tbuckley/cabot-search huggingface dataset:
A New Option for Treating Osteoporosis
Authors: B. Lawrence Riggs
Journal: New England Journal of Medicine (1990)

Osteoporosis is an enormous public health problem, causing more than 1.5 million fractures and costing up to $10 billion in the United States each year. The most widely used treatment is calcium supplementation. It is safe and relatively inexpensive. Calcium acts as a weak inhibitor of bone resorption, probably indirectly by decreasing the secretion of parathyroid hormone. Patients with more than mild disease usually receive estrogen or calcitonin in addition to calcium. Both have more potent antiresorptive effects and are the only agents approved by the Food and Drug Administration for the treatment of osteoporosis. Bone cells contain estrogen receptors, . . .
Bilateral locked posterior shoulder dislocation in a footballer.
Authors: J Ryan, M Whitten
Journal: British Journal of Sports Medicine (1997)

Posterior dislocation of the shoulder is an uncommon injury, accounting for between 2% and 4% of all shoulder dislocations. It occurs most frequently in patients following convulsions or direct anterior force to the shoulder. It is a particularly uncommon injury in sport. This paper reports an unusual case of bilateal locked posteriorly dislocated shoulders in a previously healthy young man who fell while playing football.
Stroke: A Clinical Approach
Authors: Donna Bergen
Journal: JAMA (1987)

This book is well described by its title. It is a general approach to the diagnosis and treatment of cerebral vascular disease, including subarachnoid hemorrhage and hypoxic encephalopathy. Beginning with a broad discussion of the causes of stroke, the authors proceed to a comprehensive description of the most common stroke syndromes, along with brief, well-chosen case histories of many. This section is the backbone of the book and its major strength for the clinician. Complications of stroke that can be prevented or improved are thoroughly presented. The quandary posed by methods of safe treatment of hypertension after stroke is presented, but crucial pathophysiological aspects of the dilemma of "how far to reduce blood pressure," such as loss of autoregulation in damaged cerebral tissue, are not included in the discussion. Another of the clinician's major dilemmas in the treatment of atherosclerotic brain disease, the proper use of anticoagulants, is sidestepped: "[A]
Mechanisms underlying Children's susceptibility to environmental toxicants.
Authors: E M Faustman, S M Silbernagel, R A Fenske, T M Burbacher, R A Ponce
Journal: Environmental Health Perspectives (2000)

An important public health challenge has been the need to protect children's health. To accomplish this goal, the scientific community needs scientifically based child-specific risk assessment methods. Critical to their development is the need to understand mechanisms underlying children's sensitivity to environmental toxicants. Risk is defined as the probability of adverse outcome and when applied to environmental risk assessment is usually defined as a function of both toxicity and exposure. To adequately evaluate the potential for enhanced health risks during development, both child-specific factors affecting toxicity and exposure need to be considered. In the first section of this article, example mechanisms of susceptibility relevant for toxicity assessment are identified and discussed. In the second section, examples of exposure factors that help define children's susceptibility are presented. Examples of pesticide research from the newly funded Child Health Center at the University of Washington will be given for illustration. The final section discusses the importance of putting these considerations of children's susceptibility into an overall framework for ascertaining relevancy for human risk assessment.
The University Group Diabetes Program Study Pertaining to Phenformin
Authors: Albert I. Winegrad
Journal: JAMA (1971)

The University Group Diabetes Program (UGDP) reports in this issue ofThe Journalan eight-year study in which cardiovascular and total mortality in adult-onset diabetics treated with phenformin were significantly higher than in patients treated with insulin or with a placebo. The UGDP concludes that "phenformin was no more effectual than diet alone or than diet and insulin in prolonging life" or... "in preventing the occurrence of nonfatal vascular complications associated with diabetes." The UGDP study is a pioneer effort to improve the methodology of clinical therapeutic trials. However, this study was not primarily designed to examine cardiovascular mortality, and detailed information concerning certain factors which are believed to influence death from cardiovascular disease was not obtained when the patients were admitted to the study. Nevertheless, the increased mortality from all causes, and from cardiovascular disease in particular, in the group treated with phenformin is a matter of grave concern.
Effect of moderate improvement in metabolic control on magnesium and lipid concentrations in patients with type 1 diabetes.
Authors: M S Djurhuus, J E Henriksen, N A Klitgaard, O Blaabjerg, P Thye-Rønn, B M Altura, B T Altura, H Beck-Nielsen
Journal: Diabetes Care (1999)

OBJECTIVE: To evaluate the effect of clinically obtainable improvements in metabolic control in patients with type 1 diabetes on biochemical cardiovascular risk factors. RESEARCH DESIGN AND METHODS: Blood and 24-h urinary samples were obtained from 49 patients with type 1 diabetes before and after a run-in period and after 3 months of intervention, with frequent adjustment of insulin dosage according to measured blood glucose concentrations. RESULTS: The intervention caused a mean insulin dosage increment of 10%, a 20% decrease in fasting plasma glucose concentration, a 10% decrease in albumin corrected serum fructosamine, and a somewhat lesser decrease in HbAlc.A 14% decrease in the renal excretion of magnesium (Mg) was observed, but without a change in average serum Mg concentration. Serum HDL cholesterol increased 4%, and serum triglycerides decreased 10% as an average. Looking at individual patients, the decrease in serum triglycerides correlated with both the change in serum total Mg concentration and with the increase in insulin dosage. Using the change in serum total Mg concentration and in insulin dosage as independent variables in a multiple regression analysis, the coefficient of correlation with the decrease in serum triglycerides was 0.52. CONCLUSIONS: Moderate but clinically obtainable improvement of metabolic control in patients with type 1 diabetes seems to reduce the loss of Mg, increase serum HDL cholesterol, and decrease serum triglycerides. The decrease in serum triglycerides was associated with the change in serum total Mg concentration. These reductions in Mg loss and serum triglycerides might reduce the risk of developing cardiovascular disease in patients with type 1 diabetes.
Vasodilator Therapy of Idiopathic Lactic Acidosis
Authors: Michael R. Taradash, Lester B. Jacobson
Journal: New England Journal of Medicine (1975)

Afterload reduction with sodium nitroprusside was performed in a patient with idiopathic lactic acidosis in whom sodium bicarbonate therapy had precipitated pulmonary edema. The drug reduced mean pulmonary-artery wedge pressure from 28 to 12 mm Hg, accompanied by a modest rise in left ventricular stroke work index from 33 to 43 g-m per square meter. Concomitantly, there was dramatic resolution of the metabolic acidemia, the arterial pH rising from 7.19 to 7.61, arterial carbon dioxide tension from 13 to 26 mm Hg, and bicarbonate content from 6 to 28 mEq per liter, and the anion gap falling from 32 to 11 mEq per liter. Metabolic improvement occurred despite a fall in cardiac output from 5.5 to 4.8 liters per minute. These findings support the concept that regional vasoconstriction plays a part in idiopathic lactic acidosis, and suggests that vasodilators may be an effective form of therapy for this almost uniformly fatal disorder.
Prevalence and management of asthma in children under 16 in one practice.
Authors: J Heijne den Bak
Journal: BMJ (1986)

The prevalence of childhood asthma in a small town in west Cumbria was studied. Medical records were scrutinised for keywords, children who were entered in the study were examined, and their parents were interviewed. A control group of children who were matched for sex and age was used to estimate the prevalence of asthma for the practice in the town. At the same time treatment was evaluated and improved where necessary. As expected, asthma in children was grossly underdiagnosed. The prevalence of asthma in children aged under 16 years in the practice was 15.6%, although the recorded prevalence before the study was only 7.8%. Treatment was inadequate for 42% of the children. The reasons for this were explored, and recommendations were made on management.
Letter: Drug-precipitated acute attacks of gout.
Authors: None Chan Onn Leng
Journal: BMJ (1975)

Drug-precipitated Acute Attacks of Gout SIR,-Though there has been little discussion about drug precipitation of acute atitacks of gout, it is known that diureftics such as hydrochlorothiazide, ethacrynic acid, and frusemide indiuce hyperuricaemia and thus precipitate acute attacks.'Among the other drugs implicated are pyrazinamide, niacin, pempidine, alcohol, mecamylamine, and salicylates if the dose is less than 4 g per day.2It would be of interest, therefore, to add a little to ,this list, seeing that the incidence of gout in Asians is much higher than was formerly thought.2
IS VISUAL INTERPRETATION OF CORONARY EPICARDIAL FLOW RELIABLE IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY ANGIOPLASTY? INSIGHTS FROM APEX-AMI
Authors: Osama Al-Hadramy, Cynthia M. Westerhout, Sorin J. Brener, Christopher B. Granger, Paul W. Armstrong
Journal: Journal of the American College of Cardiology (2010)
Three Methods of Opioid Detoxification in a Primary Care Setting
Authors: Patrick G. O'Connor
Journal: Annals of Internal Medicine (1997)

Background: Opioid detoxification in a primary care setting followed by ongoing substance abuse treatment may be appropriate for selected opioid-dependent patients. Objective: To compare three pharmacologic protocols for opioid detoxification in a primary care setting. Design: Randomized, double-blind clinical trial with random assignment to treatment protocols. Setting: A free-standing primary care clinic affiliated with drug treatment programs. Patients: 162 heroin-dependent patients. Interventions: Three detoxification protocols: clonidine, combined clonidine and naltrexone, and buprenorphine. Measurements: Successful detoxification (that is, when study participants received a full opioid-blocking dose [50 mg] of naltrexone), treatment retention (8 days), and withdrawal symptoms. Results: Overall, 65% of participants (36 of 55) who received clonidine, 81% (44 of 54) who received combined clonidine and naltrexone, and 81% (43 of 53) who received buprenorphine were successfully detoxified. Retention did not differ significantly across the groups: 65% of participants (36 of 55) who received clonidine, 54% (29 of 54) who received combined clonidine and naltrexone, and 60% (32 of 53) who received buprenorphine. Participants who received buprenorphine had a significantly lower mean withdrawal symptom score than those who received clonidine or combined clonidine and naltrexone. Conclusions: Participants in the combined clonidine and naltrexone group and those in the buprenorphine group were more likely to complete detoxification, although retention at 8 days did not differ among the groups. Participants who were assigned to the buprenorphine group experienced less severe withdrawal symptoms than those assigned to the other two groups.
Primary analysis of study MO19391, an open-label safety study of bevacizumab (B) plus taxane-based therapy as 1st-line treatment of patients (pts) with locally recurrent (LR) or metastatic breast cancer (mBC).
Authors: IE Smith, L Biganzoli, H Cortés-Funes, D Stroyakovskiy, FA Franke, A Chlistalla, J Pierga, C Thomssen, K Pritchard
Journal: Cancer Research (2009)

Abstract Abstract #4118 Background: The addition of B (15mg/kg q3w) to 1st-line taxane therapy significantly improved PFS in pts with LR or mBC in 2 phase III studies, E2100 and AVADO. MO19391 investigated B plus 1st-line taxane-based chemotherapy (CTx) in LR or mBC to obtain safety and efficacy data in a community-based population.&amp;#x2028; Methods: This open-label, multicentre study has completed enrolment of 2,000 pts with LR or mBC and an ECOG PS of 0–2. Exclusion criteria included prior CTx for LR or mBC and evidence of CNS metastases. The primary endpoint was safety; secondary endpoints included TTP and OS. B was administered at 10mg/kg q2w or 15mg/kg q3w plus the physician's choice of taxane regimen (or investigator's SOC, excluding anthracyclines). Treatment with B continued until disease progression or unacceptable toxicity. As well as AEs, attention was paid to AEs of special interest (hypertension, proteinuria, wound-healing complications, thromboembolic events, CNS bleeding, other haemorrhages, GI perforation, fistulae, RPLS and CHF). The safety population included all pts who received at least one dose of B.&amp;#x2028; Results: As of March 2008, the safety population consisted of 1,553 pts from 35 countries. The median number of cycles received was 6 for both B (range 1–28) and CTx (range 1–28). Pts received: single-agent taxane 66.2%, taxane combination 13.5%, other single agent 8.5%, other combination 3.3%. Frequently reported AEs are shown below. Grade 3/4 AEs of special interest were reported in 6.3% of pts, most commonly hypertension 2.2%, proteinuria 0.7%, pulmonary embolism 0.5%, epistaxis 0.4%. AEs leading to death during the study phase were reported in 27 pts (1.7%)*.&amp;#x2028; &amp;#x2028; Conclusions: MO19391 is the largest study population of pts with LR or mBC receiving B plus CTx. Toxicity was low and preliminary results are consistent with previous B safety studies. Final analysis of the primary endpoint and secondary efficacy analyses will be presented. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4118.
Predictors of Arrhythmic Death and Cardiac Arrest in the ESVEM Trial
Authors: Anthony C. Caruso, Frank I. Marcus, Elizabeth A. Hahn, Vernon L. Hartz, Jay W. Mason
Journal: Circulation (1997)

Background The purpose of this study was to determine if the presenting ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation/cardiac arrest) predicted the type of arrhythmia recurrence in patients treated with antiarrhythmic drugs. Methods and Results In the previously reported Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, there were 486 patients who were randomized to antiarrhythmic drug testing guided by electrophysiological study or by ambulatory ECG monitoring. Use of a defibrillator (implantable cardioverter-defibrillator, ICD) without stored electrograms among 81 patients precluded determination of the type of arrhythmia recurrence; thus these patients were censored at the time of ICD implantation. Of the 486 patients, 381 presented with ventricular tachycardia and 105 with cardiac arrest. Over a 6-year follow-up period, 285 of the 486 patients had an arrhythmia recurrence; of these, 97 had an arrhythmic death or cardiac arrest as a first recurrence. In the current analysis, all 129 arrhythmic deaths/cardiac arrests that occurred any time during follow-up were evaluated as end points. Conclusions Although univariate analysis suggested that there was an association between the presenting arrhythmia and outcome, multivariate analysis failed to substantiate the predictive value of the presenting arrhythmia. Left ventricular ejection fraction was the single most important predictor of arrhythmic death or cardiac arrest. This information may be an important factor in deciding whether to advise ICD therapy.
Reflexive and orienting properties of REM sleep dreaming and eye movements
Authors: John Herman
Journal: Behavioral and Brain Sciences (2000)

In this manuscript Hobson et al. propose a model exploring qualitative differences between the three states of consciousness, waking, NREM sleep, and REM sleep, in terms of state-related brain activity. The model consists of three factors, each of which varies along a continuum, creating a three-dimensional space: activation (A), information flow (I), and mode of information processing (M). Hobson has described these factors previously (1990; 1992a). Two of the dimensions, activation and modulation, deal directly with subcortical influences upon cortical structures – the reticular activation system, with regard to the activation dimension and the locus coeruleus and the pontine raphe neuclei, with regard to the modulation dimension. The focus of this review is a further exploration of the interaction between dreaming and the cortical and subcortical structures relevant to REM sleep eye movements. [Hobson et al. ]
The Effects of Atrial Pacing on the Synergy and Hemodynamics of the Orthotopically Transplanted Canine Heart
Authors: SEVERI MATTILA, NEIL B. INGELS, GEORGE T. DAUGHTERS, STEPHEN C. ADLER, LEWIS WEXLER, EUGENE DONG
Journal: Circulation (1973)

Instantaneous left ventricular dynamics were measured from cineradiographs utilizing implanted tantalum coils as myocardial site markers in the orthotopically transplanted canine heart. Four parameters of myocardial synergy were obtained: mean shortening, anisotropy of contraction, mean time to half shortening, and asynchrony of contraction. Estimates of end diastolic volume, end systolic volume, stroke volume, ejection fraction, and cardiac output were obtained. Heart rate was altered by pacing the left atrium of the donor heart. Of the nine parameters, only cardiac output was significantly changed by alterations in heart rate. The invariance of stroke volume with rate resulted in a proportional increase in cardiac output with cardioacceleration.
Stress in families of children who have ingested poisons.
Authors: R Sibert
Journal: BMJ (1975)

One hundred families of children under 5 years admitted to Cardiff Hospitals after accidentally ingesting poisons were compared with 100 control families matched for socioeconomic class and age and sex of the child. Questioning about five major stress factors (serious family illness, pregnancy, recent family moves, one parent away from home, anxiety or depression in one or both parents) disclosed significantly more stress in the affected families than in the controls. Thirty of the affected families had more than one major stress factor compared with four of the controls, while 63 of the controls had no major stress factor compared with 24 of the affected families (P less than 0.001). In only four of the affected families was there no stress factor. Fifteen children took poisons in homes other than their own. Unemployment was significantly more prevalent in the affected families than in the general population, though apart from this the socioeconomic backgrounds were similar. There were significantly more accidents and childhood poisonings in the parents and siblings of affected children than in the control families. In 25% of the cases poisoning was with Angiers Junior Aspirin.
Everywhere and nowhere---a Socratic dialogue on the new public health
Authors: I. Wylie, S. Griffiths, D. J Hunter
Journal: BMJ (1999)

This is a dialogue between Hylas and Philonous, the design of which is plainly to demonstrate the reality and perfection of partnership working and the immediate providence of a minister for health in opposition to the sceptics and atheists among public health specialists. (With apologies to Bishop Berkeley, philosopher and author of Three Dialogues Between Hylas and Philonous , 1713.1)

Philonous: Well, Hylas, what cheer? Why so downhearted, when all seems to be going so well for you? Have you not yourself told me that there has never been a better time to be in your business?

Hylas: My business? What, pray, do you call my business?

Philonous : Why, the business of public health, of course! The health of every child, woman, and, yes, even every man, in the land. After years of toiling in the underworld, haven't you been telling everyone that you have climbed into the airy uplands and are basking in the sun of recognition. Why, lately our minister herself, at a confederation meeting, has called for public health to be at the centre of the health service.

Hylas: Well, yes, it is so. But I have this note from my editor who tells me that his readers find public health vague, unexciting stuff.

Philonous : How so? Why, last time we met you told me how even heart surgeons would soon be thinking about health. How these technicians would soon become health promoters, proselytising for the greater health of the public. Won't such thoughts excite passion in thinking, sentient beings?

Hylas: They say it's all too soft. These fellows would measure social benefit by ruler and divider. All they want are facts about savings, facts about costs, facts about waiting lists, facts about facts.

Philonous : Hum. Yes, I see …
Usefulness of Intracardiac Echocardiography for the Diagnosis of Cardiovascular Implantable Electronic Device–Related Endocarditis
Authors: Maria Lucia Narducci, Gemma Pelargonio, Eleonora Russo, Leonardo Marinaccio, Antonio Di Monaco, Francesco Perna, Gianluigi Bencardino, Michela Casella, Luigi Di Biase, Pasquale Santangeli, Rosalinda Palmieri, Christian Lauria, Ghaliah Al Mohani, Francesca Di Clemente, Claudio Tondo, Faustino Pennestri, Carolina Ierardi, Antonio G. Rebuzzi, Filippo Crea, Fulvio Bellocci, Andrea Natale, Antonio Dello Russo
Journal: Journal of the American College of Cardiology (2013)
Improvement in exercise capacity of candidates awaiting heart transplantation
Authors: Lynne Warner Stevenson, Anthony E Steimle, Gregg Fonarow, Michael Kermani, Donna Kermani, Michele A Hamilton, Jaime D Moriguchi, Julie Walden, Jan H Tillisch, Davis C Drinkwater, Hillel Laks
Journal: Journal of the American College of Cardiology (1995)
Animal models of ventilator-associated pneumonia
Authors: C M Luna, O Sibila, C Agusti, A Torres
Journal: European Respiratory Journal (2008)

Animal models are an essential step between "<i>in vitro</i>" testing and clinical studies. Different animal models have been useful for the study of pathophysiology, diagnosis and therapy in ventilator-associated pneumonia (VAP). Aspiration has been studied in dog and cat models and bacteriological diagnosis has been evaluated in baboons. Pigs have been used for studying either spontaneous or induced VAP. Intubated piglets in prone position were administered analgesia and muscle paralysis was induced, and the intubated piglets underwent mechanical ventilation for several days. In this model, spontaneous VAP due to common bacterial pig colonisation develops within a few days. Pneumonia can also be induced by inoculating high concentrations of microorganisms (<i>Pseudomonas aeruginosa</i> and methicillin-resistant <i>Staphylococcus aureus</i>). Different clinical, physiological, microbiological and pathological parameters of infection have been studied in this model. In addition, administration of antibiotics and inflammatory modulators and their consequences in microbiological eradication and local and systemic inflammation have been evaluated with interesting translational results. Although bronchial inoculation of healthy subjects does not resemble the common pathophysiological mechanisms, the experimental model of ventilator-associated pneumonia induced by the inoculation of high concentrations of microorganisms in mechanically ventilated piglets is useful for the study of the local and systemic responses of lung infection and for the determination of potential measures of prevention or therapeutic modulation.
Protective effect of 20-HETE analogues in experimental renal ischemia reperfusion injury
Authors: Kevin R. Regner, Anna Zuk, Scott K. Van Why, Brian D. Shames, Robert P. Ryan, John R. Falck, Vijay L. Manthati, Meghan E. McMullen, Steven R. Ledbetter, Richard J. Roman
Journal: Kidney International (2008)