tbuckley/cabot-search huggingface dataset:
Cardiac sympathetic nervous activity in congestive heart failure. Evidence for increased neuronal norepinephrine release and preserved neuronal uptake.
Authors: I T Meredith, G Eisenhofer, G W Lambert, E M Dewar, G L Jennings, M D Esler
Journal: Circulation (1993)

BACKGROUND Increased concentrations of norepinephrine in coronary sinus plasma reported in congestive heart failure (CHF) could result from increased cardiac sympathetic nerve firing and norepinephrine release or from failure of neuronal uptake mechanisms to recapture released norepinephrine. We have applied neurochemical indexes of cardiac sympathetic nerve function in heart failure patients to delineate the underlying neural pathophysiology. METHODS AND RESULTS Cardiac norepinephrine synthesis, assessed from the cardiac overflow of the norepinephrine precursor dihydroxyphenylalanine (DOPA), intraneuronal metabolism estimated from the overflow of the intraneuronal metabolite dihydroxyphenylglycol (DHPG), neuronal norepinephrine reuptake assessed from the fractional extraction of plasma-tritiated norepinephrine and production of tritiated DHPG across the heart, and norepinephrine spillover to plasma were examined in eight patients with CHF caused by coronary artery disease (left ventricular ejection fraction of 26 +/- 5%, mean +/- SEM) and 14 age-matched healthy subjects. Cardiac norepinephrine spillover was increased eightfold in CHF subjects (127 ng/min versus 14 ng/min in healthy subjects; standard error of the difference [SED], 8 ng/min; P &lt; .002), and cardiac DOPA was increased twofold (P &lt; .02). The fractional extraction of tritiated norepinephrine across the heart was marginally less in CHF subjects (0.63 versus 0.73 in normal subjects; SED, 0.02), but the extent to which pharmacological neuronal uptake blockade with desipramine reduced the cardiac extraction of tritiated norepinephrine (by 71% versus 73% in normal subjects) and reduced the production of tritiated DHPG derived from uptake and intraneuronal metabolism of tritiated norepinephrine was similar in CHF patients and healthy subjects. CONCLUSIONS The marked increase in norepinephrine spillover from the heart in CHF attributable to coronary artery disease results primarily from an increase in sympathetic nerve firing and neuronal release of norepinephrine, not from faulty neuronal reuptake of norepinephrine.
Gastrostomy - Seeing Beyond the Endoscope
Authors: H.-U. Laasch
Journal: Endoscopy (2006)

With great interest, I read the article on unsedated transnasal gastrostomy placement by Vitale et al. [1]. Head and neck tumors prohibiting conventional oral endoscopy frequently pose a problem to the endoscopist. Described alternatives range from adventurous techniques to place the endoscope into the stomach rather than do without it [2], to surgery [3], while minimally invasive nonendoscopic techniques are often ignored.
Enforcing Patient Preferences
Authors: Marshall B. Kapp
Journal: JAMA (1989)

The legal and ethical doctrine of informed consent is well accepted in modern medicine. Nonetheless, medical interventions sometimes take place in the absence of informed consent, particularly in the case of life-sustaining medical procedures. These procedures ordinarily are reimbursed by third-party payers. This article proposes as a strategy to ensure greater attention to patient preferences in medical decision making that financial reimbursement for each medical service be linked to a requirement of valid patient (or surrogate) consent to the service involved. Utilization review bodies could monitor informed consent in the same way that other aspects of necessity, appropriateness, and quality are now monitored. (<i>JAMA</i>. 1989;261:1935-1938)
Increased risk of hepatocellular carcinoma among patients with hepatitis C cirrhosis and diabetes mellitus
Authors: Bart J. Veldt, Wendong Chen, Jenny E. Heathcote, Heiner Wedemeyer, Juerg Reichen, Peter W. Hofmann, Robert J. de Knegt, Stefan Zeuzem, Michael P. Manns, Bettina E. Hansen, Solko W. Schalm, Harry L. A. Janssen
Journal: Hepatology (2008)

Recent studies suggest that diabetes mellitus increases the risk of developing hepatocellular carcinoma (HCC). The aim of this study is to quantify the risk of HCC among patients with both diabetes mellitus and hepatitis C in a large cohort of patients with chronic hepatitis C and advanced fibrosis. We included 541 patients of whom 85 (16%) had diabetes mellitus. The median age at inclusion was 50 years. The prevalence of diabetes mellitus was 10.5% for patients with Ishak fibrosis score 4, 12.5% for Ishak score 5, and 19.1% for Ishak score 6. Multiple logistic regression analysis showed an increased risk of diabetes mellitus for patients with an elevated body mass index (BMI) (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.00-1.11; P = 0.060) and a decreased risk of diabetes mellitus for patients with higher serum albumin levels (OR, 0.81; 95% CI, 0.63-1.04; P = 0.095). During a median follow-up of 4.0 years (interquartile range, 2.0-6.7), 11 patients (13%) with diabetes mellitus versus 27 patients (5.9%) without diabetes mellitus developed HCC, the 5-year occurrence of HCC being 11.4% (95% CI, 3.0-19.8) and 5.0% (95% CI, 2.2-7.8), respectively (P = 0.013). Multivariate Cox regression analysis of patients with Ishak 6 cirrhosis showed that diabetes mellitus was independently associated with the development of HCC (hazard ratio, 3.28; 95% CI, 1.35-7.97; P = 0.009).For patients with chronic hepatitis C and advanced cirrhosis, diabetes mellitus increases the risk of developing HCC.
Re: Hamid Mazdak, Iraj Meshki and Fatemeh Ghassami. Effect of Mitomycin C on Anterior Urethral Stricture Recurrence after Internal Urethrotomy. Eur Urol 2007;51:1089–92
Authors: Ali Ayyıldız, Turgay Akgül, Barış Nuhoğlu
Journal: European Urology (2007)
Nearly half of NHS trusts in England face a challenge in meeting watchdog's registration requirement next April
Authors: Z. Kmietowicz
Journal: BMJ (2009)

The quality of care being provided by some parts of the NHS has improved markedly, England’s health watchdog has found. But a significant proportion of the 392 trusts rated by the Care Quality Commission in the past year are providing persistently substandard care. These organisations have considerable work to do if they are to qualify for the commission’s new registration system being introduced next April or face being closed down.

Under the commission’s rigorous assessment on quality and financial management, trusts are scored on a four point scale of excellent, good, fair, or weak. On quality, 15% of trusts in the English NHS were rated as excellent, 47% good, 33% fair, and 5% weak. On financial management, 26% were rated as …
In a Papular Way
Authors: Robert E. Fishbein
Journal: JAMA (1969)

To travel on the comedo express  A localized papule  Blackhead station  The acne railroad.  Granulocyte polymorph  Mount up  To pustular peak  Snow cap  Fluctuancy.  Volcanic Burst  Exit purulence  Exudate  Rare ulcer crater  Here comes the granulation team  See the fibro blast  The healing set is in  Stroma for epithelization  The road to anabolia paved  In state of tissue peace  Heal Heel my wound  Soul Sole fully
Analysis of continuous data from small samples
Authors: J M. Bland, D. G Altman
Journal: BMJ (2009)

Studies with small numbers of measurements are rare in the modern BMJ , but they used to be common and remain plentiful in specialist clinical journals. Their analysis is often more problematic than that for large samples.

Parametric methods, including t tests, correlation, and regression, require the assumption that the data follow a normal distribution and that variances are uniform between groups or across ranges.1 In small samples these assumptions are particularly important, so this setting seems ideal for rank (non-parametric) methods, which make no assumptions about the distribution of the data; they use the rank order of observations rather than the measurements themselves.1 Unfortunately, rank methods are least effective in small samples. Indeed, for very small samples, they cannot yield a significant result whatever the data. For example, when using the Mann-Witney test for comparing two samples of …
TV Film "Primates"
Authors: H. E. Kingman
Journal: JAMA (1975)

National Educational Television aired a film Thursday, Dec 5, 1974, that may have very serious effects on public attitudes toward animal experimentation. The film, produced by Frederick Wiseman, was referred to as a "documentary." However, Wiseman in his production refuses to append a commentary to the scenes he records to describe what is being shown. Wiseman has produced a number of controversial films. His first was titled the "Titicut Follies" and was filmed at the Massachusetts State Hospital for the Criminally Insane. He has also produced others such as "High School," "Law and Order," and "Juvenile Court." One of his films, a study of a religious community titled "Essene," was criticized because it was difficult to follow due to a lack of commentary. This also happened with "Primates," and since the public lacks an understanding of scientific methods, most were left with sad impressions. Placing of electrodes in the brain;
Inequity of access to investigation and effect on clinical outcomes: prognostic study of coronary angiography for suspected stable angina pectoris
Authors: Neha Sekhri, Adam Timmis, Ruoling Chen, Cornelia Junghans, Niamh Walsh, Justin Zaman, Sandra Eldridge, Harry Hemingway, Gene Feder
Journal: BMJ (2008)

To determine whether coronary angiography for suspected stable angina pectoris is underused in older patients, women, south Asian patients, and those from socioeconomically deprived areas, and, if it is, whether this is associated with higher coronary event rates.Multicentre cohort with five year follow-up.Six ambulatory care clinics in England.1375 consecutive patients in whom coronary angiography was individually rated as appropriate with the Rand consensus method.Receipt of angiography (420 procedures); coronary mortality and acute coronary syndrome events.In a multivariable analysis, angiography was less likely to be performed in patients aged over 64 compared with those aged under 50 (hazard ratio 0.60, 95% confidence interval 0.38 to 0.96), women compared with men (0.42, 0.35 to 0.50), south Asians compared with white people (0.48, 0.34 to 0.67), and patients in the most deprived fifth compared with the other four fifths (0.66, 0.40 to 1.08). Not undergoing angiography when it was deemed appropriate was associated with higher rates of coronary event.At an early stage after presentation with suspected angina, coronary angiography is underused in older people, women, south Asians, and people from deprived areas. Not receiving appropriate angiography was associated with a higher risk of coronary events in all groups. Interventions based on clinical guidance that supports individualised management decisions might improve access and outcomes.
Website of the week: Email alerting services
Authors: D. Carnall
Journal: BMJ (2002)

Legend has it that Gregor Mendel's classic paper on the genetics of the pea plant languished in the obscurity of a Czech journal for 30 years—if email alerting had existed in his day, dissemination of his results might have proved a little more rapid.

The 800 lb gorilla of such services in the United Kingdom is Zetoc, which uses British Library data indexing the contents of more than 20 000 …
The Influence of Type 1 and Type 2 Diabetes on Periodontal Disease Progression
Authors: Ryan T. Demmer, Birte Holtfreter, Moïse Desvarieux, David R. Jacobs, Wolfgang Kerner, Matthias Nauck, Henry Völzke, Thomas Kocher
Journal: Diabetes Care (2012)

To explore associations between diabetes etiology (type 1 diabetes mellitus [T1DM] vs. T2DM) and glycemic control in the prediction of 5-year periodontal status change.The Study of Health in Pomerania (SHIP) is a population-based stratified sample of German men and women. Healthy participants and those determined to have T2DM arose from the SHIP cohort, and T1DM participants were recruited from diabetes clinics in the catchment area that gave rise to SHIP. Dentate participants (n = 2,626; 53% women; 20-81 years of age) were included. Diabetes was determined via physician diagnosis and/or HbA(1c) ≥6.5% (uncontrolled diabetes >7.0%). Examiners blinded to diabetes status performed random half-mouth periodontal examinations, assessing probing depth (PD) and attachment loss (AL) (four sites/tooth) at baseline and follow-up. Participants were categorized into six groups as follows: 1) diabetes free (n = 2,280), 2) incident T2DM (n = 79), 3) controlled T2DM (n = 80), 4) uncontrolled T2DM (n = 72), 5) controlled T1DM (n = 43), and 6) uncontrolled T1DM (n = 72). In multivariable regressions, mean PD change (ΔMPD), mean AL change (ΔMAL), or incident tooth-loss values were regressed across the aforementioned diabetes categories.Mean (SD) ΔMPD and ΔMAL values among all participants were -0.08 ± 0.5 mm and 0.08 ± 1.03 mm, respectively, and 34% lost one or more teeth. Relative to diabetes-free participants, those with uncontrolled T2DM experienced greater ΔMPD ± SE (P < 0.05), whereas participants with either uncontrolled T1DM or uncontrolled T2DM realized greater ΔMAL (P < 0.05). Uncontrolled T1DM and T2DM were both associated with an increased risk of future tooth loss (P < 0.05).Diabetes control, but not etiology, was associated with future tooth loss and accelerated AL progression.
Curschmann Spirals in the Vagina
Authors: RUI LUZZATTO
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 August 1983Curschmann Spirals in the VaginaRUI LUZZATTO, M.D., SONIA R. MACIEL, C.T.RUI LUZZATTO, M.D.Search for more papers by this author, SONIA R. MACIEL, C.T.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-2-278_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In a letter published in 1974, Dr. Prolla reported finding Curschmann spirals in cervical smears of six patients and suggested a relation to a systemic effect of cigarette smoking. We have found spirals in 8 of 9474 consecutive cervical smears. The youngest of the 8 patients was 20 years old and the oldest, 34. Two of the patients were moderate smokers, but 6 had never smoked. All 8 had a history of allergy to foods or drugs or a contact type of dermatitis. None had ever had bronchial asthma.These findings confirm Dr. Prolla's statement that Curschmann...Reference1. PROLLA J. Curschmann spirals in cervical mucus [Letter]. Ann Intern Med. 1974;80:674. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Instituto de Patologia Rio Grande do Sul, Brasil PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1983Volume 99, Issue 2Page: 278-279KeywordsAllergy and immunologyAsthmaContact dermatitisDrugsFood allergiesVagina Issue Published: 1 August 1983 PDF DownloadLoading ...
The effects of verapamil, quiescence, and cardioplegia on calcium exchange and mechanical function in ischemic rabbit myocardium.
Authors: P D Bourdillon, P A Poole-Wilson
Journal: Circulation Research (1982)

The effects of verapamil (1 mg/liter, 2 x 10(-6) mol/liter), quiescence, and cardioplegia (K+ 16 mmol/liter, Mg2+ 16 mmol/liter) on calcium exchange and mechanical function during ischemia and reperfusion have been investigated in the rabbit interventricular septum at 32 degrees C. Calcium influx and efflux were recorded continuously with 47Ca2+ and 45Ca2+. After 60 minutes of total ischemia and reperfusion for 30 minutes, there was a net calcium gain of 4.9 mmol/kg dry tissue. Verapamil given before total ischemia reduced net calcium gain to 1.5 mmol/kg dry tissue (n = 5, P less than 0.03). When given only on reperfusion after total ischemia, or 10 minutes before reperfusion during low flow ischemia, verapamil did not affect calcium exchange. Cardioplegia begun 10 minutes before total ischemia reduced net calcium gain to 1.0 +/- 0.26 mmol/kg dry tissue (n = 6, P less than 0.001). Cardioplegia during the first 10 minutes of reperfusion, or lack of electrical stimulation during reperfusion, did not reduce calcium gain. Net calcium gain correlated with the maximum rise in resting tension and with the recovery of developed tension. In control experiments neither verapamil nor cardioplegia altered influx or efflux of slowly exchanging calcium. The cardioprotective effects of cardioplegia and the calcium channel blocker verapamil appear to be due to a reduction of myocardial work rather than to any specific direct action on calcium fluxes across the myocardial cell membrane.
NANOPARTICLE ENHANCED MRI: A NOVEL METHOD OF INVESTIGATING MYOCARDIAL INFLAMMATION
Authors: Shirjel Alam, Nick Spath, Jennifer Richards, Amanda Hunter, Anoop Shah, Ninian Lang, Tom MacGillivray, Graham Mckillop, Saeed Mirsadraee, Renzo Pessotto, Vipin Zamvar, Scott Semple, David Newby, Peter Henriksen
Journal: Journal of the American College of Cardiology (2013)
Significant reduction of the hybrid BCR/ABL transcripts after induction and consolidation therapy is a powerful predictor of treatment response in adult Philadelphia-positive acute lymphoblastic leukemia
Authors: F Pane, G Cimino, B Izzo, A Camera, A Vitale, C Quintarelli, M Picardi, G Specchia, M Mancini, A Cuneo, C Mecucci, G Martinelli, G Saglio, B Rotoli, F Mandelli, F Salvatore, R Foà
Journal: Leukemia (2005)
Blood Coagulation, Fibrinolysis, and Contraceptive Hormones
Authors: Pieter Brakman
Journal: JAMA (1967)

A study was made of the influence of progestogen, estrogen, and a combination of these, norethindrone with mestranol (Ortho-Novum), on selected parameters of blood coagulation and the plasma fibrinolytic system. Normal women were compared with normal men or postmenopausal women, and minimal differences were seen, except for an increase of fibrinogen level in postmenopausal women. Progestogen and estrogen alone had little effect, whereas the combination caused changes in 14 of 27 parameters studied (5% level). Changes were significant only when treatment had continued for some weeks. After discontinuation, establishment of normal values for some parameters was delayed. Blood coagulation was slightly enhanced. The fibrinogen concentration remained unchanged. Spontaneous fibrinolytic activity increased and plasminogen level decreased. Inhibition of urokinase did not increase. In contrast to the coagulation changes, during hormone treatment the fibrinolytic system did not reproduce the changes occurring during pregnancy.
US drug firm to be quizzed over growth hormone
Authors: J Roberts
Journal: BMJ (1994)

Government agencies in the US are to investigate whether the drug firm, Genentech, has been inducing doctors to prescribe its recombinant human growth hormone to normal children with short stature. The Food and Drug Administration and the Federal Trade Commission will conduct the inquiry.

The drug, marketed as Protropin, is approved for use in children with growth hormone deficiency and chronic renal insufficiency but not in those with short stature that does not have a hormonal cause. But once a drug is on the market doctors can …
Seizure Activity and Off-Label Use of Tiagabine
Authors: Charlene M. Flowers, Judith A. Racoosin, Cindy Kortepeter
Journal: New England Journal of Medicine (2006)

To the Editor: Thirty-one case reports of new-onset seizures associated with off-label use of tiagabine (Gabitril) have prompted the addition of a boldface warning to the product label.1 (Tiagabine is approved by the Food and Drug Administration [FDA] solely for adjunctive treatment of partial seizures in adults and children 12 years of age and older.) The mean duration of exposure to tiagabine before the occurrence of a seizure was three to four months, but in some cases seizures occurred within days after the initiation of the drug or an increase in the dose. Although there were no deaths, status epilepticus . . .
Alveolar Type 1 Cells Express the α2 Na,K-ATPase, Which Contributes to Lung Liquid Clearance
Authors: K.M. Ridge, W.G. Olivera, F. Saldias, Z. Azzam, S. Horowitz, D.H. Rutschman, V. Dumasius, P. Factor, J.I. Sznajder
Journal: Circulation Research (2003)

The alveolar epithelium is composed of alveolar type 1 (AT1) and alveolar type 2 (AT2) cells, which represent ≈95% and ≈5% of the alveolar surface area, respectively. Lung liquid clearance is driven by the osmotic gradient generated by the Na,K-ATPase. AT2 cells have been shown to express the α1 Na,K-ATPase. We postulated that AT1 cells, because of their larger surface area, should be important in the regulation of active Na + transport. By immunofluorescence and electron microscopy, we determined that AT1 cells express both the α1 and α2 Na,K-ATPase isoforms. In isolated, ouabain-perfused rat lungs, the α2 Na,K-ATPase in AT1 cells mediated 60% of the basal lung liquid clearance. The β-adrenergic agonist isoproterenol increased lung liquid clearance by preferentially upregulating the α2 Na,K-ATPase protein abundance in the plasma membrane and activity in alveolar epithelial cells (AECs). Rat AECs and human A549 cells were infected with an adenovirus containing the rat Na,K-ATPase α2 gene (Adα2), which resulted in the overexpression of the α2 Na,K-ATPase protein and caused a 2-fold increase in Na,K-ATPase activity. Spontaneously breathing rats were also infected with Adα2, which increased α2 protein abundance and resulted in a ≈250% increase in lung liquid clearance. These studies provide the first evidence that α2 Na,K-ATPase in AT1 cells contributes to most of the active Na + transport and lung liquid clearance, which can be further increased by stimulation of the β-adrenergic receptor or by adenovirus-mediated overexpression of the α2 Na,K-ATPase.
Effect of uraemia upon the performance of the rat heart
Authors: S. PENPARGKUL, J. SCHEUER
Journal: Cardiovascular Research (1972)

The purpose of the present experiments was to study whether the uraemic state causes any change in intrinsic cardiac function in the rat. Hearts of animals were studied 24 hr after bilateral nephrectomy (acute uraemia) or two weeks after 5/6 nephrectomy (chronic uraemia). Ventricular function curves were performed in an isolated working rat heart apparatus. Hearts from animals with acute uraemia performed the same as hearts from sham controls. Hearts from animals with chronic uraemia had enhanced performance as evidenced by increased cardiac output, peak and mean left ventricular systolic pressure, maximum rate of left ventricular pressure rise, and external work. Coronary flow, myocardial oxygen consumption, and external efficiency were also greater in hearts of rats with chronic uraemia. These studies demonstrate that short-term chronic uraemia is not associated with depressed intrinsic cardiac performance. On the contrary, isolated hearts from chronic uraemic rats, while performing external work, demonstrate enhanced dynamic and metabolic responses to increasing filling pressures.
Prions and dentistry
Authors: S. R Porter
Journal: Journal of the Royal Society of Medicine (2002)

The risk of transmission of prions during dental care is not known, although on existing evidence it is likely to be very low. Although prions may be detected in the oral tissues of inoculated laboratory animals, at present there are no published reports of the detection of prions in nonlymphoid tissues of humans with any form of Creutzfeldt—Jakob disease (CJD). The present article reviews current knowledge of the presence of prions in the mouth, discusses the possible transmission of prions via oral tissues and outlines the possible modifications of infection control measures required for the dental health care of patients with prion disease.