tbuckley/cabot-search huggingface dataset:
Interfacing between Spontaneous Breathing and Mechanical Ventilation Affects Ventilation-Perfusion Distributions in Experimental Bronchoconstriction
Authors: Christian Putensen, Jukka Räsänen, Frank A. López
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

The effect of interfacing between spontaneous and mechanical ventilation on ventilation-perfusion (a/) distributions was determined during pressure-support ventilation (PSV) and in the presence and absence of spontaneous breathing during biphasic positive airway pressure (BIPAP) in 10 pigs with methacholine-induced bronchoconstriction. Whereas BIPAP without spontaneous breathing provides full and PSV breath-to-breath synchronized ventilatory support, BIPAP allows unrestricted spontaneous breathing throughout the mechanical cycle. Compared with BIPAP with and without spontaneous breathing, PSV effected an increase in ventilatory rate (p < 0.05) and a higher minute ventilation (e) (p < 0.05). Spontaneous breathing during BIPAP accounted for 15 ± 1% of the e and increased cardiac output (CO) from 4.5 ± 0.2 to 5.3 ± 0.2 L/min (p < 0.05), Pao2 from 55 ± 3 to 80 ± 4 mm Hg (p < 0.05), and oxygen delivery (Do2) from 442 ± 39 to 630 ± 43 ml/min (p < 0.05). PSV did not increase CO, Pao2 and Do2. Spontaneous breathing did not affect oxygen consumption. During BIPAP spontaneous breathing accounted for a 15 ± 2% decrease (p < 0.05) in blood flow to shunt units and a 16 ± 2% increase (p < 0.05) in the perfusion of normal a/ units. Perfusion of shunt and normal a/ units was similar during PSV and BIPAP without spontaneous breathing. Dead space ventilation decreased with spontaneous breathing during BIPAP by 12% compared with PSV (p < 0.05). Dispersion of ventilation distribution was lowest during BIPAP. Uncoupling of spontaneous and mechanical ventilation during BIPAP improved gas exchange by allowing better a/ matching during experimental bronchoconstriction. Apparently, the spontaneous respiratory effort during PSV is not sufficient to counteract the a/ maldistribution caused by airway occlusion and positive pressure lung inflation.
Antenatal Diagnosis of Hemoglobinopathies: An Exquisite Molecular Brew
Authors: David G. Nathan
Journal: New England Journal of Medicine (1976)

The DNA of mammalian cells contains two complementary strands of polydeoxynucleotides wound about each other in the form of a double helix. The term "complementary" describes the fact that the adenine bases of the nucleotides in either strand are opposite to thymidines in the other, and guanines are opposite to cytidines. One strand is arbitrarily designated as plus, and the other as minus. The double helix is stabilized by hydrogen bonds between these complementary bases. A simple model suggests that one of the helical strands (the minus strand) contains the structural genes. These are linear arrays of polynucleotides that serve . . .
The new agenda for general practice computing.
Authors: M Pringle
Journal: BMJ (1990)

large proportion of the daily calcium requirements, may well reduce the prevalence of bladder stones,7 but again, the effect of differing water hardness on the distribution of stones is completely unknown.Development may result in endemic stones disappearing, but there is no evidence that the poor of the bladder stone belt in Asia have reached the stage of the declining disease experienced by the poor in England at the turn of the century.
Impact assessment of energy-efficient lighting in patients with lupus erythematosus: a pilot study
Authors: L. Fenton, R. Dawe, S. Ibbotson, J. Ferguson, S. Silburn, H. Moseley
Journal: British Journal of Dermatology (2014)

Background Patients with lupus erythematosus (LE) are often abnormally photosensitive. Ultraviolet (UV) exposure can not only induce cutaneous lesions but may also contribute to systemic flares and disease progression. Various forms of energy-efficient lighting have been shown to emit UV radiation. Objectives To determine the effects of these emissions on individuals with LE. Methods This assessment investigated cutaneous responses to repeated exposures from three types of lighting: compact fluorescent lamp (CFL), light-emitting diode (LED) and energy-efficient halogen (EEH). The subjects were 15 patients with LE and a control group of five healthy volunteers. Results No cutaneous LE lesions were induced by any of the light sources. Delayed skin erythema was induced at the site of CFL irradiation in six of the 15 patients with LE and two of the five healthy subjects. Erythema was increased in severity and more persistent in patients with LE. One patient with LE produced a positive delayed erythema to the EEH. A single patient with LE produced immediate abnormal erythemal responses to the CFL, LED and EEH. Further investigation revealed that this patient also had solar urticaria. All other subjects had negative responses to LED exposure. Conclusions Compact fluorescent lamps emit UV that can induce skin erythema in both individuals with LE and healthy individuals when situated in close proximity. However, this occurs to a greater extent and is more persistent in patients with LE. EEHs emit UVA that can induce erythema in patients with LE. LEDs provide a safer alternative light source without risk of UV exposure.
Assessment of need for coordinated approach in families with victims of head injury.
Authors: M G Livingston
Journal: BMJ (1986)

Forty two men with severe head injury, and 41 with minor head injury, together with their families, were assessed at home after the injury. Despite significant impairment with respect to physical symptoms, personality difficulties, and occupational status in severely injured patients after one year, there was a very poor uptake of hospital rehabilitation facilities. In addition, patients' relatives showed significant psychosocial impairment throughout this period. There is a need for a specialist to coordinate rehabilitation services for patients with head injury and their relatives and, in particular, to integrate physical and psychological aspects of management with a multidisciplinary team approach. Although this task will require specialist hospital teams for future development, at present general practitioners have some specialised knowledge that would enable them to coordinate rehabilitation.
STUDIES ON THE OXIDATION AND REDUCTION OF IMMUNOLOGICAL SUBSTANCES
Authors: James M. Neill, William L. Fleming, Emidio L. Gaspari
Journal: The Journal of Experimental Medicine (1927)

THE FOLLOWING MODIFICATIONS OF THE ANTIGEN (PNEUMOCOCCUS HEMOTOXIN) WERE STUDIED: (1) the hemolytically active (reduced) substance; (2) the hemolytically inactive, reversible oxidation product; (3) the inactive irreversible products formed by treatment With high concentrations of H(2)O(2); (4) the inactive products formed by heat. The antibody-invoking property of the reversibly oxidized form seemed to be identical with that of the original, hemolytically active or reduced form; neither of the other two hemolytically inactive products invoked antibody production. The same modifications of the antigen which exhibited the antibody-invoking property in vivo possessed the antibody-combining property in vitro; and the modifications which lacked the one property also lacked the other. Evidence is presented that the groups of the hemotoxin molecule in which the true antigenic properties are resident are not necessarily altered by processes which inactivate the groupings responsible for the toxic (hemolytic) action of the original antigen. The lack of antigenic properties on the part of the other two hemolytically inactive modifications is evidence that the treatment employed to alter the toxic property of the molecule must be properly chosen to avoid profound changes which affect the antigenically effective groupings. From an immunological point of view, the reversibility of the antigenically effective oxidation product of pneumococcus hemotoxin is important as an index that the loss of toxicity (hemolysis) was accomplished without a profound change in the molecule. The theoretical significance of the antigenicity of non-toxic modifications of toxic antigens is discussed.
Gestational Diabetes
Authors: John B. O'Sullivan
Journal: New England Journal of Medicine (1961)

ALTHOUGH much has been written about the harmful effects on pregnancy of diabetes mellitus and its earlier stages,1 2 3 variously termed suspected diabetes, latent diabetes and prediagnosis diabetes or prediabetes, there is disagreement about the diagnostic criteria. The answer to this situation is complicated by problems of definition, confused by spontaneous remissions and hindered by lack of well documented longitudinal studies with the available diagnostic tools, which are, unfortunately, far from ideal. As a result claims are made for the predictive value of minor deviations in glucose tolerance whether produced artificially by glucogenic steroids4 or naturally by conditions with diabetogenic effects . . .
Identification of glutathione S-transferase isozymes and ?-glutamylcysteine synthetase as negative acute-phase proteins in rat liver
Authors: Timo M. Buetler
Journal: Hepatology (1998)

Because acute infection and inflammation affect drug metabolism and drug-metabolizing enzymes, the effect of the acute-phase response on the expression of glutathione S-transferase (GST) isoenzymes, glutathione synthesis, and several antioxidant enzymes was investigated. Hepatic expression of GST isozymes, positive and negative acute-phase reactants, and antioxidant enzymes were determined by Northern blotting and hybridization with gene-specific oligonucleotide probes after lipopolysaccharide treatment of rats. Lipopolysaccharide caused the expected acute-phase response as judged by the increased expression of positive and decreased expression of negative acute-phase proteins. The messenger RNA (mRNA) expression of the major hepatic rat GST isozymes A1, A2, A3, M1, and M2 was decreased 50% to 90%. Total hepatic GST activity toward 1-chloro-2,4-dinitrobenzene was also significantly decreased. mRNA expression of gamma-glutamylcysteine synthetase (GCS) large subunit and catalase was reduced by approximately 60%. GCS enzyme activity was also decreased, resulting in a 35% decrease in the hepatic content of reduced glutathione 4 days after lipopolysaccharide challenge. Mn-Superoxide dismutase expression was increased 13-fold, and thioredoxin level was elevated 3-fold after lipopolysaccharide challenge. The expression of all parameters determined returned to near control levels 7 days after treatment. Together, these data show that GSTs and GCS are negative acute-phase proteins and that decreased GCS activity results in a decrease in hepatic glutathione content. Thus, in addition to the phase I drug-metabolizing enzymes known to be decreased during the acute-phase response, some phase II enzymes involved in the elimination of xenobiotics and carcinogens are also decreased.
Risk of oral infection with bovine spongiform encephalopathy agent in primates
Authors: Corinne Ida Lasmézas, Emmanuel Comoy, Stephen Hawkins, Christian Herzog, Franck Mouthon, Timm Konold, Frédéric Auvré, Evelyne Correia, Nathalie Lescoutra-Etchegaray, Nicole Salès, Gerald Wells, Paul Brown, Jean-Philippe Deslys
Journal: The Lancet (2005)
How to be a GP locum.
Authors: D. A. Stocks
Journal: BMJ (1989)

Our senior partner has collapsed.Can you take over, starting this evening?"Jobs are rarely arranged at such short notice, but when a doctor becomes "established" as a general practitioner locum the phone never stops ringing.Always keep a diary or calendar by the phone and pencil in the dates there and then.Have nothing to do with scraps of paper or the backs of envelopes: they float away into drawers and dustbins with important information lost forever.Double booking is the cardinal sin. Becoming knownHow does word get round that you are available for work?Try these methods:Write to local general practitioners -I suggest sending a formal letter giving the dates when you are free.Enclose a copy of your curriculum vitae.A job might not be forthcoming but general
Time to go to get your hat
Authors: R. Quinton, S. H S Pearce, J. L Sievenpiper
Journal: BMJ (2008)

Cooper (doi 10.1136/bmj.a1126) finds Menzies’s observations more compelling than Shuster’s, as he expects most dermatologists in the world would.1 2 He is also concerned about Shuster’s article translating into an epidemic of non-melanoma skin cancer. Finally, he professes to be unaware of evidence that ultraviolet light may protect against some …
Sullivan Calls for State Ban on Cigarette Vending Machines
Authors: M. Kreuter
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article Sullivan Calls for State Ban on Cigarette Vending Machines Get access Matthew Kreuter Matthew Kreuter Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 14, 18 July 1990, Page 1179, https://doi.org/10.1093/jnci/82.14.1179 Published: 18 July 1990
Renal Effects of Dental Amalgam in Children: The New England Children’s Amalgam Trial
Authors: Lars Barregard, Felicia Trachtenberg, Sonja McKinlay
Journal: Environmental Health Perspectives (2007)

Mercury is nephrotoxic and dental amalgam is a source of mercury exposure.Children 6-10 years of age (n = 534) with two or more posterior teeth with caries but no prior amalgam restorations, were randomized to one of two treatments--amalgam or resin composite (white fillings)--used for caries treatment during 5 years of follow-up. The primary outcome was change in IQ, but important secondary outcomes were effects on markers of glomerular and tubular kidney function: urinary excretion of albumin, alpha-1-microglobulin (A1M), gamma-glutamyl transpeptidase (gamma-GT), and N-acetyl-beta-d-glucosaminidase (NAG). These markers were measured on several occasions during the trial, together with urinary mercury and covariates. We evaluated the results using repeated-measures analyses.There were no significant differences between treatment groups in average levels of renal biomarkers, nor significant effects of number of dental amalgams on these markers. There was, however, a significantly increased prevalence of microalbuminuria (MA) among children in the amalgam group in years 3-5 (adjusted odds ratio 1.8; 95% confidence interval, 1.1-2.9). Most of these cases are likely to be temporary MA, but 10 children in the amalgam group had MA in both years 3 and 5, versus 2 children in the composite group (p = 0.04). There were no differences in the occurrence of high levels of renal tubular markers (A1M, gamma-GT, or NAG).The increase in MA may be a random finding, but should be tested further. The results did not support recent findings in an observational study of an effect of low-level mercury on tubular biomarkers in children.
Abstract 3805: Identification of a distinctive pattern of lipid composition in Irvalec® resistant tumor cells
Authors: José M. Molina-Guijarro, Victoria Moneo, Juan F. Martínez-Leal, Rogelio Fernández-Rodríguez, Carmen Cuevas, Luis F. Garcia-Fernandez, Carlos M. Galmarini
Journal: Cancer Research (2012)

Abstract Irvalec® is a marine derived synthetic depsipeptide showing cytotoxic activity against a wide diversity of tumor cells both in vitro and in vivo. The compound is currently undergoing Phase II clinical studies in patients with solid tumors. The existing data on the mechanism of action of Irvalec® indicate that the compound inserts and self-organize in the plasma membrane of tumor cells, rapidly inducing loss of membrane integrity and cell permeabilization, giving rise to a fast and dramatic necrotic death. By continuous exposure of human colon carcinoma HCT-116 cells to stepwise increasing concentratrions of Irvalec®, a resistant subclone of the cell line was established, named HCT-116-Irv. In dose-response cytotoxicity assays, HCT-116-Irv cells showed a GI50 value &amp;gt;50 μM, representing a specific resistance index to the compound greater than 10.8 as compared to their wt counterpart. The resistant cells did not show any of the morphological and physiological responses to Irvalec® observed in parental cells and no overexpression of Pgp efflux pump or significant cross-resistance to other antitumoral drugs was detected. Due to the presumably direct effect of Irvalec® on the cell membrane, we searched for possible changes in the lipid composition of the resistant cells, acquired during the process of resistance development. After fractionation of the lipid extracts using thin layer cromatography (TLC), two differential fractions, that were completely absent in the resistant cells as compared to wt cells, were identified and purified. Interestingly, one of these fractions, named F4, was found to be able to interact with a biotinilated derivative of Irvalec®, using a standard overlay assay. These results suggested that the lipid composition could be directly related to the sensitivity of tumor cells to Irvalec®. Efforts are now focused on the chemical characterization of the selected lipid fraction and its putative biological role mediating the cytotoxic response to Irvalec®. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3805. doi:1538-7445.AM2012-3805
Former chair of RCGP will head government's "listening" panel on NHS reforms
Authors: Z. Kmietowicz
Journal: BMJ (2011)

Steve Field, a GP and former chairman of the Royal College of General Practitioners, will chair the government’s new “NHS Future Forum,” which is intended to gather together the opinions of patients, staff, and others on how the reforms planned for the English NHS can be carried forward.

Prime Minister David Cameron, together with his deputy and health secretary, launched a “listening exercise” on Wednesday (6 April) to try to silence critics and come to some consensus about how the NHS needed to be changed.

On Monday the health secretary for England, Andrew Lansley, made a statement in the House of Commons conceding that some of the concerns raised about the Health and Social Care Bill were genuine and that he wanted to pause and listen to objections to his plans ( BMJ 2011;342:d2216, doi:10.1136/bmj.d2216). The bill, which has passed the committee stage, is awaiting its third …
Giant Coronary Artery Aneurysm
Authors: Samuel Zoneraich
Journal: JAMA (1975)

A HIGH-PITCHED middiastolic murmur arising from a diseased coronary artery<sup>1,2</sup>is an important sign in detecting structural and hemodynamic changes in the coronary circulation. We report a large aneurysm of the coronary artery that occurred as a sizable bulge of the left border of the cardiac silhouette and gave rise to a high-pitched mid-late diastolic murmur. <h3>Report of a Case</h3> A 78-year-old man was hospitalized in December 1973 because of shortness of breath and syncopal attacks. For many years he complained of mild angina. On physical examination, a high-pitched middiastolic murmur was heard in a strictly localized area in the third left intercostal space, outside the left sternal border. A faint bruit was heard over the left femoral artery. The electrocardiogram suggested an old anteroseptal wall myocardial infarction. X-ray films of the chest showed a bulging area (Fig 1) in the midportion of the left cardiac border and infiltrates
Reduction in Urinary Arsenic Levels in Response to Arsenic Mitigation Efforts in Araihazar, Bangladesh
Authors: Yu Chen, Alexander van Geen, Joseph H. Graziano, Alexander Pfaff, Malgosia Madajewicz, Faruque Parvez, A.Z.M. Iftekhar Hussain, Vesna Slavkovich, Tariqul Islam, Habibul Ahsan
Journal: Environmental Health Perspectives (2007)

There is a need to identify and evaluate an effective mitigation program for arsenic exposure from drinking water in Bangladesh.We evaluated the effectiveness of a multifaceted mitigation program to reduce As exposure among 11,746 individuals in a prospective cohort study initiated in 2000 in Araihazar, Bangladesh, by interviewing participants and measuring changes in urinary As levels.The interventions included a) person-to-person reporting of well test results and health education; b) well labeling and village-level health education; and c) installations of 50 deep, low-As community wells in villages with the highest As exposure.Two years after these interventions, 58% of the 6,512 participants with unsafe wells (As >/=50 microg) at baseline had responded by switching to other wells. Well labeling and village-level health education was positively related to switching to safe wells (As < 50 mug/L) among participants with unsafe wells [rate ratio (RR) = 1.84; 95% confidence interval (CI), 1.60-2.11] and inversely related to any well switching among those with safe wells (RR = 0.80; 95% CI, 0.66-0.98). The urinary As level in participants who switched to a well identified as safe (< 50 microg As/L) dropped from an average of 375 microg As/g creatinine to 200 microg As/g creatinine, a 46% reduction toward the average urinary As content of 136 microg As/g creatinine for participants that used safe wells throughout. Urinary As reduction was positively related to educational attainment, body mass index, never-smoking, absence of skin lesions, and time since switching (p for trend < 0.05).Our study shows that testing of wells and informing households of the consequences of As exposure, combined with installation of deep community wells where most needed, can effectively address the continuing public health emergency from arsenic in drinking water in Bangladesh.
Transparency: a modern essential
Authors: Richard Smith
Journal: BMJ (2004)

“What isn't transparent is assumed to be biased, incompetent, or corrupt until proved otherwise.” This sentence “came to me” in some way. I might have dreamt it (I have strange dreams), composed it during a discussion, or even heard it said by somebody else. Usually when I use the sentence—which is very often—I precede it with “Whether you like it or not…” The sentence is much less a judgment of how things should be and much more an observation of how they are.

Did the British prime minister have his baby son given the measles, mumps, and rubella (MMR) vaccine? …
THE LABYRINTHINE TESTS IN CEREBELLAR DIAGNOSIS
Authors: LAURENCE SELLING
Journal: JAMA (1923)

Barany's labyrinthine studies, initiated in the years 1907-1909, and followed up in this country more particularly by the work of Jones and Fisher, have stimulated our interest in the borderland that lies between the fields of neurology and otology. They have led to a more careful analysis of vertigo and nystagmus, symptoms common to the two fields; and in past pointing, have introduced an additional method of studying cerebellar disturbances.  The field of usefulness for the labyrinthine tests is clearly defined by the anatomic limits of the labyrinthine pathways, and can be deduced from those limits. It includes: (1) the labyrinth and the vestibular nerves; (2) the brain stem, especially the upper medulla and pons; (3) the cerebellum—the end organ for the labyrinthine impulses, and (4) indirectly, may give some information regarding lesions of the cerebrum itself.  In a general way, study of the labyrinth and the vestibular nerve, and