency as a Poisson process and estimated the likelihood that seizure frequency had decreased by 50% compares to baseline using both a Bayesian and maximum likelihood approach. We simulated trials to estimate the influence of this design on statistical power and observation duration with each treatment. For patients with 9 baseline seizures in 4 weeks who had no change in seizure frequency, the simulation identified non-response in a median of 16 days. The response-adaptive crossover design resulted in a modest increase in statistical power to identify an effective treatment while maximizing the time in a group producing a response. Only 8% of participants remained in the placebo group for all 90 days of the simulated trials. These example theoretical results can provide quantitative guidance regarding objective criteria to determine non-response in real-time during a controlled clinical trial without revealing the assigned treatment. Implementing a response-adaptive crossover design may both improve statistical power while minimizing participant risk.
Effects of Physical Training on the Metabolism of Skeletal Muscle
Authors: Jan Henriksson
Journal: Diabetes Care (1992)

With moderate training (30-60 min daily at 70–80% of VO2 max, 3–5 times weekly), the trained muscles display a 40–50% increase in the content of mitochondrial oxidative enzymes. Concomitantly, the total number of muscle capillaries may increase by 50%, whereas the content of glycolytic enzymes is not, or only marginally, affected. The oxidative enzyme increase, which occurs over 6–8 wk, is lost in 4–6 wk if training is stopped. This loss occurs faster than the decrease in muscle capillarization and in the whole-body VO2 max. Trained muscles of athletes have 3–4 times higher oxidative enzyme levels and two- to threefold more capillaries per muscle fiber than untrained muscle. Extensive endurance training results in an enhanced percentage of slow-twitch fibers, but the time course of this change is not known. More extensive changes are observed in chronically stimulated rabbit muscle. In this case, enzymes of oxidation display large increases (6- to 12-fold), whereas there is a decrease of 70–90% in enzymes of glycolysis, glycogenolysis, gluconeogenesis, and high-energy phosphate transfer. There is a normal training response in mitochondrial enzyme activities in individuals with insulin-dependent and non-insulin-dependent diabetes, but the ability to form new skeletal muscle capillaries in response to physical training may be deficient in insulin-dependent diabetes. Training-induced changes in the metabolic character of skeletal muscle leads to an increased reliance on fat metabolism during exercise, with a lowered blood lactate concentration and a sparing of muscle glycogen.
A simple animal model of hyperammonemia
Authors: Inmaculada Azorín, María-Dolores Miñana, Vicente Felipo, Santiago Grisolía
Journal: Hepatology (1989)

Rats were fed a standard diet or the standard diet supplemented with ammonium acetate (20% w/w) for up to 100 days. The effect of the ingestion of the high-ammonium diet on some aspects of nitrogen metabolism in rats was studied. Ammonia levels in blood increased ≈3-fold; in brain, liver and muscle the increases were 36, 34 and 50%, respectively. Urea levels in blood and urea excretion increased ≈2-fold. There was no increase of carbamyl phosphate synthase. Liver glutamine synthase activity increased by 58% and glutamate dehydrogenase by 40%, whereas glutaminase was not affected. Glutamine content in brain was twice that of controls. This new animal model to study hyperammonemia offers several advantages over others: it is simpler, is bloodless, requires no animal manipulation and permits long-term studies.
QTC DISPERSION ON 12-LEAD ELECTROCARDIOGRAM IS INVERSELY CORRELATED WITH T1 RELAXATION TIMES IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
Authors: David Hurtado de Mendoza, Celia P. Corona-Villalobos, Styliani Vakrou, Stefan L. Zimmerman, Yalda Soleimanifard, Jacsel Suarez, Jorge David Gonzales Cordova, Diego Montoya Cerrillo, Wilfredo Mormontoy Laurel, Ketty Cerna, Iraklis Pozios, Sergio Perez-Melo, David Bluemke, Theodore P. Abraham, Maria Roselle Abraham
Journal: Journal of the American College of Cardiology (2014)
THE FUNCTION OF THE SOLUBLE FERMENTS OF THE BLOOD IN INTRACELLULAR DIGESTION.
Authors: ALFRED C. CROFTAN
Journal: JAMA (1902)

<h3>METABOLISM COMPARED TO COMBUSTION.</h3> The constituents of the food, viz., the proteids, fats, carbohydrates and salts are indifferent to oxygen outside of the animal organisms but readily combine with oxygen within the body. As a certain amount of heat is generated and a certain amount of energy liberated during the passage of the food-material through the body, the whole process has been rather crudely compared to a combustion, life to a flame and the body to a machine that burns the fuel that is fed to it. This conception is inaccurate, for it merely considers the most superficial manifestations of the life-process, the initial and the terminal stages of a most intricate process, the finer, intermediary mechanism of which we are just beginning to understand. If we determine the quantity of oxygen inspired within a stated time-unit and the quantity of oxygen excreted (in gaseous, liquid or solid combinations) through
SUBSTERNAL THYROID WITH BILATERAL LARYNGEAL PARALYSIS
Authors: Louis Hubert
Journal: JAMA (1923)

It is now generally recognized that, in cases of thyroid disease, paresis or paralysis of the vocal cords may occur previous to an operation on the thyroid gland. Any laryngeal impairment that is caused by an enlargement of the thyroid gland is nearly always unilateral. When a bilateral involvement exists previous to operation, it is usually caused either by some lesion in the central nervous system, such as syphilis, or by a malignant disease of the thyroid gland.<sup>1</sup> The case here reported presents a bilateral involvement of the vocal cords, without demonstrable lesion in the central nervous system and without evidence of malignancy in the thyroid gland. <h3>REPORT OF CASE</h3><h3>History.</h3> —D. G., a woman, aged 50, born in Poland, came to the Manhattan Eye, Ear and Throat Hospital, clinic of Dr. McCullagh, Jan. 7, 1922, complaining of difficulty in breathing and of choking attacks. The family history had
A MAJOR GENETIC LOCUS AFFECTING RESISTANCE TO INFECTION WITH MURINE LEUKEMIA VIRUSES
Authors: Wallace P. Rowe, James B. Humphrey, Frank Lilly
Journal: The Journal of Experimental Medicine (1973)

The Fv-1 gene, which regulates sensitivity of mouse cells to infection by naturally occurring host-range types of murine leukemia virus, was shown to be located on linkage group VIII (chromosome 4), 39 map units from b.
P43 Do changes in objective outcome measures match patient-reported experience of pulmonary rehabilitation?
Authors: R. Fowler, K. Ingram, A. Clark, C. Nolan, W. Man
Journal: Thorax (2010)

<h3>Introduction</h3> There are a variety of different objective outcome measures that are currently used to assess patients′ response to pulmonary rehabilitation (PR) and the effectiveness of service delivery. Most of these measures have well defined minimal clinically important difference (MCID) thresholds, including the Incremental Shuttle Walk (ISW), Chronic Respiratory Questionnaire (CRQ) and the Hospital Anxiety and Depression scale (HAD). However, it is not clear how many outcome measures are needed to encapsulate patient-reported improvement following PR. <h3>Methods</h3> 101 patients, completing an 8 week supervised outpatient pulmonary rehabilitation programme, were asked to rate their response with the following question: ‘How do you feel your overall condition has changed after rehabilitation?’ Responses were categorised according to a Likert scale ranging from 1 ‘I feel much better’ to 5 ‘I feel much worse’. All patients were blinded to the results of their objective assessments. For every patient responding category 1, we determined whether the MCID was achieved for each of seven different outcome measures: the ISW (&gt;48 m), the four domains of the CRQ (mean change &gt;0.5 per domain), HAD-anxiety (&lt;−1.5) and HAD-depression (&lt;−1.5). <h3>Results</h3> 64 patients (63%) recorded a response of ‘I feel much better’. Of these, the proportion of patients achieving the MCID for the seven different outcome measures is seen in Abstract P43 Table 1 below. 6 patients (9%) achieved the MCID for all outcome measures tested, whilst one patient (1.6%) did not achieve the MCID in any of the outcome measures. Four patients (6.25%) did not achieve the MCID in either the ISW or any of the CRQ domains. <h3>Discussion</h3> Patient-reported positive response to PR is probably determined by several factors, which differ from individual to individual, and cannot be captured by use of only one outcome measure. More than 98% of patients who reported feeling much better following pulmonary rehabilitation achieve the MCID in at least one of ISW, CRQ domains or HAD.
Acute Effects of Intravenous Administration of a Preparation of<i>Veratrum Viride</i>in Patients with Severe Forms of Hypertensive Disease
Authors: Norman S. Stearns, Laurence B. Ellis
Journal: New England Journal of Medicine (1952)

THE pharmacology of Veratrum alkaloids has been reviewed recently1 and several reports dealing with their clinical use have also appeared in the literature.2 3 4 5 6 7 8 9 The purpose of the present investigation was to determine the relative safety of the intravenous administration of Veratrum viride to lower acutely the blood pressure in patients with severe hypertension associated with cerebral, cardiac and renal impairment. For this purpose a biologically standardized10 reproducible mixture10 , 11 of alkaloidal substances from V. viride§ was administered intravenously 36 times to 25 patients.Selection of PatientsThe patients included in this study were classified in two groups: those with a malignant . . .
Increased Incidence of Retinopathy in Diabetics with Elevated Blood Pressure
Authors: William C. Knowler, Peter H. Bennett, Elmer J. Ballintine
Journal: New England Journal of Medicine (1980)

The incidence of retinopathy was assessed in 188 diabetic and 284 nondiabetic Pima Indian adults six years after an initial examination had shown each to be free of retinopathy. Exminations included direct ophthalmoscopy through dilated pupils. The incidence of retinal lesions was strongly related to the presence of diabetes and, among the diabetic subjects, to insulin treatment, disease duration, plasma glucose concentration, and presence of other complications such as proteinuria, loss of deep tendon reflexes, and increased vibration-sensation threshold. In diabetic subjects not taking insulin, the incidence of exudates in those with systolic blood pressures of at least 145 mm Hg was more than twice that of those with pressures of less than 125 mm Hg. This association persisted when assessed within categories of subjects stratified according to 13 potentially confounding variables, suggesting that control of blood pressure may reduce the incidence of retinal exudates in diabetics not treated with insulin.
Reviews, Notes, and Listings: Fibrinolysis, Thrombosis, and Hemostasis: Concepts, Perspectives, and Clinical Applications
Authors: David C. Sane
Journal: Annals of Internal Medicine (1993)

Literature of Medicine1 March 1993Reviews, Notes, and Listings: Fibrinolysis, Thrombosis, and Hemostasis: Concepts, Perspectives, and Clinical ApplicationsDavid C. Sane, MDDavid C. Sane, MDDuke University Medical Center, Durham, NC 27710.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-5-199303010-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fibrinolysis, Thrombosis, and Hemostasis: Concepts, Perspectives, and Clinical ApplicationsSol Sherry. 318 pages. Philadelphia: Lea & Febiger; 1992. $59.50.Any book dedicated to more than 100 of the author's colleagues and collaborators is likely to be rich in historical perspective. In this book, written by one of the pioneers in thrombolytic therapy, we cover almost 60 years of scientific inquiry in fibrinolysis: from Tillett's observations on filtrates of streptococci in 1933 to recombinant activators and adjuvant agents in the 1990s. There is a brief discussion of streptokinase administration into the intrapleural space for treatment of hemothorax and empyema, and of the trials ... Author, Article, and Disclosure InformationAffiliations: Duke University Medical Center, Durham, NC 27710. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1993Volume 118, Issue 5Page: 399KeywordsFibrinolysisHemorrhageHemostasisMyocardial infarctionPharmacologyPulmonary arteriesPulmonary embolismResearch laboratoriesScientistsThrombosis ePublished: 15 August 2000 Issue Published: 1 March 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Organ Procurement Expenditures and the Role of Financial Incentives
Authors: Roger W. Evans
Journal: JAMA (1993)

To evaluate the billed charges for organ procurement and to consider the role of financial incentives to encourage organ donation.Observational study. Data were obtained on donor organ acquisition charges from a random sample of kidney, heart, liver, heart-lung, and pancreas transplants.The data were based on 28.7% of all transplants performed in the United States in 1988.Total charges for donor organ acquisition.The median charges (1988 dollars) for donor organs were as follows: kidney, $12,290; heart, $12,578; liver, $16,281; heart-lung, $12,028; and pancreas, $15,400. Since 1983, kidney acquisition charges have increased by 12.9%, heart charges by 64.1%, and liver charges by 61.8%, after adjusting for inflation. Between 9% and 31% of total transplant procedure-specific charges were associated with donor organ acquisition.There is wide unexplained variation in organ procurement charges. Data on actual costs are required to establish the appropriateness of current charges. Prevailing billing and payment methods should be reevaluated in an effort to address a variety of issues related to reimbursement. Current payment methods may actually contribute to cost inefficiency. Finally, while financial incentives may enhance the efficiency of organ procurement efforts, they will adversely affect the cost-effectiveness of transplantation.
Remifentanil/midazolam versus fentanyl/midazolam for analgesia and sedation of mechanically ventilated neonates and young infants: a randomized controlled trial
Authors: Lars Welzing, Andre Oberthuer, Shino Junghaenel, Urs Harnischmacher, Hartmut Stützer, Bernhard Roth
Journal: Intensive Care Medicine (2012)
The prognostic significance of leukemic cells clearance kinetics evaluation during the initial course of induction therapy with HAD (homoharringtonine, cytosine arabinoside, daunorubicin) in patients with de novo acute myeloid leukemia
Authors: Zhijian Xiao, Hua Xue, Rui Li, Li Zhang, Minghua Yu, Yushu Hao
Journal: American Journal of Hematology (2007)

Abstract The impact of the percentage of residual leukemic cells (RLCs) at the end of first course of induction chemotherapy (T1) or during aplasia (T2) on complete remission (CR) rate, disease‐free survival (DFS), and overall survival (OS) were retrospectively analyzed in 72 cases of de novo acute myeloid leukemia (AML) treated with HAD (homoharringtonine, cytosine arabinoside, and daunorubicin) regimen. The patients were separated into two subgroups by a cutoff of 10% bone marrow leukemic cells at T1 or T2 time point. The CR rate, DFS, and OS were significantly different between the two groups. We further confirmed that the percentage of RLCs at T1 or T2 is an independent prognostic factor of AML. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.
Ruptured Arteriosclerotic Aneurysms of the Abdominal Aorta
Authors: Murray L. Janower
Journal: New England Journal of Medicine (1961)

THE prognosis after rupture of an aneurysm of the A abdominal aorta has improved with recent advances in cardiovascular surgery,1 2 3 4 5 6 7 and it is therefore of vital importance to make an early diagnosis. Although the clinical signs and symptoms of this condition have been adequately described8 9 10 11 the diagnostic value of the plain film of the abdomen has not been given the attention that it deserves. This paper summarizes the pertinent x-ray findings in 20 cases of ruptured aneurysms proved at autopsy or surgery. The findings in 37 cases of intact aneurysms are included as controls.The great majority of abdominal aneurysms . . .
Impaired Heart Rate Response to Graded Exercise
Authors: Michael S. Lauer, Peter M. Okin, Martin G. Larson, Jane C. Evans, Daniel Levy
Journal: Circulation (1996)

Background Previous reports have suggested that an attenuated exercise heart rate response may be associated with coronary heart disease risk and with mortality. These observations may parallel the association between reduced heart rate variability during normal activities and adverse outcome. This investigation was designed to look at the prognostic implications of exercise heart rate response in a population-based sample. Methods and Results In this prospective cohort investigation, 1575 male participants (mean age, 43 years) in the Framingham Offspring Study who were free of coronary heart disease, who were not taking β-blockers, and who underwent submaximal treadmill exercise testing (Bruce protocol) were studied. Heart rate response was assessed in three ways: (1) failure to achieve 85% of the age-predicted maximum heart rate, which has been the traditional definition of chronotropic incompetence; (2) the actual increase in heart rate from rest to peak exercise; and (3) the ratio of heart rate to metabolic reserve used by stage 2 of exercise (“chronotropic response index”). Proportional hazards analyses were used to evaluate the associations of heart rate responses with all-cause mortality and with coronary heart disease incidence during 7.7 years of follow-up. Failure to achieve target heart rate occurred in 327 (21%) subjects. During follow-up there were 55 deaths (14 caused by coronary heart disease) and 95 cases of incident coronary heart disease. Failure to achieve target heart rate, a smaller increase in heart rate with exercise, and the chronotropic response index were predictive of total mortality and incident coronary heart disease ( P &lt;.01). Failure to achieve target heart rate remained predictive of incident coronary heart disease even after adjusting for age, ST-segment response, physical activity, and traditional coronary disease risk factors (adjusted hazard ratio, 1.75; 95% confidence interval, 1.11 to 2.74; P =.02). After adjusting for the same factors, the increase in exercise heart rate remained inversely predictive of total mortality ( P =.04) and coronary heart disease incidence ( P =.0003). The chronotropic response index also was predictive of total mortality ( P =.05) and incident coronary heart disease ( P =.001) after adjusting for age and other risk factors. Conclusions An attenuated heart rate response to exercise, a manifestation of chronotropic incompetence, is predictive of increased mortality and coronary heart disease incidence.
Radioisotopic Flow Scanning for Portal Blood Flow and Portal Hypertension
Authors: CHARLES S. HESDORFFER, WERNER R. BEZWODA, MERVYN D. DANILEWITZ, JAN D. ESSER, MILTON TOBIAS
Journal: Clinical Nuclear Medicine (1987)

The use of a simple, noninvasive, isotope scanning technique for the determination of relative portal blood flow and detection of portal hypertension is described. Using this technique the presence of portal hypertension was demonstrated in seven of nine patients known to have elevated portal venous pressure. By contrast, esophageal varices were demonstrated in only five of these patients, illustrating the potential value of the method. Furthermore, this technique has been adapted to the study of portal blood flow in patients with myeloproliferative disorders with splenomegaly but without disturbances in hepatic architecture. Results demonstrate that the high relative splenic flow resulting from the presence of splenomegaly may in turn be associated with elevated relative portal blood flow and portal hypertension. The theoretic reasons for the development of flow-related portal hypertension and its relationship to splenic blood flow are discussed.
Escape to Eden
Authors: George Dunea
Journal: BMJ (2001)

The aeroplane is speeding west towards the City of Eden. I sit in an exit row; plenty of legroom, but the footrest won't go up. On my right, two lovebirds: same sweaters, same laptops, same spreadsheets. Across the aisle, two women: one, enormously fat, can hardly fit into her seat. The other has talked for hours without taking a breath: has high blood pressure; takes aspirin and herbs; blood pressure is 140/90, but she does not remember which number should be …