tbuckley/cabot-search huggingface dataset:
Stabilization of Chronic Remodeling by Asynchronous Cardiomyoplasty in Dilated Cardiomyopathy
Authors: Himanshu J. Patel, David J. Polidori, James J. Pilla, Theodore Plappert, David Kass, Martin St John Sutton, Edward B. Lankford, Michael A. Acker
Journal: Circulation (1997)

Background Dynamic cardiomyoplasty is a promising new therapy for dilated cardiomyopathy. The girdling effects of a conditioned muscle wrap alone have recently been postulated to partly explain its mechanism. We investigated this effect in a canine model of chronic dilated cardiomyopathy. Methods and Results Twenty dogs underwent rapid ventricular pacing (RVP) for 4 weeks to create a model of dilated cardiomyopathy. Seven dogs were then randomly selected to undergo subsequent cardiomyoplasty, and all dogs had 6 weeks of additional RVP. The cardiomyoplasty group also received 6 weeks of concurrent skeletal muscle stimulation consisting of single twitches delivered asynchronously at 2 Hz to transform the wrap without active assistance. All dogs were studied by pressure-volume analysis and echocardiography at baseline and after 4 and 10 weeks of pacing. Systolic indices, including ejection fraction (EF), end-systolic elastance (Ees), and preload-recruitable stroke work (PRSW) were all increased at 10 weeks in the wrap versus controls (EF, 34.0 versus 27.1, P =.008; Ees, 1.65 versus 1.26, P =.09; PRSW, 35.9 versus 25.5, P =.001). Ventricular volumes, diastolic relaxation, and left ventricular end-diastolic pressures stabilized in the cardiomyoplasty group but continued to deteriorate in controls. Both the end-systolic and end-diastolic pressure-volume relationships shifted farther rightward in controls but remained stable in the cardiomyoplasty group. Conclusions In addition to potential benefits from active systolic assistance, benefits from dynamic cardiomyoplasty appear to be partially accounted for by the presence of a conditioned muscle wrap alone. This conditioned wrap stabilizes the remodeling process of heart failure, arresting progressive deterioration of systolic and diastolic function.
Pancytopenia Following Low-Dose Methotrexate Therapy
Authors: Elizabeth A. Abel
Journal: JAMA (1988)

Drs Shupack and Webster<sup>1</sup>have refreshed our awareness of the risk-benefit considerations for methotrexate therapy for nononcological disorders by means of their pertinent and timely description, in this issue ofTHE JOURNAL, of two patients who developed pancytopenia following low-dose methotrexate therapy for psoriasis. Six additional cases of methotrexate-related bone marrow suppression<sup>2</sup>are also reviewed. Their report is particularly relevant in view of the See also p 3594. increasing use of methotrexate therapy for rheumatoid arthritis<sup>3,4</sup>and extra-articular manifestations of rheumatoid arthritis, including vasculitis.<sup>5</sup>In addition, low-dose methotrexate has been investigated as a steroid-sparing agent in patients with severe asthma.<sup>6</sup> Methotrexate is a highly effective therapy for patients with severe disabling psoriasis that is resistant to conventional topical therapy and photochemotherapy with methoxsalen and ultraviolet-A irradiation (PUVA). The drug is administered orally or intramuscularly in a weekly dosage of 7.5 to 15 mg. As a
Emerging New Technologies in Pharamcogenomics: Rapid SNP detection, molecular dynamic simulation, and QSAR analysis methods to validate clinically important genetic variants of human ABC Transporter ABCB1 (P-gp/MDR1)
Authors: Toshihisa Ishikawa, Aki Sakurai, Hiroyuki Hirano, Alexander Lezhava, Minoru Sakurai, Yoshihide Hayashizaki
Journal: Pharmacology & Therapeutics (2010)
Use of zidovudine for drug misusers infected with human immunodeficiency virus
Authors: F.M. Cowan, G. Jones, J. Bingham, P.J. Flegg, L.R. MacCallum, J. Whitelaw, D. Hargreave, J.A. Gray, P.D. Welsby, R.P. Brettle
Journal: Journal of Infection (1989)
Placement of central feeding catheters.
Authors: P Jacobs, J Jacobson
Journal: BMJ (1978)

cook to boil an egg, but it is hardly necessary or desirable.Doctors should be important teachers of health care and be able to concentrate their other skills and expertise mainly on complex problems and diseases which are often their major interest.This would ensure the greater availability of appropriate care at all the required levels for people who might otherwise be denied this.Many may feel threatened by change and resist any delegation of part of their traditional roles.Innovative schemes with all acting in a responsible fashion should ensure both the greater wellbeing of the community and justifiably earn the trust of patients.The primary health care nurse is a valuable member of the health care team in her own right and should not be seen as a "doctor-substitute" or assistant.
Asthma and allergy in Russian and Norwegian schoolchildren: results from two questionnaire‐based studies in the Kola Peninsula, Russia, and northern Norway
Authors: A. Selnes, J. Ø. Odland, R. Bolle, J. Holt, L. K. Dotterud, E. Lund
Journal: Allergy (2001)

Background: Previous studies have shown that the prevalence of asthma and allergy in children is lower in Eastern than Western Europe. Methods: We have compared the prevalence of asthma, respiratory symptoms, allergic rhinoconjunctivitis, and atopic dermatitis in schoolchildren aged 7–13 years in a questionnaire‐based study conducted in the city of Nikel on the Kola Peninsula, Russia, in 1994 ( n =1143) and another conducted in northern Norway in 1995 ( n =8676). Results: The prevalence of diagnosed asthma was 5.1% in Russian children and 8.6% in Norwegian children; RR=0.58 (95% CI: 0.44–0.76). The prevalence of all respiratory symptoms was higher in Russian children. The prevalence of allergic rhinoconjunctivitis was 16.9% in Russian children and 22.1% in Norwegian children: RR=0.74 (95% CI: 0.65–0.85). The prevalence of atopic dermatitis was 7.4% in Russian children and 19.7% in Norwegian children; RR=0.38 (95% CI: 0.31–0.46). Conclusions: We conclude that the prevalence of diagnosed asthma, allergic rhinoconjunctivitis, and atopic dermatitis was higher in Norwegian than Russian schoolchildren. The higher prevalence of respiratory symptoms in Russian children probably reflects a higher prevalence of undiagnosed, nonallergic asthma.
A longitudinal study of exercise metabolism during recovery from viral illness.
Authors: P Jakeman
Journal: British Journal of Sports Medicine (1993)

An élite athlete engaged in a longitudinal programme of physiological assessment suffered a loss of performance that was later ascribed to an asymptomatic viral illness. In this 15-month, single subject, repeated measures study it was possible to demonstrate a severe decrease of exercise performance following viral illness. The oxygen uptake equivalent to the onset of blood lactate accumulation of 4 mmol l-1 (OBLA) decreased by 17% following viral illness, then recovered slowly, but had not returned to pre-viral levels 50 weeks later. Steady state exercise metabolism was also affected. During prolonged exercise at 70% of VO2max the proportion of energy derived from carbohydrate metabolism increased and an inability to maintain euglycaemia was observed. In both the graded and prolonged exercise tests, a pronounced tachycardia was evident after viral illness, possibly as a result of a febrile response to the infection, or, a direct effect of the virus upon myocardial performance. These data provide some preliminary and unique findings of the effects of viral illness upon the physiological and metabolic responses to exercise in an élite athlete. The data also demonstrate the sensitivity of currently used laboratory measures of exercise performance to monitor the changes in physiological function during recovery from viral illness.
Handbook of Clinical Laboratory Data
Authors: Rex B. Conn
Journal: JAMA (1965)

<h3>Manual for Clinical Laboratory Procedures,</h3> edited by Henry C. Damm and John W. King, no pagination, loose-leaf binder, $12.50, Cleveland: Chemical Rubber Co., 1965. All laboratory workers are familiar with the excellent<i>Handbook of Chemistry and Physics</i>, published by the Chemical Rubber Company. The same company has now brought out a<i>Handbook of Clinical Laboratory Data</i>, which unfortunately proves to be disappointing. Tables of normal values, discussions on blood constituents, descriptions of laboratory tests, and individual sections on various aspects of laboratory medicine are included. The handbook should be useful both for the physician and the laboratory worker, but extraordinary carelessness in compilation, arrangement, and indexing greatly reduces the value of the book. The table of contents is incomplete and inconsistent, most of the major headings have been left out of the body of the text, making it difficult to identify individual sections, and there are errors in indexing. In
The Dilemma of Myomectomy, Morcellation, and the Demand for Reliable Metrics on Surgical Quality
Authors: Ceana Nezhat
Journal: JAMA Oncology (2015)

In late 2013, a public awareness campaign was initiated after electromechanical morcellation (EMM) of a uterus with presumed benign leiomyoma, which in fact was leiomyosarcoma (LMS).Over the past year, the focus of the medical community has been on the incidence of occult LMS, specifically related to EMM.The risk of intracorporeal tissue dissemination by EMM resulted in some manufacturers halting sales of the EMM device, various hospitals banning the procedure, and ultimately a black box warning from the US Food and Drug Administration (FDA) for electromechanical morcellators. 1his type of issue is not new in medicine.In the 1950s and early 1960s, laparoscopic surgery was banned in Germany owing to electrosurgical complications during laparoscopic sterilization. 2 This led to greater understanding of sparking, capacitation, and coupling related to electrosurgery during laparoscopy; subsequent technological improvements and surgeon education resulted in electrosurgery being an integral part of minimally invasive surgery today.Albert Einstein defined insanity as doing the same thing over and over again and expecting different results.As with electrosurgery, EMM needs reassessment and improvement in technique and instrumentation for proper use.Systematic literature reviews, 3 reports from multispecialty centers, 4 and large group studies 5 have mainly focused on hysterectomy patients with estimations of uterine sarcoma relating primarily to symptomatic women requiring hysterectomy.This methodology overlooks a large data set of patients undergoing myomectomy to restore anatomy and preserve and enhance fertility. 6Worldwide, thousands of myomectomies are performed vaginally or by minilaparotomy, conventional laparotomy, laparoscopy, or hysteroscopy, primarily in women of reproductive age for subfertility.While EMM is used mostly during laparoscopic myomectomies, with or without robotic assistance, the impact and outcome of tissue disruption at the time of myomectomy by any method, including laparotomy, carries a small risk of intraperitoneal dissemination of occult malignant tissue.In this issue of JAMA Oncology, Wright and colleagues 7 report their analysis concerning the prevalence of undetected cancer and precancerous changes in women who underwent myomectomy with and without EMM.In light of the limited data regarding safety and risks in women undergoing myomectomy with EMM, this report broadens the focus on this matter.Owing to lack of information regarding the risk of occult uterine malignant neoplasms in reproductive-age women and possible tumor dissemination during myomectomy, with or without morcellation, the magnitude of harm is unknown.Consequently, not only morcellation, but the
Reanalysis of the effects of air pollution on daily mortality in Seoul, Korea: A case-crossover design.
Authors: J T Lee, J Schwartz
Journal: Environmental Health Perspectives (1999)

We used the case-crossover design to identify any increase in mortality in Seoul, Korea, when there were higher levels of ambient air pollution on case-days than would be expected solely as a result of chance. This empirical study showed that either unidirectional retrospective (selecting only control days prior to death) or prospective (selecting only control days after death) control sampling could cause risk estimates to be confounded by seasonal waves as well as time trends in air pollution levels. In bidirectional control sampling in which exposures at death were compared with exposures both before and after death, the estimated mortality was resistant to confounding by time patterns of air pollution. Using a bidirectional control sampling approach, the results from a conditional logistic regression model controlling for weather conditions showed that the nonaccidental mortality associated with a 50-ppb increment over a 3-day moving average of SO(2) concentrations, including the concurrent day and preceding 2 days, was 1.023 [95% confidence interval (CI), 1.016-1.084]. The relative risk of death was 1.023 (CI, 0.999-1.048) per 50 ppb for 1-hr maximum O(3) and 1.010 (CI, 0.988-1.032) per 100 microg/m(3 )or total suspended particulates. In conclusion, the findings of this study were 2-fold: given the consistency of the observed association between SO(2) and daily mortality across different analysis methods, the association reported here indicates that air pollution is a probable contributor to premature death; and bidirectional control sampling is needed in a case-crossover design applied to air pollution epidemiologic studies to control confounding by seasonal patterns of air pollution as well as time trends.
Breast cancer screening: the current position.
Authors: T Dowell, M Gosling
Journal: BMJ (1991)

positive.We obtained some of the same urine specimen and repeated the Clearview test, which now also gave a positive result.Laparoscopy and subsequent laparotomy confirmed a right tubal ectopic pregnancv.We presume that the initial result was negative because the urine was dilute, the patient having filled her bladder for a scan.As this is frequently part of the investigation of gynaecological patients with pain and abnormal bleeding doctors should beware of testing urine samples passed for a short while afterwards.
CALCIUM AND PHOSPHORUS METABOLISM IN PATIENTS WITH FRACTURES
Authors: FREDERICK F. TISDALL
Journal: JAMA (1922)

The exact mechanism by means of which calcium salts are deposited in areas of bone growth or bone repair is to a large extent unknown. While part, at least, of the process must take place at the site of growth or fracture, there is reason to believe that changes in the inorganic metabolism of the body may accompany and perhaps determine the deposition of bone salts. During the last three or four years, many investigations have been undertaken in the study of one of the frequently encountered diseases of childhood which produces marked changes in the osseous system; namely, rickets. These investigations included not only the experimental production of rickets in animals, but also the study of the inorganic metabolism in children with this disease. Howland and Kramer<sup>1</sup>have shown that in rachitic infants the inorganic phosphate content of the blood serum is markedly reduced,'and that when healing occurs,
Diabetic Diarrhea and Steatorrhea
Authors: FRANZ GOLDSTEIN
Journal: Annals of Internal Medicine (1970)

Aerobic bacterial cultures of upper gastrointestinal aspirates were performed in 10 patients with diabetes mellitus and gastrointestinal disturbances. All but one had diarrhea, five also had steatorrhea. "Normal" bacterial growth as previously defined was encountered in seven patients. One of the three patients with excessive bacterial growth had gastric atony without diarrhea. Two patients with diabetic diarrhea and steatorrhea had excessive small-intestinal bacterial growth (106 to 107 colony-forming units (cfu)/ml). Their diarrhea and steatorrhea were controlled by antibiotics selected according to the sensitivities of the recovered organisms. Thus, these two patients, in contrast to the remainder of the group, represented another variant of the blind-loop syndrome responsive to antibiotic treatment.
Acquired Refractoriness to Thyroid Hormone Action in Treated Toxic Nodular Goiter
Authors: Kenneth Sterling
Journal: JAMA (1981)

A case of apparent target organ refractoriness to thyroid hormones has been observed during the recovery phase of toxic nodular goiter after 131I therapy. The serum PBI was normal before the onset, but elevated serum PBI and T4 concentrations were observed during the toxic phase, and after recovery, with elevated T3 as well. The case differed in important respects from the congenital, hereditary disorder known as the Refetoff syndrome.
TRPM3 Is a Nociceptor Channel Involved in the Detection of Noxious Heat
Authors: Joris Vriens, Grzegorz Owsianik, Thomas Hofmann, Stephan E. Philipp, Julia Stab, Xiaodi Chen, Melissa Benoit, Fenqin Xue, Annelies Janssens, Sara Kerselaers, Johannes Oberwinkler, Rudi Vennekens, Thomas Gudermann, Bernd Nilius, Thomas Voets
Journal: Neuron (2011)
Headache and drowsiness in a 22 year old student
Authors: H. M. Jor, H. R Dalton
Journal: BMJ (2008)

A 22 year old female medical student presented as an emergency with headache and drowsiness. She shared a flat with three other students, all of whom were well, and who found her in bed after she failed to turn up for lectures. She had no relevant medical history and was well the day before. The only drug she takes is the oral contraceptive pill. On examination she was flushed and drowsy, afebrile, and had no skin rash. Her pulse was 100 (sinus rhythm), blood pressure was 120/80 mm Hg, the Glasgow coma score was 11/15 (localising pain, inappropriate speech, eye opening in response to speech), and pulse oximetry showed an oxygen saturation on air of 98%. Her blood gases were as follows: arterial blood gas on air pH 7.35 (normal range 7.35-7.45), partial pressure of oxygen (pO2) 8.2 kPa (>10.6 kPa), partial pressure of carbon dioxide (pCO2) 5.8 kPa (4.7-6 kPa), bicarbonate ions 24 mmol/l (24-28 mmol/l). The rest of the examination, including a detailed neurological examination and fundoscopy, was normal. ### Short answers
Questions remain over lack of UN role in humanitarian aid in Iraq
Authors: S. Hargreaves
Journal: BMJ (2003)

As the first deliveries of humanitarian aid arrived overland from Kuwait at the Iraqi port of Umm Qasr last week, aid agencies questioned why the United Nations was not more involved in coordinating the humanitarian relief effort and postwar reconstruction. The supplies of food and water were distributed by British troops amid angry mob scenes by the local population.

“We have learned from other conflicts that the UN has got to take the coordinating role in humanitarian relief efforts,” a spokesperson from Care International told the BMJ . She added that now, and in the long term, “We would be unhappy working under the military to distribute aid.”

Leading aid agencies said that the military cannot provide impartial humanitarian assistance on the basis of need. The agencies have called on the United Nations, which pulled out of …
Aspirin for the Primary Prevention of Cardiovascular Events: An Update of the Evidence for the U.S. Preventive Services Task Force
Authors: Tracy Wolff
Journal: Annals of Internal Medicine (2009)

Background: Coronary heart disease and cerebrovascular disease are leading causes of death in the United States. In 2002, the U.S. Preventive Services Task Force (USPSTF) strongly recommended that clinicians discuss aspirin with adults who are at increased risk for coronary heart disease. Purpose: To determine the benefits and harms of taking aspirin for the primary prevention of myocardial infarctions, strokes, and death. Data Sources: MEDLINE and Cochrane Library (search dates, 1 January 2001 to 28 August 2008), recent systematic reviews, reference lists of retrieved articles, and suggestions from experts. Study Selection: English-language randomized, controlled trials (RCTs); case–control studies; meta-analyses; and systematic reviews of aspirin versus control for the primary prevention of cardiovascular disease (CVD) were selected to answer the following questions: Does aspirin decrease coronary heart events, strokes, death from coronary heart events or stroke, or all-cause mortality in adults without known CVD? Does aspirin increase gastrointestinal bleeding or hemorrhagic strokes? Data Extraction: All studies were reviewed, abstracted, and rated for quality by using predefined USPSTF criteria. Data Synthesis: New evidence from 1 good-quality RCT, 1 good-quality meta-analysis, and 2 fair-quality subanalyses of RCTs demonstrates that aspirin use reduces the number of CVD events in patients without known CVD. Men in these studies experienced fewer myocardial infarctions and women experienced fewer ischemic strokes. Aspirin does not seem to affect CVD mortality or all-cause mortality in either men or women. The use of aspirin for primary prevention increases the risk for major bleeding events, primarily gastrointestinal bleeding events, in both men and women. Men have an increased risk for hemorrhagic strokes with aspirin use. A new RCT and meta-analysis suggest that the risk for hemorrhagic strokes in women is not statistically significantly increased. Limitations: New evidence on aspirin for the primary prevention of CVD is limited. The dose of aspirin used in the RCTs varied, which prevented the estimation of the most appropriate dose for primary prevention. Several of the RCTs were conducted within populations of health professionals, which potentially limits generalizability. Conclusion: Aspirin reduces the risk for myocardial infarction in men and strokes in women. Aspirin use increases the risk for serious bleeding events.
Altered Microenvironmental Regulation of Leukemic and Normal Stem Cells in Chronic Myelogenous Leukemia
Authors: Bin Zhang, Yin Wei Ho, Qin Huang, Takahiro Maeda, Allen Lin, Sung-uk Lee, Alan Hair, Tessa L. Holyoake, Claudia Huettner, Ravi Bhatia
Journal: Cancer Cell (2012)

We characterized leukemia stem cells (LSC) in chronic phase chronic myelogenous leukemia (CML) using a transgenic mouse model. LSC were restricted to cells with long-term hematopoietic stem cell (LTHSC) phenotype. CML LTHSC demonstrated reduced homing and retention in the bone marrow (BM), related to decreased CXCL12 expression in CML BM, resulting from increased G-CSF production by leukemia cells. Altered cytokine expression in CML BM was associated with selective impairment of normal LTHSC growth and a growth advantage to CML LTHSC. Imatinib (IM) treatment partially corrected abnormalities in cytokine levels and LTHSC growth. These results were validated using human CML samples and provide improved understanding of microenvironmental regulation of normal and leukemic LTHSC and their response to IM in CML.
11 Efficacy of standard-dose and fixed-dose induction peginterferon alpha-2a (40KD) (PEGASYS®) plus ribavirin (COPEGUS®) among pegylated interferon alpha-2b (12kd)/ribavirin non-responders: Interim analysis of the repeat study
Authors: P. Marcellin, G. Teuber, V. Canva, O. Weiland, A. Di Bisceglie, C. Brandao-Mello, B. Freilich, D. Jensen
Journal: Journal of Hepatology (2006)
Influence of social deprivation and air pollutants on serious asthma: Table 1–
Authors: Stephen E. Roberts, Lori A. Button, Julian M. Hopkin, Michael J. Goldacre, Ronan A. Lyons, Sarah E. Rodgers, Ashley Akbari, Keir E. Lewis
Journal: European Respiratory Journal (2012)

potentially lethal side-effects in patients with AECOPD.
The Effects of Drugs on the Fetus and Nursing Infant
Authors: M. J Seller
Journal: BMJ (1996)

J M Friedman, Janine E Polifka Johns Hopkins University Press, £34.00, pp 648 ISBN 0 8018 5345 1

“Breast is best” is good advice that hopefully emanates from our maternity units. But the statement is not necessarily true if the breast milk is laced with any drug that the mother is being treated with.

Because of their generally low molecular weight and lipid solubility, almost all drugs that happen to be circulating in the mother are secreted in breast milk. Consequently, it is a reasonable assumption that suckling infants will receive any …