tbuckley/cabot-search huggingface dataset:
A Randomized Trial Comparing Peak Expiratory Flow and Symptom Self-management Plans for Patients with Asthma Attending a Primary Care Clinic
Authors: MARK O. TURNER, DARLENE TAYLOR, RON BENNETT, J. MARK FITZGERALD
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Great emphasis is placed on educating asthmatics to use action plans to achieve better control of symptoms. The use of peak flow meters (PFM) has been recommended as an important part of self-management plans. We studied 92 (47 F) adult patients with asthma in a primary care setting to compare the effectiveness of action plans using either peak flow monitoring or symptoms to guide self-management. Each patient was instructed in the use of the action plan in the context of a 6-mo asthma education program taught by a nurse. Patients were already using inhaled corticosteroids or were newly prescribed corticosteroids by their family physician. Forty-four patients were randomized to the PFM group and 48 to the symptoms group. Spirometry, symptom scores, quality of life, medication use, and measures of health care utilization and morbidity (emergency department visits, hospitalizations, unscheduled doctor visits, and days lost from work or school) were recorded at baseline and throughout the study period. PC20 methacholine was measured at the first and at the final visits. There were significant improvements within groups for FEV1, symptoms score, PC20 methacholine, and quality of life, but no between-group differences. A significant shift from higher to lower daily use of beta-agonists (p < 0.008 for both groups) and significant shifts to higher daily doses of inhaled steroids (p < 0.001) occurred in each group. Adherence to the self-management plans was only 65% in the PFM group and 52% in the symptoms group. Outcomes for health care utilization were similar except for fewer patients making unscheduled doctor visits within the PFM group. Our findings show that education, regular follow-up, and an action plan are effective in improving asthma control and quality of life, but the routine use of PFM to guide interventions is not the only way to accomplish these objectives.
Calmodulin Mediates Calcium-Dependent Inactivation of N-Methyl-D-Aspartate Receptors
Authors: Su Zhang, Michael D Ehlers, Jeffery P Bernhardt, Ching-Tien Su, Richard L Huganir
Journal: Neuron (1998)

Ca2+ influx through N-methyl-D-aspartate (NMDA) receptors activates signal transduction pathways critical for many forms of synaptic plasticity in the brain. NMDA receptor-mediated Ca2+ influx also downregulates the gating of NMDA channels through a process called Ca2+-dependent inactivation (CDI). Recent studies have demonstrated that the calcium binding protein calmodulin directly interacts with NMDA receptors, suggesting that calmodulin may play a role in CDI. We report here that the mutation of a specific calmodulin binding site in the CO region of the NR1 subunit of the NMDA receptor blocks CDI. Moreover, intracellular infusion of a calmodulin inhibitory peptide markedly reduces CDI of both recombinant and neuronal NMDA receptors. Furthermore, this inactivating effect of calmodulin can be prevented by coexpressing a region of the cytoskeletal protein alpha-actinin2 known to interact with the CO region of NR1. Taken together, these results demonstrate that the binding of Ca2+/calmodulin to NR1 mediates CDI of the NMDA receptor and suggest that inactivation occurs via Ca2+/calmodulin-dependent release of the receptor complex from the neuronal cytoskeleton.
Dietary Fiber and Human Health
Authors: Albert I. Mendeloff
Journal: New England Journal of Medicine (1977)

Modern nutritional science advanced by demonstrating that the great variety of foodstuffs eaten by man and animals contained measurable amounts of protein, fats, carbohydrate, water, minerals and vitamins. This demonstration converted chaos to order, aided by the recognition of diseases directly resulting from deficiency or excess of each of the nutrients identified. The culmination of this science may have been the finding that the laboratory rat and the chick could be made to grow, stay healthy and reproduce when fed a highly purified mixture of these nutrients. Dietary allowances of each nutrient were recommended for animals, including man, at levels . . .
One–Two PM Punch: Gene Combination Increases Vulnerability to Air Pollutant
Authors: Bob Weinhold
Journal: Environmental Health Perspectives (2007)

About 15% of the U.S. population get their drinking and household water from a largely unmonitored source: private residential wells.About 400,000 new wells are drilled every year.A new USGS study suggests that the water in a small percentage of domestic wells could contain unsafe levels of volatile organic compounds (VOCs) [EHP 115:1539-1546; Rowe et al.].VOCs come from a wide variety of sources, including gasoline, plastics, paints, dyes, solvents, adhesives, insecticides, and spot removers, and have wide-ranging health effects.The chemical and physical properties of VOCs allow the compounds to move between the atmosphere, soil, surface water, and groundwater.Once in the environment, some VOCs degrade quickly whereas others persist for decades.The USGS collected data on 55 VOCs primarily between 1991 and 2002.The team analyzed water samples before homeowners treated or filtered the water, which could help reduce VOCs.Many-possibly half of all well users-don't filter their water.The wells ranged in depth from 6 to 1,500 feet, with a median depth of about 140 feet.Of the 2,401 wells studied, 65% had detectable levels of VOCs, and 1% had levels above the EPA maximum contaminant level for the compound(s) observed.The most common compounds found were chloroform, toluene, 1,2,4-trimethylbenzene, and perchloroethene.Factors associated with the presence of VOCs were dissolved oxygen content, precipitation, the presence of a hazardous waste site within 1 km of the well, aquifer type, and water temperature.The authors note that identifying factors associated with VOC occurrence may aid in understanding the sources, transport, and fate of these compounds in groundwater.-
Services for Pregnant Teenagers in the Large Cities of the United States, 1970-1980
Authors: Helen M. Wallace
Journal: JAMA (1982)

This article reports the findings of the third national survey of services for and needs of pregnant teenagers and their infants in the large cities of the United States, done in 1979-1980. Only five cities have developed a new program since 1976, and major unmet needs continue to exist. The survey also provides baseline data on the status of health, social, and educational care for this target population. With the substantial decrease in the various sources of federal funds due to current budgetary reduction, continued monitoring is required to determine the effects on services for pregnant teenagers and their infants, as well as on the incidence of teenage pregnancy.
Peanut oral immunotherapy modifies IgE and IgG4 responses to major peanut allergens
Authors: Brian P. Vickery, Jing Lin, Michael Kulis, Zhiyan Fu, Pamela H. Steele, Stacie M. Jones, Amy M. Scurlock, Gustavo Gimenez, Ludmilla Bardina, Hugh A. Sampson, A. Wesley Burks
Journal: Journal of Allergy and Clinical Immunology (2012)
Molecular clustering identifies complement and endothelin induction as early events in a mouse model of glaucoma
Authors: Gareth R. Howell, Danilo G. Macalinao, Gregory L. Sousa, Michael Walden, Ileana Soto, Stephen C. Kneeland, Jessica M. Barbay, Benjamin L. King, Jeffrey K. Marchant, Matthew Hibbs, Beth Stevens, Ben A. Barres, Abbot F. Clark, Richard T. Libby, Simon W.M. John
Journal: Journal of Clinical Investigation (2011)

Glaucoma is one of the most common neurodegenerative diseases. Despite this, the earliest stages of this complex disease are still unclear. This study was specifically designed to identify early stages of glaucoma in DBA/2J mice. To do this, we used genome-wide expression profiling of optic nerve head and retina and a series of computational methods. Eyes with no detectable glaucoma by conventional assays were grouped into molecularly defined stages of disease using unbiased hierarchical clustering. These stages represent a temporally ordered sequence of glaucoma states. We then determined networks and biological processes that were altered at these early stages. Early-stage expression changes included upregulation of both the complement cascade and the endothelin system, and so we tested the therapeutic value of separately inhibiting them. Mice with a mutation in complement component 1a (C1qa) were protected from glaucoma. Similarly, inhibition of the endothelin system with bosentan, an endothelin receptor antagonist, was strongly protective against glaucomatous damage. Since endothelin 2 is potently vasoconstrictive and was produced by microglia/macrophages, our data provide what we believe to be a novel link between these cell types and vascular dysfunction in glaucoma. Targeting early molecular events, such as complement and endothelin induction, may provide effective new treatments for human glaucoma.
Delayed Food Challenge Reactions Correspond Temporally to the Appearance of CD63+ Basophils in Subjects with IgE to alpha-Gal
Authors: S. Mozzicato, H.R. James, M.H. Land, S.L. Pochan, L.J. Workman, T.A.E. Platts-Mills, S.P. Commins
Journal: Journal of Allergy and Clinical Immunology (2012)
Relief of Uremic Polyneuropathy after Bilateral Nephrectomy
Authors: Mordecai M. Popovtzer, Barry J. Rosenbaum, Arthur Gordon, Morton H. Maxwell
Journal: New England Journal of Medicine (1969)

PERIPHERAL neuropathy is often associated with chronic renal insufficiency. This complication has become more frequent as patients with terminal renal disease are living longer because of treatment with chronic hemodialysis.1 , 2 The etiology and pathogenesis of this disorder are poorly understood.3 Intermittent hemodialysis has variously been reported to improve, arrest or aggravate uremic neuropathy, and the most beneficial effects appear to accrue from successful kidney transplantation.4 5 6 This report describes a patient with end-stage renal disease being treated with hemodialysis who experienced complete relief of a disabling peripheral neuropathy immediately after bilateral nephrectomy, which was performed as a therapeutic measure for uncontrollable . . .
Protective Role of Angiopoietin-1 in Experimental Pulmonary Hypertension
Authors: Yidan D. Zhao, Andrew I.M. Campbell, Malcolm Robb, Douglas Ng, Duncan J. Stewart
Journal: Circulation Research (2003)

Angiopoietin-1 (Ang-1), a newly discovered ligand of the endothelial-specific tyrosine kinase receptor Tie-2, has been found to promote cell survival, vascular maturation, and stabilization. We hypothesized that Ang-1 gene transfer to the pulmonary microcirculation would improve pulmonary hemodynamics and vascular remodeling in experimental pulmonary hypertension. Rat pulmonary artery smooth muscle cells were transfected with Ang-1 cDNA or null (pFLAG-CMV-1) vector. Syngeneic Fisher 344 rats were treated with monocrotaline (MCT) (75 mg/kg IP) with or without delivery of 5×10 5 Ang-1–transfected cells into the right jugular vein. After 28 days, plasmid-derived Ang-1 mRNA was consistently and robustly detected by reverse transcriptase–polymerase chain reaction in lungs from all animals receiving Ang-1 gene therapy. Tie-2 receptor expression was markedly downregulated in rats treated with MCT, and this was partially restored by gene therapy with Ang-1. Animals receiving MCT exhibited 77% mortality by 28 days. In contrast, in pAng-1–treated animals, the 28-day mortality was only 14% ( P &lt;0.0001). In addition, right ventricular systolic pressure was reduced from 52±1.3 mm Hg in the MCT-treated group to 38±1.3 mm Hg by Ang-1 gene transfer ( P &lt;0.01), whereas the measurement of right to left ventricular plus septal weight ratio was also reduced from 0.41±0.03 to 0.31±0.01 ( P &lt;0.05). Moreover, MCT resulted in increased apoptosis, mainly in the microvasculature, and reduced endothelial NO synthase mRNA expression, both of which were prevented by Ang-1 gene transfer. Thus, cell-based gene transfer with Ang-1 improved survival and pulmonary hemodynamics in experimental pulmonary hypertension by a mechanism involving the inhibition of apoptosis and protection of the pulmonary microvasculature.
ROLE OF PHYSICAL MEDICINE AND REHABILITATION IN A LARGE NEUROPSYCHIATRIC HOSPITAL
Authors: Daniel Dancik
Journal: JAMA (1952)

By tradition, a neuropsychiatric hospital is a place where mentally ill persons may receive shelter from the stormy blasts of life, care and attention of nursing and medical auxiliaries, and the individual attention of a psychiatrist. The concept of a neuropsychiatric hospital as a refuge often means, however, that patients are robbed of their individuality and are made to become overly dependent on the meager staff employed to administer care. It is too frequently found that neuropsychiatric hospitals still adhere to the doctrine of attempting to provide individual psychotherapeutic treatment for an individual patient by an individual psychiatrist, without facing the fact that individual psychotherapy is not a practical proposition, because of the huge number of patients confronting the psychiatric world. While it is true that radical individual treatment can free the inner drives of the emotionally ill patient, it is doubtful whether the large neuropsychiatric hospital of today, with
SPARC is expressed in renal interstitial fibrosis and in renal vascular injury
Authors: Raimund H. Pichler, Christian Hugo, Stuart J. Shankland, May J. Reed, James A. Bassuk, Takeshi F. Andoh, Donna M. Lombardi, Stephen M. Schwartz, William M. Bennett, Charles E. Alpers, E. Helene Sage, Richard J. Johnson, William G. Couser
Journal: Kidney International (1996)
Hidden or misreported trial results cause widespread patient harm
Authors: D. W. Light
Journal: BMJ (2013)

The editors of the BMJ and PLOS Medicine describe the crisis of hidden or misreported information as “one of the leading scientific problems of our time.”1 As two new studies show, it has also produced an epidemic of harmful side effects from drugs with few clinical advantages to offset the harms.2 3 Patent replacement drugs are the …
IMPACT OF ATRIAL FIBRILLATION ON EXERCISE CAPACITY IN DIASTOLIC HEART FAILURE: A RELAX TRIAL ANCILLARY STUDY
Authors: Rosita Zakeri, Barry Borlaug, Steven McNulty, Selma Mohammed, Gregory Lewis, Marc Semigran, Anita Deswal, Martin LeWinter, Adrian Hernandez, Eugene Braunwald, Margaret Redfield
Journal: Journal of the American College of Cardiology (2013)
Needs of disabled refugees are "routinely ignored"
Authors: P. Moszynski
Journal: BMJ (2008)

Refugees with disabilities are among “the most underserved and neglected people in the world,” says a report by the Women’s Commission for Refugee Women and Children, which maintains that the needs of millions of disabled people are routinely ignored.

A six month investigation by the US based research and advocacy charity was funded by the United Nations High Commissioner for Refugees to investigate the needs of “a virtually invisible population—refugees and displaced people who suffer from physical, sensory, or mental disabilities.”

The World Health Organization estimates that there are 600 million people with disabilities worldwide—between 7% and 10% of the …
Disrupted Expected Value and Prediction Error Signaling in Youths With Disruptive Behavior Disorders During a Passive Avoidance Task
Authors: Stuart F. White, Kayla Pope, Stephen Sinclair, Katherine A. Fowler, Sarah J. Brislin, W. Craig Williams, Daniel S. Pine, R. James R. Blair
Journal: American Journal of Psychiatry (2013)

Objective Youths with disruptive behavior disorders, including conduct disorder and oppositional defiant disorder, show major impairments in reinforcement-based decision making. However, the neural basis of these difficulties remains poorly understood. This partly reflects previous failures to differentiate responses during decision making and feedback processing and to take advantage of computational model-based functional MRI (fMRI). Method Participants were 38 community youths ages 10–18 (20 had disruptive behavior disorders, and 18 were healthy comparison youths). Model-based fMRI was used to assess the computational processes involved in decision making and feedback processing in the ventromedial prefrontal cortex, insula, and caudate. Results Youths with disruptive behavior disorders showed reduced use of expected value information within the ventromedial prefrontal cortex when choosing to respond and within the anterior insula when choosing not to respond. In addition, they showed reduced responsiveness to positive prediction errors and increased responsiveness to negative prediction errors within the caudate during feedback. Conclusions This study is the first to determine impairments in the use of expected value within the ventromedial prefrontal cortex and insula during choice and in prediction error-signaling within the caudate during feedback in youths with disruptive behavior disorders.
Echocardiographic features of subpulmonic obstruction in dextro-transposition of the great vessels.
Authors: N C Nanda, R Gramiak, J A Manning, E O Lipchik
Journal: Circulation (1975)

Eleven patients with dextro-transposition of the great vessels (TGV) and subpulmonic (left ventriclar outflow) obstruction documented by cardiac catheterization and angiography were studied by echocardiography. Echocardiographic features were which characterized the outflow obstruction included a) prolonged diastolic apposition of the mitral valve with the ventricular septum (10 patients), b) smaller width of the pulmonary artery as compared to the aortic root (10 cases), and c) narrowing of the subpulmonic area demonstrated by beam anglation studies through the planes of the mitral valve and the pulmonary artery (five cases). In addition, four patients showed abnormal systolic anterior movements (SAMs) of the anterior mitral leaflet resembling those observed in idiopathic hypertrophic subaortic stenosis. The SAM'S WERE LARGE IN THREE PATIENTS AND MAY HAVE ACCENTUATED THE OUTFLOW OBSTRUCTION. Additional evidence for this was provided by the movement of the pulmonary valve towards closure with the onset of the mitral SAM'S. These features were uncommon or absent in a comparison group of 17 patients with TGV and no outflow obstruction. Echocardiography appears to be useful in the diagnosis of subpulmonic muscular obstruction in TGV. Demonstration of definite mitral SAM'S IN SOME PATIENTS SUGGEST THE PRESSENCE OF ASSOCIATED FUNCTIONAL OBSTRUCTION OF THE TYPE SEEN IN IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS.
Lymphoblastic Neoplasia in a Homosexual Patient with Kaposi's Sarcoma
Authors: NICULAE CIOBANU
Journal: Annals of Internal Medicine (1983)

The bone marrow aspirate from a leukopenic homosexual patient with Kaposi's sarcoma showed a minimal increase (10%) in the blast count with 25% of mononuclear cells positive for terminal deoxynucleotidyl transferase. Flow cytometry study detected a hyperdiploid clone representing 47% of the marrow cell population. The findings are consistent with a lymphoblastic neoplasia in preleukemic phase.
On an Epidemic of Jaundice in King's Lynn, 1895
Authors: C. B. Plowright
Journal: BMJ (1896)

m T cHiLoinmAL 1321 substantiate this proposition.Certainly the earlier cited cases show prolonged taxis to be attended with more serious consequences than prolonged strangulation alone.By way of deduction again from these I should say that if there is any doubt as to a severe hernia being reducible or not, in treatment give the benefit of the doubt to an early surgical operation.And, in the second place, that if from any cause there may be delay in operating, such as for want of instrument or assistance, suspend all attempts at reduction by taxis after one trial.
Pressurized Aerosols in Asthma
Authors: J. Read
Journal: BMJ (1967)

<h3>Background</h3> Facing increasing obesity prevalence and obesity-related disease burden, South Africa has devised an obesity prevention strategy that includes a recently implemented tax on the sugar content of sugar-sweetened beverages (SSB). We assess the potential distributional impact (across socioeconomic groups) of this tax on type 2 diabetes mellitus (T2DM) incidence and associated mortality and its financial burden on households. <h3>Methods</h3> We conducted an extended cost-effectiveness analysis of the new 10% tax on SSBs in South Africa, and estimated: the averted premature deaths related to T2DM, the financial benefits to households (out-of-pocket (OOP) medical costs and indirect costs due to productivity losses averted), the increased government tax revenues and healthcare savings for the government, all across income quintiles. <h3>Findings</h3> A 10% SSB tax increase would avert an estimated 8000 T2DM-related premature deaths over 20 years, with most deaths averted among the third and fourth income quintiles. The government would save about South African rand (ZAR) 2 billion (US$140 million) in subsidised healthcare over 20 years; and would raise ZAR6 billion (US$450 million) in tax revenues per annum. The bottom two quintiles would bear the smallest tax burden increase (36% of the additional taxes). The bottom two income quintiles would also have the lowest savings in OOP payments due to significant subsidisation provided by government healthcare. Lastly, an estimated 32 000 T2DM-related cases of catastrophic expenditures and 12 000 cases of poverty would be averted. <h3>Conclusions</h3> SSB taxation would have a substantial distributional impact on obesity-related premature deaths, cost savings to the government and the financial outcomes of South Africa’s population.
CHANGES in the NEURONAL CENTRES in BERI-BERIC NEURITIS
Authors: H. Wright
Journal: BMJ (1901)

<h3>Introduction</h3> In pancreatic cancer, preoperative biliary drainage (PBD) increases complications compared with surgery without PBD, demonstrated by a recent randomised controlled trial (RCT). This outcome might be related to the plastic endoprosthesis used. Metal stents may reduce the PBD-related complications risk. <h3>Methods</h3> A prospective multicentre cohort study was performed including patients with obstructive jaundice due to pancreatic cancer, scheduled to undergo PBD before surgery. This cohort was added to the earlier RCT (ISRCTN31939699). The RCT protocol was adhered to, except PBD was performed with a fully covered self-expandable metal stent (FCSEMS). This FCSEMS cohort was compared with the RCT’s plastic stent cohort. PBD-related complications were the primary outcome. Three-group comparison of overall complications including early surgery patients was performed. <h3>Results</h3> 53 patients underwent PBD with FCSEMS compared with 102 patients treated with plastic stents. Patients’ characteristics did not differ. PBD-related complication rates were 24% in the FCSEMS group vs 46% in the plastic stent group (relative risk of plastic stent use 1.9, 95% CI 1.1 to 3.2, p=0.011). Stent-related complications (occlusion and exchange) were 6% vs 31%. Surgical complications did not differ, 40% vs 47%. Overall complication rates for the FCSEMS, plastic stent and early surgery groups were 51% vs 74% vs 39%. <h3>Conclusions</h3> For PBD in pancreatic cancer, FCSEMS yield a better outcome compared with plastic stents. Although early surgery without PBD remains the treatment of choice, FCSEMS should be preferred over plastic stents whenever PBD is indicated. <h3>Trial registration number:</h3> Dutch Trial Registry (NTR3142).
A memorable patient: To cure a mockingbird
Authors: J. Richardson
Journal: BMJ (2001)

Many years ago, I daily visited a gentle family man who was terminally ill in bed. He was 80 years old and a widower, and was supported by his daughter, who lived with him.

One day I found him lying propped up on his bed and looking in a distressed state at the cuckoo clock hanging on the opposite wall. When I asked how he was feeling he told me: “I am very miserable as the cuckoo …