tbuckley/cabot-search huggingface dataset:
Quality of Life in Patients With Supraventricular Arrhythmia
Authors: Mark A. Hlatky, William K. Vaughn
Journal: Circulation (1996)

Physicians have always sought to relieve the suffering of patients and, if possible, to extend their lives. These goals may be expressed in modern terminology as improving the quality of life and reducing mortality. Although death is a definitive end point that is relatively simple to assess, quality of life is much more difficult to define and measure. Consequently, quality of life has less often been included as an outcome in clinical research, and clinicians have had little solid information about the effect of treatment on quality of life. Fortunately, more studies now include quality of life assessments, so clinicians will soon have a more complete picture of the outcomes of care.

Quality of life measurement is a relatively new field in medicine1 2 3 4 that is derived from two broad schools of thought in the social sciences, which have led to two distinct approaches to measurement. Researchers grounded in the discipline of psychology have emphasized the multiple dimensions of quality of life and developed instruments that assess each dimension separately.3 5 The scales originally developed at the RAND Corporation for use in the Medical Outcomes Study exemplify this approach.6 An abbreviated version of this instrument, known as the Short Form-36 (SF-36), contains 36 items that are scored in scales assessing physical limitations, emotional health, role functioning, pain, and general health. In contrast, researchers grounded in the disciplines of economics and decision analysis have emphasized the synthesis of quality of life assessment into a single summary measure corresponding to the concept of “utility,” which incorporates both the patient's rating of his or her state of health and how the patient values that state of health.7 Health utility has been measured with a variety …
Indications and limitations of endoscopic ultrasound elastography for evaluation of focal pancreatic lesions
Authors: T. Hirche, A. Ignee, A. Barreiros, D. Schreiber-Dietrich, S. Jungblut, M. Ott, H. Hirche, C. Dietrich
Journal: Endoscopy (2008)

See also: Commentaire de travail de T. O. Hirche et al., pp. 910Endoscopy 2008; 40(11): 1058-1058DOI: 10.1055/s-0032-1306887
Inactivation of the <i>Wwox</i> Gene Accelerates Forestomach Tumor Progression <i>In vivo</i>
Authors: Rami I. Aqeilan, John P. Hagan, Haifa A. Aqeilan, Flavia Pichiorri, Louise Y.Y. Fong, Carlo M. Croce
Journal: Cancer Research (2007)

Abstract The WWOX gene encodes a tumor suppressor spanning the second most common human fragile site, FRA16D. Targeted deletion of the Wwox gene in mice led to an increased incidence of spontaneous and ethyl nitrosourea–induced tumors. In humans, loss of heterozygosity and reduced or loss of WWOX expression has been reported in esophageal squamous cell cancers (SCC). In the present study, we examined whether inactivation of the Wwox gene might lead to enhanced esophageal/forestomach tumorigenesis induced by N-nitrosomethylbenzylamine. Wwox+/− and Wwox+/+ mice were treated with six intragastric doses of N-nitrosomethylbenzylamine and observed for 15 subsequent weeks. Ninety-six percent (25 of 26) of Wwox+/− mice versus 29% (10 of 34) of Wwox+/+ mice developed forestomach tumors (P = 1.3 × 10−7). The number of tumors per forestomach was significantly greater in Wwox+/− than in Wwox+/+ mice (3.2 ± 0.34 versus 0.47 ± 0.17; P &amp;lt; 0.0001). In addition, 27% of Wwox+/− mice had invasive SCC in the forestomach, as compared with 0% of wild-type controls (P = 0.002). Intriguingly, forestomachs from Wwox+/− mice displayed moderately strong Wwox protein staining in the near-normal epithelium, but weak and diffuse staining in SCC in the same tissue section, a result suggesting that Wwox was haploinsufficient for the initiation of tumor development. Our findings provide the first in vivo evidence of the tumor suppressor function of WWOX in forestomach/esophageal carcinogenesis and suggest that inactivation of one allele of WWOX accelerates the predisposition of normal cells to malignant transformation. [Cancer Res 2007;67(12):5606– 10]
Method of Physician Payment and Hospital Length of Stay
Authors: Richard H. Egdahl, Cynthia H. Taft, Kenneth J. Linde
Journal: New England Journal of Medicine (1977)

Hospitalization accounts for a major share of health-care costs. One of the principal attractions of the Kaiser-type health-maintenance organization (HMO), which employs salaried physicians, is its potential for reducing the amount of hospital care.1 Advocates of this kind of closed-panel HMO suggest that one reason for the decreased hospitalization is the removal of incentives for hospitalizing patients that exist in fee-for-service practice. These incentives are mostly economic, it is claimed, and derive from the way in which physicians are reimbursed under the usual health-insurance programs that cover hospital care but not the same services provided on an outpatient basis. An . . .
Cure of heterophobia by sexual surrogate therapy.
Authors: C Brewer
Journal: BMJ (1978)

Results of desmopressin urine concentration test at different ages Age group No of subjects Mean maximum (years) osmolality (mmol/kg) ± SD (A) 20-24 7 1044±73 (B) 25-29 3 983 ±48 (C) 30-34 3 983 ±152 (D) 35-39 6 935 ±82 (E) 40-44 8 894 ±95 (F) 45-49 3 926 ±143 (G) 50-54 8 873 ±142 (H) 55-59 5 909±91patients aged 40-59 (864 i 164 mmol/kg).Thus although all subjects achieved a concentration which we would regard as normal our results suggest that urine-concentrating ability diminishes with advancing age.We have found no evidence of diminished ability as a consequence of various non-renal diseases.
Comparative pharmacokinetics of zolpidem tartrate in five ethnic populations of China
Authors: Tao Guo, Guifu Mao, Longshan Zhao, Dongya Xia, Lu Yang
Journal: Acta Pharmaceutica Sinica B (2014)

The objective of this study was to evaluate the difference in the pharmacokinetics of zolpidem tatrate in subjects from five Chinese ethnicities (Han, Mongolian, Uigur, Korean and Hui). Healthy subjects (10 Hans, 10 Mongolians, 10 Uigurs, 10 Koreans and 9 Huis) were recruited and each received a 10 mg tablet-dose of zolpidem tatrate. A total of 12 plasma samples were collected over a 12 h period after administration. The concentrations of zolpidem in plasma were determined by an HPLC-FLU method, after which the pharmacokinetic parameters were determined using DAS 2.0 software and analyzed by SPSS 16.0 software. After normalization by weight, no differences were noted in the pharmacokinetic parameters of zolpidem tatrate among the five ethnic groups (P>0.05). However, there were statistically significant differences between males and females for the pharmacokinetic parameters (P<0.05). The metabolism of zolpidem tatrate in males was faster than in females. Results indicate that ethnicity has no significant impact on the pharmacokinetics of zolpidem tatrate after a single oral dose in healthy Chinese subjects. However, an effect of gender on the pharmacokinetics of zolpidem tatrate can be noted.
The Distress of Internship
Authors: Jack D. McCue
Journal: New England Journal of Medicine (1985)

The ultimate effects of residency training on the personal and professional lives of physicians are largely unknown. We do not know, for example, whether young physicians are influenced by their training to be compassionate and concerned or instead to learn behaviors that insulate them emotionally from their patients' needs. We do know, however, that during the years of residency training a young physician must face, simultaneously, many intense and stressful experiences,1 2 3 which are likely to change future behaviors and his or her self-image as a physician. The intern must, for the first time, assume responsibility for difficult and emotionally charged . . .
Screening tests for autoimmune-related immunotoxicity.
Authors: R Pieters, R Albers
Journal: Environmental Health Perspectives (1999)

A large number of chemicals induce or exacerbate autoimmune-like diseases in man. Because of the complexity of processes involved, these adverse effects are often if not always missed in standard toxicity testing. To date no validated and generally applicable predictive animal model exists and only a few chemicals have actually been shown to induce adverse autoimmune effects in certain animals. The popliteal lymph node assay (PLNA) is a very promising animal test to (pre)screen for systemic immunosensitizing, including autoimmunogenic potential. This review describes the essentials of the various PLNAs against the background of current understanding of chemically induced systemic immunostimulation. The most simple primary PLNA measures enlargement of the popliteal lymph node 6-8 days after subcutaneous injection of a chemical into the footpad. The primary PLNA can distinguish between immunostimulating (both sensitizers and irritants) and innocent chemicals but does not assess the involvement of T cells or immunosensitization. For this, but also for elucidation of relevant mechanisms, detection of anamnestic responses in secondary PLNAs or responses to reporter antigens in the modified PLNA are suitable. To date over 100 compounds (drugs and environmental pollutants) have been tested, and results show a good correlation with reported immunostimulating (both autoimmunogenic and allergic) potential. Importantly, no false-negative chemicals were detected if metabolism was considered. The various types of the PLNA, but in particular the secondary and modified PLNAs, await extensive validation before they can be recommended as a standard test for autoimmunogenic potential.
Doctors — Supply and Demand
Authors: John Lister
Journal: New England Journal of Medicine (1954)

IN an address in 1895 at the opening of the new building of the Medical Faculty in McGill University (at that time only of college status), Sir William Osler remarked that it was no vain fancy that before the twentieth century was very old there might be effective vaccines against many of the contagious diseases. He went on to tell how a shrewd old fellow in contemplating this prophecy had said to him "Yes, many diseases are less frequent, others have disappeared, but new ones are always cropping up and I notice that there is not only no decrease but . . .
Scintiscan Demonstration of Double Thyroid
Authors: ASEEM BHATNAGAR, MAHESMWAR SAHU, L. RAVISHANKAR, CHANDRAMOHAN KHANNA, NASKE LAL SONI
Journal: Clinical Nuclear Medicine (1997)

Multiple ectopia of the thyroid resulting from aberrant thyroid descent is rare. The authors present a case of a young woman, initially euthyroid, who developed nodules at the base of the tongue and suprahyoid area during puberty. These were later shown to be functioning ectopic thyroid tissue on a Tc-99m pertechnetate scan. She then developed frank hypothyroidism after a few years. The sequence of events suggests adequate thyroid function during childhood, conpensatory hypertrophy during young adulthood, ultimately going into decompensation.
IRREGULAR OR ATYPICAL GOUT—HOW SHALL WE KNOW IT?
Authors: JAMES TYSON
Journal: JAMA (1895)

It has always seemed to me that if the department of medicine as contrasted with surgery is to make advances, it must be by the application of accurate methods. This is equally true of nomenclature as of clinical investigation. In no subject in medicine has there been greater looseness in the application of terms than in that of gout, and in some recent studies of this interesting subject I have been so impressed with this fact that it occurred to me it might be worth while to attempt to formulate, briefly, criteria by which to judge of the presence of gout in its more irregular forms, with regard to which alone as contrasted with regular or typical gout the confusion really exists. While many theories have been advanced and many experiments performed with a view to explaining the method of its accumulation, all pathologists agree that the fundamental condition of
Book Review Human Behavior, Learning, and the Developing Brain: Typical Development Edited by Donna Coch, Kurt W. Fischer, and Geraldine Dawson. 412 pp., illustrated. New York, Guilford Press, 2007. $50. 978-1-59385-136-1 Human Behavior, Learning, and the Developing Brain: Atypical Development Edited by Donna Coch, Geraldine Dawson, and Kurt W. Fischer. 378 pp., illustrated. New York, Guilford Press, 2007. $50. 978-1-59385-137-8
Authors: Gerald S. Golden
Journal: New England Journal of Medicine (2007)
Systematic evaluation of coding variation identifies a candidate causal variant in TM6SF2 influencing total cholesterol and myocardial infarction risk
Authors: Oddgeir L Holmen, He Zhang, Yanbo Fan, Daniel H Hovelson, Ellen M Schmidt, Wei Zhou, Yanhong Guo, Ji Zhang, Arnulf Langhammer, Maja-Lisa Løchen, Santhi K Ganesh, Lars Vatten, Frank Skorpen, Håvard Dalen, Jifeng Zhang, Subramaniam Pennathur, Jin Chen, Carl Platou, Ellisiv B Mathiesen, Tom Wilsgaard, Inger Njølstad, Michael Boehnke, Y Eugene Chen, Gonçalo R Abecasis, Kristian Hveem, Cristen J Willer
Journal: Nature Genetics (2014)
Relation of Obesity to Circulating B-Type Natriuretic Peptide Concentrations in Blacks
Authors: Ervin R. Fox, Solomon K. Musani, Aurelian Bidulescu, Harsha S. Nagarajarao, Tandaw E. Samdarshi, Samson Y. Gebreab, Jung Hye Sung, Michael W. Steffes, Thomas J. Wang, Herman A. Taylor, Ramachandran S. Vasan
Journal: Circulation (2011)

Background— Lower plasma B-type natriuretic peptide (BNP) concentrations in obese individuals (“natriuretic handicap”) may play a role in the pathogenesis of obesity-related hypertension. Whether this phenomenon may contribute to hypertension in blacks is unknown. We tested the hypothesis that body mass index is inversely related to BNP concentrations in blacks. Methods and Results— We examined the relation of plasma BNP to body mass index in 3742 Jackson Heart Study participants (mean age, 55±13; 62% women) without heart failure using multivariable linear and logistic regression, adjusting for clinical and echocardiographic covariates. The multivariable-adjusted mean BNP was higher for lean participants compared with obese participants in both normotensive ( P &lt;0.0001) and hypertensive ( P &lt;0.0012) groups. In sex-specific analyses, the adjusted mean BNP was higher in lean hypertensive individuals compared with obese hypertensive individuals for both men (20.5 versus 10.9 pg/mL, respectively; P =0.0009) and women (20.0 versus 13.8 pg/mL; P =0.011). The differences between lean and obese participants were more pronounced in normotensive participants (men, 9.0 versus 4.4 pg/mL; P &lt;0.0001; women, 12.8 versus 8.4 pg/mL; P =0.0005). For both hypertensive and normotensive individuals in the pooled sample, multivariable-adjusted BNP was significantly related to both continuous body mass index ( P &lt;0.05 and P &lt;0.0001, respectively) and categorical body mass index ( P for trend &lt;0.006 and &lt;0.0001, respectively). Conclusion— Our cross-sectional study of a large community-based sample of blacks demonstrates that higher body mass index is associated with lower circulating BNP concentrations, thereby extending the concept of a natriuretic handicap in obese individuals observed in non-Hispanic whites to this high-risk population.
Energy drinks for children and adolescents
Authors: W H Oddy, T A O'Sullivan
Journal: BMJ (2009)

Erring on the side of caution may reduce long term health risks

Energy drinks have catapulted to popularity with young consumers. Clever marketing has been the key, with companies playing on associations with danger, power, and youth culture. The business of “liquid energy” has grown exponentially, with nearly 200 brands of energy drinks available in more than 140 countries. Energy drinks represent a rapidly expanding segment of the beverage industry, and 31% of 12-17 year olds have reported regular consumption of the drinks.1

Energy drinks are set apart from other soft drinks and sports drinks by their high caffeine content and their promotion as a way to relieve fatigue and improve performance.2 Most energy drinks contain about 80 mg of caffeine per 250 ml can, although some contain as much as 300 mg.3 In comparison, the same amount of tea contains around 30 mg, and percolated coffee contains 90 mg.

Caffeine is a widely used addictive drug that is generally recognised as safe. It stimulates the central and peripheral nervous system and is the only psychoactive drug legally available to children.4 At moderate intakes, caffeine can enhance endurance …
The Medical Student: Tomorrow's Teacher
Authors: David Seegal
Journal: New England Journal of Medicine (1968)

The complex and dynamic nature of the educative process in medicine will always contain some deficiencies of curriculum and pedagogy. I believe that there is merit in certain of the students' complaints and that the teaching program can be improved, but only through a serious Cooperative effort by both schools and students. The student must learn that within a few years after graduation, he will cease being the passive recipient of medical information and will be called upon to join the active educational groups whose contributions he may have viewed with little enthusiasm. Upon assuming teaching responsibilities, he will find . . .
Isolated Hormone Receptors
Authors: Philip R. Steinmetz, Christine Balko, Robert J. Lefkowitz
Journal: New England Journal of Medicine (1973)

DURING the past decade, the many and varied roles of the "second-messenger" cyclic AMP have become better understood.1 Figure 1, based on the work of Sutherland et al.,2 shows how hormones act on cyclic AMP. In this scheme, hormones that circulate in blood are the "first messengers." They interact with the enzyme adenyl cyclase in the plasma membranes of their target tissues, leading to the conversion of ATP to cyclic AMP, which then exerts the characteristic effects of the particular hormone. One of the intriguing features of this sequence is that it is, on the one hand, so general, and, on . . .
Angiostatin
Authors: Ryoji Koshida, Jingsong Ou, Toshiro Matsunaga, William M. Chilian, Keith T. Oldham, Allan W. Ackerman, Kirkwood A. Pritchard
Journal: Circulation (2003)

Background— Angiostatin is known to inhibit certain aspects of endothelial function, eg, angiogenesis. Here we investigated the effects of angiostatin on another aspect of endothelial function, vasodilation, and examined mechanisms of inhibition—namely, association of heat-shock protein 90 (hsp90) with endothelial nitric oxide synthase (eNOS) and endothelial generation of nitric oxide (·NO) and superoxide anion ( ). This avenue of investigation was based on recent reports suggesting that hsp90 modulates NOS production of ·NO and . Methods and Results— Effects of angiostatin on vasodilation were determined in arterioles with the use of videomicroscopy in response to endothelium- and ·NO-dependent vasodilators, acetylcholine (ACh) and vascular endothelial growth factor (VEGF), and an endothelium-independent agonist, papaverine. Association of hsp90 with eNOS was determined in rat aortas and bovine aortic endothelial cells (BAECs). Effects of angiostatin on ·NO and generation by BAECs were determined by ozone chemiluminescence and superoxide dismutase (SOD)–inhibitable ferricytochrome c reduction, respectively. Angiostatin impaired vasodilation mediated by ACh and VEGF but not papaverine. Pretreating arterioles with polyethylene glycolated–SOD (PEG-SOD) improved vasodilation to ACh and VEGF. Angiostatin decreased the association of hsp90 with eNOS in aortas and BAEC cultures and increased generation in stimulated BAECs by an Lγ-nitroargininemethylester (L-NAME)–inhibitable mechanism. Conclusions— These data indicate angiostatin alters endothelial function by allowing eNOS to generate on activation. Such changes in enzyme function begin to explain, in part, why angiostatin is antiangiogenic and impairs endothelium-dependent vasodilation.
Drug-Induced Hypoglycemia
Authors: Barr H. Forman
Journal: JAMA (1974)

<h3>To the Editor.—</h3> We wish to report an interesting case of drug-induced hypoglycemia to call attention to the severity and duration from a small dose of chlorpropamide in a healthy young patient. A 17-year-old youth in excellent health, but with a history of occasional marihuana abuse, took 500 mg of chlorpropamide orally three days prior to admission, and another 250 mg one day later. He was found at home unconscious and was hospitalized. Blood glucose level was 34 mg/100 ml, and he awoke after intravenous infusion of 50 ml of 50% glucose. The history was noncontributory for endocrine disease, recent fasting, alcohol intake, or other drug ingestion for two weeks. Additional intravenous infusion of 5% glucose was begun, but ten hours later, he became diaphoretic and incoherent, and thrashed about in bed. The blood glucose level was now 30 mg/100 ml. He became calm and lucid after the administration of
The Healing Hand: Man and Wound in the Ancient World
Authors: R. Ted Steinbock
Journal: JAMA (1993)

I already consider this book, first published in 1975, a classic in its approach to our understanding of wound treatment by many ancient cultures. Dr Majno provides a narrative and visual odyssey of discovery replete with learned yet clear discussions of ancient writings, art forms, metallurgy, and pharmaceuticals. Here we may visually understand the evolution of Assyrian cuneiform writings pertaining to medicine, the amazing complexities of unraveling the Egyptian hieroglyphs and interpreting the ancient medical papyri, and a succinct survey of the Hippocratic corpus of writings, as well as the nearly contemporary Nei Ching medical and philosophical classic from China or the many Indian vedas and mantras relating to medicine and surgery. Dr Majno even reproduces ancient formulas for plasters, poultices, salves, and ointments and proves experimentally their bactericidal or bacteriostatic effects. He analyzes and confirms the bactericidal power of wine and vinegar, both commonly used to wash wounds by
n-3 Fatty Acids in the Treatment of Diabetic Patients
Authors: Raffaele De Caterina, Rosalinda Madonna, Alessandra Bertolotto, Erik Berg Schmidt
Journal: Diabetes Care (2007)

The current interest for the use of n-3 (polyunsaturated) fatty acids in vascular disease can be originally tracked to observations in Greenland Inuits (Eskimos), revealing a lower prevalence of coronary heart disease (CHD) in these populations compared with Scandinavian control subjects (1–4). In a series of pioneering studies, Dyerberg and Bang (5,6) originally showed that Inuits had an attenuated platelet reactivity and a prolonged bleeding time compared with Scandinavian control subjects. This was attributed to the Eskimo diet, with an extremely high content of fish or of fish-derived products (such as seal), abundant in n-3 fatty acids, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (7). In other populations with a high consumption of fish, such as the Japanese (8,9) and the Alaskans (10), a similar inverse correlation between fish consumption and mortality from CHD has been subsequently found. However, in Western populations with a generally low intake of n-3 fatty acids, both protective effects (11–16) and no effects (17–20) of n-3 fatty acids on CHD have been reported. There are good explanations for the lack of uniformity in the epidemiological data, including the difficulty in maintaining constant feeding habits in a population during long observational studies and the influence of other dietary principles, including the simultaneous ingestion of saturated or other unsaturated fatty acids. Overall, the bulk of epidemiological data suggests the existence of favorable associations between fish consumption and mortality from CHD (21–24), as reflected in a recent health statement from the American Heart Association (25). In addition, a host of in vitro and in vivo studies have provided possible biological explanations for the epidemiological observations. Such studies have demonstrated that 1 ) diets rich in n-3 fatty acids partially replace n-6 with n-3 fatty acids in …