tbuckley/cabot-search huggingface dataset:
Hemoglobin Synthesis in Hemorrhagic Anemia
Authors: Henry Brown
Journal: JAMA (1962)

STUDIES have been carried out to determine whether globin peptides might be more efficient for synthesis of hemoglobin in hemorrhagic anemia than equivalent amounts of free amino acids. In preliminary experiments it was shown that both globin peptides and free amino acids were well utilized by rats, but there was evidence that globin peptides were better used in hemoglobin synthesis.  The present studies have been directed toward the determination of the extent of incorporation into hemoglobin of isotopically labeled free amino acids and peptides derived from globin. The possible direct incorporation of small peptides into protein units is a basic problem that may be important not only in hemoglobin formation, but also in the synthesis of many proteins.  Materials and Methods Female white rats weighing 200 gm. were bled an amount equal to half their original blood volumes by cardiac puncture over a 2-day period. Following this they were injected
Better Surgery and Better Surgeons
Authors: Emery M. Porter
Journal: New England Journal of Medicine (1950)

IN PREPARING the subject for my presidential address I have done what I presume many of my predecessors have done. I have re-read the addresses of former presidents in order to select a new topic, a topic that, according to the spirit of our constitution, should be chosen "for the purpose of promoting the science of surgery and kindred arts and sciences and the welfare of the profession of surgery in New England."My experience leads me to suggest that some of the older, and all of the more recent, members of the Society review the past volumes of the . . .
Could one in ten members of the public possibly have anxiety and depression due to reflux? a snapshot of 348 'healthy' volunteers
Authors: S. M. Barratt, J. S. Leeds, D. S. Sanders
Journal: Gut (2011)

<h3>Introduction</h3> This study aimed to chart the prevalence and character of reflux symptoms in members of the public accompanying family and friends to a large medical out-patient department and determine how such symptoms are associated with quality of life (QoL), and the likelihood of anxiety and depression. <h3>Methods</h3> 348 non-health seeking members of the public (self-identifying as ‘healthy9) (13% 18–25 years, 9% 26–35 years, 12% 36–45 years, 19% 46–55 years, 21% 56–65 years, 26% &gt;66 years) of which 36% were male completed a reflux symptom screen. This included the type (heartburn, regurgitation, retrosternal pain, belching, dysphagia), frequency (&lt;2 days/week, 3–5 days/week, &gt;5 days/week) and severity (mild, moderate, severe) of reflux symptoms in the previous twenty-eight days. QoL was measured by the Short-Form 36-Item Health Survey (SF-36) and psychological wellbeing by The Hospital Anxiety and Depression Scale (HADS). <h3>Results</h3> Age and sex were not confounding factors. 50% (n=176) were reflux symptom free. 35% (n=124) reported heartburn, 8% (n=30) regurgitation, 19% (n=69) belching, 4% (n=17) dysphagia and 11% (n=41) retrosternal pain. 33% (n=114) reported mild reflux, 13% (n=45) moderate and 3% (n=13) severe reflux. 34% (n=121) experienced reflux &lt;2 days/week, 10% (n=36) 3–5 days/week and 5% (n=19) &gt;5 days/week. Stepwise reductions in the SF-36 subscales of general health, physical functioning, bodily pain and role-physical were associated with increasing reflux severity (p=0.001). Moderate reflux was associated with possible anxiety (HADS-A score &gt;8, p=&lt;0.0001) and possible depression (HADS-D score &gt;8, p=0.002). <h3>Conclusion</h3> Based on our findings 50% of self-identifying healthy individuals experience reflux symptoms, most likely heartburn, in a 28 day period. In the majority, these symptoms are of mild intensity and relatively infrequent. However, we have observed that increasing reflux severity is associated with reductions in QoL. Furthermore, over one in ten participants report moderate reflux, which is associated with possible and anxiety and depression when rated by a popular, valid and reliable instrument. Applied to a wider population our findings suggest that one in ten members of the public possibly experience psychological distress as a consequence of untreated reflux.
Paying to see a specialist: welcome to the two tier NHS
Authors: M. McCartney
Journal: BMJ (2014)

The healthcare company Better as.one has a vision: “Your dream NHS, made a reality.”1 Sadly it doesn’t include George Clooney; it’s a new scheme in which people pay a few hundred pounds a year for insurance that entitles them to one or two “free” specialist consultations a year. The website says that no one is turned down and that “as.one is responsible for your medical welfare from diagnosis through to full recovery. We arrange all tests, procedures and treatments to ensure your complete peace of mind.”

With “no waiting …
Propensity Scores for Rare Outcomes and Common Treatments
Authors: W T. Longstreth, Carol E. Fahrenbruch, Thomas D. Koepsell
Journal: Annals of Internal Medicine (2003)

Letters15 July 2003Propensity Scores for Rare Outcomes and Common TreatmentsW T. Longstreth Jr, MD, MPH, Carol E. Fahrenbruch, MSPH, and Thomas D. Koepsell, MD, MPHW T. Longstreth Jr, MD, MPHHarborview Medical Center; Seattle, WA 98104 (Longstreth Jr., Fahrenbruch)University of Washington; Seattle, WA 98195 (Koepsell), Carol E. Fahrenbruch, MSPHHarborview Medical Center; Seattle, WA 98104 (Longstreth Jr., Fahrenbruch)University of Washington; Seattle, WA 98195 (Koepsell), and Thomas D. Koepsell, MD, MPHHarborview Medical Center; Seattle, WA 98104 (Longstreth Jr., Fahrenbruch)University of Washington; Seattle, WA 98195 (Koepsell)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-2-200307150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We describe another use for propensity scores in addition to those reviewed by Braitman and Rosenbaum (1). In a randomized, double-blind clinical trial, some of us were faced with imbalances in baseline variables (2). We sought to use risk differences to summarize treatment effects but needed a method to adjust for the baseline differences. Typically, a multivariable method such as logistic regression or Cox proportional-hazards regression is used with prognostic factors and treatment status predicting the outcome of interest. Such an approach typically assumes a constant odds ratio (if logistic regression) or a constant hazard ratio (if ...References1. Braitman LE, Rosenbaum PR. Rare outcomes, common treatments: analytic strategies using propensity scores [Editorial]. Ann Intern Med. 2002;137:693-5. [PMID: 12379071] LinkGoogle Scholar2. Longstreth WT, Fahrenbruch CE, Olsufka M, Walsh TR, Copass MK, Cobb LA. Randomized clinical trial of magnesium, diazepam, or both after out-of-hospital cardiac arrest. Neurology. 2002;59:506-14. [PMID: 12196641] CrossrefMedlineGoogle Scholar3. Fleiss JL. Statistical Methods for Rates and Proportions. 2nd ed. New York: J Wiley; 1981:160-5. Google Scholar Author, Article, and Disclosure InformationAuthors: W T. LongstrethJr, MD, MPH; Carol E. Fahrenbruch, MSPH; Thomas D. Koepsell, MD, MPHAffiliations: Harborview Medical Center; Seattle, WA 98104 (Longstreth Jr., Fahrenbruch)University of Washington; Seattle, WA 98195 (Koepsell) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRare Outcomes, Common Treatments: Analytic Strategies Using Propensity Scores Leonard E. Braitman and Paul R. Rosenbaum Metrics Cited byDoes recombinant activated protein C work in patients with severe sepsis?*Cocaine, Myocardial Infarction, and β-Blockers: Time to Rethink the Equation? 15 July 2003Volume 139, Issue 2Page: 152-153KeywordsClinical trialsHazard ratioOdds ratioRandomized trialsRisk management ePublished: 15 July 2003 Issue Published: 15 July 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Comparison of the Effect of Sildenafil and Apomorphine SL on Nocturnal Erections in Healthy Volunteers: A Placebo-Controlled Study
Authors: Andrea Salonia, Luigi Barbieri, Juza Chen, Alberto Briganti, Federico Dehò, Richard Naspro, Ubaldo Del Carro, Kostantinos Rokkas, Vincenzo Scattoni, Patrizio Rigatti, Francesco Montorsi
Journal: European Urology (2005)
STUDIES ON AN UNCOMPLICATED CORYZA OF THE DOMESTIC FOWL
Authors: John B. Nelson
Journal: The Journal of Experimental Medicine (1936)

A strain of fowl coryza of slow onset was carried through 20 successive passages in susceptible birds over a period of approximately 19 months. During this period it retained its initial characteristics as did also a coryza of rapid onset which was similarly maintained. 88 per cent of 72 birds infected with the coryza of slow onset showed a nasal discharge after an incubation period of 12 days or more; the actual limits being 9 to 31 days. 98 per cent of 54 birds infected with the coryza of rapid onset showed a nasal discharge on the 1st or 2nd day after injection. The duration of both coryzas was prolonged. Bacteriological examination indicated that Hemophilus gallinarum which is invariably present in the nasal exudate of birds infected with the coryza of rapid onset is not associated with the coryza of slow onset.
Dobutamine and salbutamol in cardiogenic shock
Authors: B Silke, G Nelson
Journal: BMJ (1982)

Elderly implies that the answers which may be produced by this large multinational, hospital-based trial will be no more clearcut than the ones we reported from our small single-centre trial.If so, we share the hopes of Professor W S Peart and his colleagues (p 1397) that a further "trial of antihypertensive treat- ment in people aged 65-74 may be mounted attempting to determine the balance between the benefits of pressure reduction and any adverse effects."
Fluctuating hemiparesis in a young man.
Authors: R Wray
Journal: BMJ (1969)

MEDBRITJSHonly one of the three cases with the deficiency developed anaemia in the course of the typhoid.Psychosis is another recognized complication of typhoid which appeared in these cases, but it usually occurs in the acute febrile stage, and indeed may be the presenting symptom.The late onset of psychosis in typhoid is, however, well known to local psychiatrists (Singer, personal communication).
P224Relationship between high altitude de-adaptation and acute high altitude response, cardiac function injury after returning to lower altitude population exposure to high altitude environment
Authors: Q Zhou
Journal: Cardiovascular Research (2014)

Objective: to assess the relationship between high altitude de-adaptation response (HADAR) and acute high altitude response (AHAR), cardiac function injury. Methods: Cardiac function indicators were assessed for 96 men (18 - 35 years old) dep- loyed into a high altitude (3700 - 4800 m) envi- ronment requiring intense physical activity. The subjects were divided into 3 groups based on AHAR at high altitude: severe AHAR (n = 24), mild to moderate AHAR (Group B, n = 47) and non-AHAR (Group C, 25); and based on HADAR: severe HADAR (Group E, n = 19), mild to mod- erate HADAR (Group F, n = 40) and non-HADAR (Group G, n = 37) after return to lower altitude (1,500 m). Results: Cardiac function indicators were measured after 50 days at high altitude and at 12 h, 15 days, and 30 days after return to lower al- titude. Controls were 50 healthy volunteers (Group D, n = 50) at 1500 m. Significant differ- ences were observed in cardiac function indi- cators among groups A, B, C, and D. AHAR score was positively correlated with HADAR score (r = 0.863, P < 0.001). Significant differ- ences were also observed in cardiac function indicators among groups D, E, F, and G, 12 h and 15 days after return to lower altitude. There were no significant differences in cardiac function indicators among the groups, 30 days after re- turn to lower altitude, compared to group D. Conclusion: The results indicated that the severity of HADAR is associated with the severity of AHAR and cardiac injury, and prolonged recovery.
Early and Late Effects of Clopidogrel in Patients With Acute Coronary Syndromes
Authors: Salim Yusuf, Shamir R. Mehta, Feng Zhao, Bernard J. Gersh, Patrick J. Commerford, Mel Blumenthal, Andrzej Budaj, Thomas Wittlinger, Keith A.A. Fox
Journal: Circulation (2003)

The risk of ischemic events is high, both early and late after acute coronary syndromes (ACS). We examine the benefits and risks associated with the use of adding clopidogrel to aspirin within the first 30 days and later (31 days to 12 months) in 12 562 patients with ACS. A total of 12 562 ACS patients were randomized to receive clopidogrel (300 mg initially followed by 75 mg/d) or placebo for 3 to 12 months. The proportion of patients experiencing cardiovascular death, myocardial infarction, or strokes (primary outcome) at 30 days was 5.4% in the placebo group and 4.3% in the active group (relative risk 0.79, 95% CI 0.67 to 0.92). Beyond 30 days, the corresponding rates were 6.3% versus 5.2% (relative risk 0.82, 95% CI 0.70 to 0.95). There was no significant excess in life-threatening bleeds in each period (0.97% versus 1.28%, relative risk 1.32, 95% CI 0.95 to 1.84 for 0 to 30 days; 0.83% versus 0.91%, relative risk 1.09, 95% CI 0.75 to 1.59 for 31 days to 12 months). Further subdivision of the early data indicates benefits within 24 hours with consistently lower rates of the primary outcome in combination with refractory or severe ischemia. Clopidogrel reduces the risk of ischemic vascular events, with the benefits emerging within 24 hours of initiation of treatment and continuing throughout the 12 months (mean 9 months) of the study.
Abstract 3391: Tie2 signaling regulates osteoclastogenesis and osteolytic bone invasion of breast cancer
Authors: Yongfen Min, Xiubao Ren, Charles Lin
Journal: Cancer Research (2010)

Abstract Breast to bone metastasis is a common occurrence in the majority of patients with advanced breast cancer. The resultant metastases are incurable, are associated with bone destruction and high rates of morbidity. Understanding the underlying mechanisms of how metastatic tumor cells induce bone destruction is critically important. We previously reported that Tie2, a receptor tyrosine kinase, is significantly increased in human breast cancer tissues compared to normal and benign breast tumors, and regulates tumor angiogenesis. In this study, we identify a new function of Tie2 in osteoclastogenesis and osteolytic bone invasion of breast cancer. Tie2 is present in hematopoietic stem/precursor cells. Genetic deletion of Tie2 or neutralization of Tie2 function using soluble Tie2 receptor impaired osteoclastogenesis in an embryonic stem (ES) cells differentiation assay. In contrast, deletion of Tie2 has no effect on osteoblastogenesis. As monocyte has the potential to become osteoclast and Tie2 is present in certain population of monocyte, we isolated Tie2+ and Tie2- monocyte. We observed a dramatic reduction of osteoclastogenesis in Tie2- monocyte compared to Tie2+ and total monocyte. These data together reveal a direct role of Tie2 signaling in osteoclast differentiation. Consistently, neutralization of Tie2 activity in vivo significantly inhibited osteolytic bone invasion and tumor growth in a mammary tumor model, which correlated with a significant reduction of osteoclast and tumor angiogenesis. Collectively, these findings identify Tie2 a therapeutic target for controlling not only tumor angiogenesis, but also osteolytic bone metastasis. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3391.
Intestinal apolipoprotein AI gene transcription is regulated by multiple distinct DNA elements and is synergistically activated by the orphan nuclear receptor, hepatocyte nuclear factor 4.
Authors: G S Ginsburg, J Ozer, S K Karathanasis
Journal: Journal of Clinical Investigation (1995)

We have used apolipoprotein genes to investigate the signal transduction mechanisms involved in the control of intestinal specific gene expression. The human apoAI, apoCIII, and apoAIV genes are tandemly organized within a 15-kb DNA segment and are expressed predominantly in the liver and intestine. Transient transfection of various human apoAI gene plasmid constructs into human hepatoma (HepG2) and colon carcinoma (Caco-2) cells showed that apoAI gene transcription is under the control of two separate and distinct cell-specific promoters. The region between nucleotides -192 and -41 is essential for expression in HepG2 cells, whereas the region from -595 to -192 is essential for expression in Caco-2 cells. A third 0.6 kb DNA fragment in the apoCIII gene promoter region, approximately 5 kb down-stream from the human apoAI gene, enhances transcription mediated by either of these two tissue-specific apoAI promoters. In Caco-2 cells, expression of the apoAI gene and activation by the distal enhancer required the presence of a nuclear hormone receptor response element (NHRRE) located in the -214 to -192 apoAI promoter region. Overexpression of the orphan receptor hepatocyte nuclear factor 4 (HNF-4), which binds to the NHRRE, dramatically stimulates apoAI gene expression in Caco-2 cells but not in HepG2 cells. Maximal stimulation of transcription by HNF-4 in Caco-2 cells required the presence of both the intestinal specific promoter, the NHRRE, and distal enhancer elements. Transactivation by HNF-4 thus appears to result from functional synergy between the NHRRE binding HNF-4 and distal DNA elements containing intestinal-specific DNA binding activities. The apoAI gene provides a model system to define the mechanism(s) governing intestinal cell specific gene regulation and the role of nuclear hormone receptors in the establishment and regulation of enterocytic gene transcription.
Inhaled Insulin Improves Glycemic Control When Substituted for or Added to Oral Combination Therapy in Type 2 Diabetes
Authors: Julio Rosenstock
Journal: Annals of Internal Medicine (2005)

Background: Patients with type 2 diabetes who do not achieve glycemic control with oral agent therapy eventually require insulin. Objective: To determine the effect on glycemic control of inhaled insulin alone or added to dual oral therapy (insulin secretagogue and sensitizer) after failure of dual oral therapy. Design: Open-label, randomized, controlled trial. Setting: 48 outpatient centers in the United States and Canada. Patients: 309 patients with type 2 diabetes, no clinically significant respiratory disease, and hemoglobin A1c level of 8% to 11% who were receiving dual oral therapy. Measurements: Primary end point was change in hemoglobin A1c level from baseline to 12 weeks. Secondary outcomes included hemoglobin A1c level less than 8% and less than 7%, hypoglycemia, weight, lipid levels, pulmonary function, insulin antibody binding, and adverse events. Intervention: Inhaled insulin (Exubera; Pfizer Inc. [New York, New York], sanofi-aventis Group [Paris, France], and Nektar Therapeutics [San Carlos, California]), titrated to blood glucose, administered alone (n = 104) or added to dual oral agents (n = 103) versus oral therapy alone (n = 99). Results: Reductions in hemoglobin A1c level were greater with inhaled insulin. Adjusted treatment group differences for inhaled insulin plus oral agents and inhaled insulin alone compared with continued oral agent therapy were −1.67 percentage points (95% CI, −1.90 to −1.44 percentage points; P < 0.001) and −1.18 percentage points (CI, −1.41 to −0.95 percentage point; P < 0.001), respectively. Hemoglobin A1c level less than 7% was achieved by 32% (inhaled insulin plus oral agents) and by 1% (oral agent therapy) of patients (adjusted odds ratio, 44.7 [CI, 6.0 to 335.2]). Hypoglycemia, mild weight gain, mild cough, and insulin antibodies were more frequent with inhaled insulin than with oral agent therapy alone. Pulmonary function was similar in all groups. Limitations: This study evaluated only patients with hemoglobin A1c levels of 8% to 11%, did not compare inhaled insulin with other insulins or oral therapy except a dual regimen of secretagogue and sensitizer, and lasted only 12 weeks. Conclusions: Inhaled insulin improved overall glycemic control and hemoglobin A1c level when added to or substituted for dual oral agent therapy with an insulin secretagogue and sensitizer. Consistent with other insulin therapies, hypoglycemia and mild weight gain occurred. Pulmonary function showed no between-group differences.
Rectal Cancer: Rectal Excision for Cancer: The Selection of Suitable Cases and the Prognosis
Authors: H. Cripps
Journal: BMJ (1892)

the present moment much is being written, both in England and abroad, concerning the parasitic origin of cancer, and as I have had opportunities of examining several cases lately, with reference to this parasitic origin, I wish to place the few following observations on record.The protozoa, which have been discovered in cancerous tumours, have been most carefully described by Dr.
Tokelau on Naboo
Authors: S. A Norton
Journal: BMJ (2000)

Tinea imbricata, a superficial fungal infection of man, has an ornate appearance composed of concentric circles and polycyclic or serpiginous scaly plaques (fig 1). The condition is common in several humid tropical regions, especially in parts of Polynesia and Melanesia. It is also reported occasionally in the Amazon basin and other tropical areas in both hemispheres. 1 2 The precise distribution of tinea imbricata, however, has been poorly defined ever since the disease was named by Sir Patrick Manson, the father of tropical medicine. 3 4



Fig 1. 
“We discover a pattern … as if the disease had advanced in parallel and concentric lines from a great many different centres”—Patrick Manson4



I report the possible presence of tinea imbricata outside its previously known geographic and taxonomic distribution. Several Gungan inhabitants of Naboo, a planet of the Galactic Republic depicted in Star Wars Episode 1: The Phantom Menace , have skin with the distinctive annular and polycyclic pattern of tinea imbricata. Jar Jar Binks, a Gungan who figures prominently in this movie, shows this eruption in figure 2. Manson wrote of the infection, “Again, tinea imbricata, if it has been in existence any length of time, involves a very large surface, as an entire limb, or side of the trunk, or oftener still, if not checked, nearly the whole surface of the body … As advancing rings spread, their regularity is modified by the shape of the parts, the nature of the skin they travel over, and by encountering other systems of rings.” …