tbuckley/cabot-search huggingface dataset:
Easy-rider sling.
Authors: T K Hanid
Journal: BMJ (1979)

in water and ethanol, insoluble in chloroform and ether, stable at pH 6 8, and moderately stable to heat.'He also consulted a number of colleagues in 1929 and subsequently about how to proceed with extraction.Two of them, Stuart Craddock and Frederick Ridley, evaporated extracts in vacuo without success.Fleming then consulted several chemists independently, including Harold King, head of the Medical Research Council's laboratory at Hampstead, who told me later that they "had not been able to do much work on penicillin."Harold Raistrick, professor of biochemistry at the London School of Hygiene, worked harder on the problem collaboratively with R Lovell and P W Clutterbuck, but they were equally unsuccessful.2I have in my possession a bottle of dried yellow pigment purified by Raistrick from the crude brew in 1930 and given to me later by one of his assistants.When tested many years ago it contained none of the stable degradation products of penicillin.From 1932 onward, there are no records of further attempts to extract any active principles from the penicillin mould or the crude brew.In retrospect, it is very surprising that bacteriologists of the time ignored his findings, for filtrates of crude brew killed staphylococci and other organisms at dilutions of 1600, were non-toxic to leucocytes, and apparently eliminated sensitive organisms from burns, wounds, and ocular and other localised infections.3Until 1936 Fleming continued to draw attention to these unique properties but no one in the domestic research councils or pharmaceutical industry, or internationally, evinced any interest.4My reading of the record' and my acquaintance (later) with Fleming himself leave me convinced that he did not surrender easily to Wright or anyone else, but that he was by 1936 at his wit's end.So he followed the only course open to an honest scientist by describing his findings in a manner which left open the track, accurately, for the subsequent discovery of the active principle at Oxford a few years later by Chain, Florey, and their colleagues.
A NEW MOUSE IMMUNOGLOBULIN: I<scp>G</scp>G3
Authors: Howard M. Grey, Judith Wegman Hirst, Melvin Cohn
Journal: The Journal of Experimental Medicine (1971)

A new subclass of mouse IgG for which we propose the name IgG3 has been shown to have a mol wt of 150,000 consistent with an L(2)H(2) structure, and is present in normal mouse serum at a concentration of 0.1-0.2 mg/ml. Its molecular weight, low carbohydrate content, glycopeptide analysis, and C-terminal analysis are all typical of the IgG class. The intact protein had a strong tendency to form noncovalent aggregates with itself which were dissociable in acid. Upon papain digestion an Fab fragment of 47,000 mole wt was generated along with an Fc fragment which was insoluble at neutral pH. As for its biology, the protein did not fix complement, was not cytophilic for gammaG2 receptor sites on macrophages, and did not show passive cutaneous anaphylaxis. It was very efficiently transported across the placenta so that its concentration in the newborn was twice that in the serum of the mother, compared to the concentration of IgG1 and IgG2 proteins which were only present at one-third the concentration of that found in the serum of the mother. The Fc fragment of this protein reacted with and was solubilized by the staphylococcal A protein which also precipitated the intact immunoglobulin. In addition, the myeloma protein which was the prototype for this gammaG subclass exhibited binding activity for levan which was localized to the Fab fragment.
Jaundice Associated with Administration of Iproniazid
Authors: S. Benaim, M. F. Dixon
Journal: BMJ (1958)

situation on the basis of the number of anginal attacks and the effort required to produce them.It should always be stopped before the patient returns to work.Because of the danger of masking myocardial ischaemia, the numerous side-effects, and the risk of serious liver damage, iproniazid is not indicated for the patient with mild angina.Although the drug could theoretically give rise to "silent infarction," this did not happen in any of our patients.Two of them had infarcts while receiving iproniazid.Both were at rest at the time and had typical pain.The side-effects of iproniazid are described by Robitzek and Selikoff (1952) as, firstly, those referable to autonomic stimulation, including dryness of the mouth, constipation, delayed micturition, and difficulties in visuLal accommoda- tion ; secondly, those referable to central nervous system stimulation, including vertigo, muscle-twitching, hyper- reflexia, excitement, euphoria, somnolence; and, thirdly, those referable to antagonism to vitamin B, including peripheral neuropathy.Unfortunately these and other sideeffects limit the usefulness of the drug.Summary Iproniazid has been given to 40 patients with severe angina pectoris from occlusive coronary atherosclerosis, and was highly effective in reducing the frequency and severity of anginal attacks.It appears to act by blocking pain and not by improving the coronary circulation.Side-effects are common ; many of our patients com- plained of giddiness and two developed pulmonary oedema, presumably from fluid retention.The blocking of angina may encourage the patient to be more active and may precipitate infarction.Because of this and the side-effects, the drug is not indicated for patients with mild angina pectoris.In the patient with severe and intractable angina it is of great value, especially if anti- coagulant therapy can be given in addition.The patient can often be helped over a prolonged ischaemic episode, the drug being withdrawn when the condition improves.We are grateful to Dr.
Aerosolized Prostacyclin and Iloprost in Severe Pulmonary Hypertension
Authors: Horst Olschewski
Journal: Annals of Internal Medicine (1996)

Objective: To compare the effects of aerosolization of prostacyclin and its stable analog iloprost with those of nasal oxygen, inhaled nitric oxide, and intravenous prostacyclin on hemodynamics and gas exchange in patients with severe pulmonary hypertension. Design: Open uncontrolled trial. Setting: Justus-Liebig-University, Giessen, Germany. Patients: 4 patients with primary pulmonary hypertension and 2 patients with severe pulmonary hypertension associated with calcinosis, the Raynaud phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia (the CREST syndrome). All were classified as New York Heart Association class III or class IV. Intervention: Short-term applications of O2, inhaled nitric oxide, intravenous prostacyclin, aerosolized prostacyclin, and aerosolized iloprost during repeated catheter investigation of the right side of the heart within a 1-month period. One patient had long-term therapy with inhaled iloprost. Results: Aerosolized prostacyclin decreased pulmonary artery pressure in 6 patients from (mean ± SE) 62.3 ± 4.1 mm Hg to 50.8 ± 5.5 mm Hg and reduced pulmonary vascular resistance from 1721 ± 253 dyne/s · cm−5 to 1019 ± 203 dyne/s · cm−5, and it increased cardiac output from 2.75 ± 0.21 L/min to 4.11 ± 0.54 L/min, mixed venous oxygen saturation from 51.1% ± 3.4% to 66.3% ± 4.1%, and arterial oxygen saturation from 90.6% ± 2.7% to 93.8% ± 23% (P < 0.05 for all changes). Mean systemic arterial pressure was only slightly affected. The responses lasted for 10 to 30 minutes after inhalation was terminated. Aerosolized iloprost had an identical efficacy profile but was associated with a longer duration of the pulmonary vasodilatory effect (60 min to 120 min). In comparison, intravenous prostacyclin reduced pulmonary vascular resistance with corresponding efficacy but produced a more pronounced decline in systemic artery pressure and no clinically significant decrease in pulmonary artery pressure. Nitric oxide and O2 were less potent pulmonary vasodilators in these patients. In one patient, 1 year of therapy with aerosolized iloprost (100 µg/d in six aerosol doses) resulted in sustained efficacy of the inhaled vasodilator regimen and clinical improvement. Conclusion: Aerosolization of prostacyclin or its stable analog iloprost causes selective pulmonary vasodilatation, increases cardiac output, and improves venous and arterial oxygenation in patients with severe pulmonary hypertension. Thus, it may offer a new strategy for treatment of this disease.
NHS figures on non-treatment of emergencies are misleading, experts say
Authors: A. McGauran
Journal: BMJ (2011)

The national organisation that oversees professional training in emergency medicine has urged caution in interpreting new NHS figures showing that a large number of patients who visit emergency departments in England are not treated. The College of Emergency Medicine of the United Kingdom and Ireland points out that the figures include data from minor injury units caring for patients who may need only advice and reassurance.

The figures in the report from the NHS Information Centre show that about 40% of the 10.3 million visits to accident and emergency departments in 2009-10 in which a valid treatment code was recorded ended with the …
Functional characteristics of red cells of sickle cell anemia patients with and without α‐thalassemia‐2
Authors: E. C. Abraham, T. H. J. Huisman
Journal: American Journal of Hematology (1980)

Abstract Oxygen equilibrium curves, red cell indices, 2,3‐DPG levels, and the percentages of ISC and Hb F were determined for red cell fractions isolated by Dextran 40 density gradient centrifugation from blood of a sickle cell anemia (SS) patient, an SS patient with an additional homozygosity for α‐thalassemia‐2, and a normal control. In the SS patient, the MCHC and P 50 values increased and 2,3‐DPG levels decreased with an increase in red cell density; the P 50 values were directly related to the MCHC values and inversely related to the 2,3‐DPG levels. The bottom fraction contained about 80% ISC, and had the highest MCHC and P 50 values and the lowest 2,3‐DPG level. In the SS α‐thalassemia‐2 patient, a decrease in the P 50 value corresponded with a decrease in 2,3‐DPG levels because no change in MCHC value was observed. The bottom fraction contained about 10% ISC and had the lowest P 50 value. These data confirm that both MCHC and 2,3‐DPG levels influence the oxygen affinity of SS red cells; an increase in MCHC decreases the oxygen affinity to a great extent while a concomitant decrease in 2,3‐DPG level partially abolishes this effect.
P255 Once-daily Tiotropium Respimat(R) Add-on To At Least Ics Maintenance Therapy Reduces Exacerbation Risk In Patients With Uncontrolled Symptomatic Asthma
Authors: D Halpin, ED Bateman, P Paggiaro, ER Bleecker, M Engel, P Moroni-Zentgraf, H Schmidt, Ham Kerstjens
Journal: Thorax (2014)

<h3>Background</h3> A reduction in asthma exacerbation risk may provide improvements in clinical burden, patient experience and healthcare costs. In Phase III trials, once-daily tiotropium (delivered via the Respimat<sup>®</sup> SoftMist™ inhaler) added on to at least inhaled corticosteroids (ICS) improved lung function in patients with symptomatic asthma. We investigated exacerbation risk in each trial. <h3>Methods</h3> Five Phase III, double-blind, placebo-controlled, parallel-group trials in patients with symptomatic asthma. Patients received tiotropium Respimat<sup>®</sup> 5 µg or placebo as add-on to at least ICS maintenance therapy (Table). Pre-planned co-primary or secondary end points were time to first severe exacerbation and time to any asthma worsening. <h3>Results</h3> Mean baseline% of predicted forced expiratory volume in 1 second, seven-question Asthma Control Questionnaire score and ICS dose (µg) were: 56.0 ± 13.1, 2.6 ± 0.7, 1198 ± 539 (PrimoTinA-asthma<sup>®</sup>); 75.1 ± 11.5, 2.2 ± 0.5, 660 ± 213 (MezzoTinA-asthma<sup>®</sup>); 77.7 ± 11.9, 2.1 ± 0.4, 381 ± 78 (GraziaTinA-asthma<sup>®</sup>). Tiotropium Respimat<sup>®</sup> 5 µg reduced severe asthma exacerbation risk by at least 21% in all three severity cohorts (Table) and asthma worsening risk versus placebo in all trials, with a statistically significant reduction in the PrimoTinA-asthma<sup>®</sup> trial. <h3>Conclusion</h3> Once-daily tiotropium Respimat<sup>®</sup> 5 µg add-on to at least ICS maintenance therapy consistently reduced exacerbations across asthma severities and so may be a beneficial add-on option to reduce current and future exacerbation risk.
Delayed rectifier potassium current in undiseased human ventricular myocytes
Authors: Norbert Iost, László Virág, Miklós Opincariu, János Szécsi, András Varró, Julius Gyula Papp
Journal: Cardiovascular Research (1998)

Objective: The purpose of the study was to investigate the properties of the delayed rectifier potassium current (IK) in myocytes isolated from undiseased human left ventricles. Methods: The whole-cell configuration of the patch-clamp technique was applied in 28 left ventricular myocytes from 13 hearts at 35°C. Results: An E-4031 sensitive tail current identified the rapid component of IK (IKr) in the myocytes, but there was no evidence for an E-4031 insensitive slow component of IK (IKs). When nifedipine (5 μM) was used to block the inward calcium current (ICa), IKr activation was fast (τ=31.0±7.4 ms, at +30 mV, n=5) and deactivation kinetics were biexponential and relatively slow (τ1 =600.0±53.9 ms and τ2=6792.2±875.7 ms, at −40 mV, n=7). Application of CdCl2 (250 μM) to block ICa altered the voltage dependence of the IKr considerably, slowing its activation (τ=657.1±109.1 ms, at +30 mV, n=5) and accelerating its deactivation (τ=104.0±18.5 ms, at −40 mV, n=8). Conclusions: In undiseased human ventricle at 35°C IKr exists having fast activation and slow deactivation kinetics; however, there was no evidence found for an expressed IKs. IKr probably plays an important role in the frequency dependent modulation of repolarization in undiseased human ventricle, and is a target for many Class III antiarrhythmic drugs.
Intravenous Infusion Filters
Authors: William H. Graybeal
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Schmidt's reply to Dougherty's question about intravenous (IV) infusion filters (242:1790, 1979) was lacking in several respects. His discussion of blood product filters did not relate to IV drug administration, since drugs are not given concurrently with blood products. Dr Schmidt apparently overlooked much information on what is becoming standard practice at many institutions. In 1975 the National Coordinating Committee on Large Volume Parenterals recommended the inclusion of in-line filters with all IV infusions to reduce particulate contamination. It is also now possible to ensure the sterility of IV solutions with a 0.22-μm in-line filter and still maintain more than adequate solution flow rates without air-locking. There have been numerous articles describing the efficacy of 0.45-μm and smaller in-line filters in reducing infusion phlebitis.<sup>1,2</sup>The lypholyzed powder from which many drugs are reconstituted necessarily has a high particulate content, and unfiltered preparations of drugs such as
Blood and neoplastic diseases: megaloblastic anaemia.
Authors: A V Hoffbrand, A Lavoie
Journal: BMJ (1974)

Reasons for SuccessThe decentralized system for delivering medicine in China means that the whole population has access to contraceptive advice and to abortions and sterilizations.However, experi- ence throughout the world has shown that simple provision of contraceptive technology by itself does little to affect popu- lation growth.The success of China's policy is that it is un- equivocal and direct-there are no warring factions as there are in Britain.The policy is based on the acceptance by the people of the three main principles: no sex before marriage, only two children to the family, and abortion for any unintended pregnancies.So far as we could see, these messages are constantly re- peated by the posters and in the political thought sessions that are a major feature of life in China.Whenever we dis- cussed the concepts and methods with doctors, workers, or patients we were impressed by their positive attitude.What would in the West be thought of as severe restrictions on individual liberty are evidently not seen in that light in China.
Chicken Pox with Simultaneous Idiopathic Thrombocytopenic Purpura
Authors: Jerome J. Cohen, Charlotte Bansmer
Journal: New England Journal of Medicine (1947)

CHICKEN pox is generally considered a benign disease. The following case was accompanied by primary idiopathic hemorrhagic purpura. Since similar reported cases are few and all indicate a grave prognosis, this case is presented.An 11-year-old boy entered the hospital because of a hemorrhagic vesicular rash, petechiae, ecchymosis, epistaxis, melena and hematuria. He had been perfectly well until 3 days before admission, when a slight fever, nausea and vomiting and headache developed. On the following day a vesicular eruption appeared on the head, face, neck and upper chest. During the next 24 hours these vesicles became hemorrhagic; petechiae, purpuric spots . . .
Correct Serum Levels of Antibiotics
Authors: A. J. Rosenberg
Journal: JAMA (1971)

<h3>To the Eidtor.—</h3> A BRIEF REPORT, "Neurotoxic Reaction to Penicillin and Carbenicillin," considers the neurotoxic reaction in patients with diminished renal function who received large doses of penicillin (<b>214</b>: 1320, 1970). The importance of reemphasizing the dosage recommendations for carbenicillin in patients with renal failure has been adequately documented by Eastwood<sup>1</sup>and Hoffman.<sup>2</sup>The important factors in antibiotic therapy are the serum and tissue levels obtained after administration of the particular drugs. The serum half-life of antibiotics is of extreme importance in evaluating these levels. In the instance of penicillins specifically, carbenicillin serum half-life is governed predominantly by renal function. The normal mean serum half-life of carbenicillin after intravenous dosage is one hour, while in the face of renal failure the mean half-life increases to 12.5 hours according to Eastwood and 15.7 hours according to Hoffman. Therefore, in the case reported with a blood urea nitrogen level of 105
CASE OF FRACTURE OF ANATOMIC NECK OF THE HUMERUS.
Authors: E. L. GIBSON
Journal: JAMA (1895)

A 16-year-old boy, of good build, fell about twenty feet into some ladders. I saw him about two hours after the injury; he complained of great pain at the shoulder joint. A slight contusion was seen on the front of the arm at the shoulder joint; I was unable to find any other contusion. On superficial examination, I thought I had a subspinous dislocation; but the protrusion did not look as large as would be expected. To isolate fracture, I placed the fingers of one hand on the bicipital tuberosities and rotated the humerus; they were felt to move under my fingers; no crepitation was elicited in this way. Dr. J. St. P. Gibson saw him at this time and confirmed my diagnosis. He was given chloroform; reduction was effected by Koker's method after several trials. Rotation was now made and crepitation was very perceptible. Treatment: Gibson's wire splint, which
A Single Nucleotide Polymorphism in the CCL1 Gene Predicts Acute Exacerbations in Chronic Obstructive Pulmonary Disease
Authors: Noriaki Takabatake, Yoko Shibata, Shuichi Abe, Toshihiro Wada, Jun-ichi Machiya, Akira Igarashi, Yoshikane Tokairin, Guijin Ji, Hidenori Sato, Makoto Sata, Yasuchika Takeishi, Mitsuru Emi, Masaaki Muramatsu, Isao Kubota
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Acute exacerbations (AEs) in chronic obstructive pulmonary disease (COPD) are a major cause of morbidity and mortality in COPD.The marked heterogeneity in the host defense mechanisms may be attributed to single nucleotide polymorphisms (SNPs) in the inflammatory chemokines that show enhanced expression in the airway of patients with COPD who experience AEs.We investigated four SNPs of the CCL11, CCL1, and CCL5 genes in relation to the frequency and severity of AEs in retrospective and prospective studies of a cohort of 276 male patients with COPD.In the 2-yr retrospective study , one SNP (National Center for Biotechnology Information SNP reference: rs2282691) in the predicted enhancer region of the CCL1 gene, encoding a chemotactic factor for a series of leukocytes, was significantly associated with the frequency of AEs in a dominant model (Fisher's exact test: odds ratio [OR], 2.70; 95% confidence interval [CI], 1.36-5.36; p=0.004; logistic regression: OR, 3.06; 95% CI, 1.46-6.41; p=0.003; and Kruskal-Wallis test: p=0.003). In the 30-mo prospective study, the "A" allele was a significant risk allele for the severity of AEs, with a gene-dosage effect (Kaplan-Meier method with log-rank test: AA vs. TT; log-rank statistic: 7.67, p=0.006; Cox proportional hazards regression method: OR, 5.93; 95% CI, 1.28-27.48; p=0.023). The electromobility shift assay showed that C/EBPbeta, a key transcriptional factor in response to pulmonary infections, binds to the "T" allele, but not to the "A" allele.Variants in the CCL1 gene are associated with susceptibility to AEs through their potential implication in the host defense mechanisms against AEs.
Transcontinental Spread of Multidrug-resistant<i>Mycobacterium bovis</i>
Authors: RICHARD LONG, EVA NOBERT, SYLVIA CHOMYC, JAN van EMBDEN, CIARAN McNAMEE, RAFAEL REY DURAN, JAMES TALBOT, ANNE FANNING
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Globally, the proportion of all cases of tuberculosis (TB) caused by drug-resistant strains is increasing. We report the case of a Canadian citizen who acquired a highly drug-resistant strain of Mycobacterium bovis while visiting a relative with AIDS-related tuberculosis in Spain. The origin of the strain was traced using spoligotyping, a polymerase chain reaction (PCR)-based fingerprint technology, and the European DNA database. The level of primary drug resistance-all five first-line drugs and 19 of 21 second-line drugs-in this case was unprecedented in Canada. Isolation of this strain from a Canadian citizen represents the first report of its appearance in this hemisphere. The infection was contained and combined medical-surgical treatment delivered.
Transcutaneous Measurement of the Elastic Properties of the Human Femoral Artery
Authors: DAVID J. MOZERSKY, DAVID S. SUMNFR, D. EUGENE HOKANSON, D. EUGENE STRANDNESS
Journal: Circulation (1972)

Measurements of human femoral arterial wall properties have been obtained transcutaneously in a group of males who were clinically free of arteriosclerosis obliterans. The patients were divided into three groups according to age: under 35, 35-60, and over 60 years. Diameter and changes in diameter were measured using an ultrasonic echo-tracking system. Arterial pulse pressure was determined by the auscultatory method. The results suggest that arteries become stiffer with age. The pressure-strain elastic modulus (Ep) varied from 2.6 ± 0.3 sem x 10 6 dynes/cm 2 in the young group to 6.3 ± 1.0 sem x 10 6 dynes/cm 2 in the old group. These values are similar to those reported by other investigators using invasive and in vitro technics. Although statistical comparisons indicate a significant difference between groups, there was considerable variation within the groups. Not infrequently, values for Ep obtained from individuals in the oldest group fell well within the range of the values obtained in the young group.