tbuckley/cabot-search huggingface dataset:
Effect of Pramlintide on Prandial Glycemic Excursions During Closed-Loop Control in Adolescents and Young Adults With Type 1 Diabetes
Authors: Stuart A. Weinzimer, Jennifer L. Sherr, Eda Cengiz, Grace Kim, Jessica L. Ruiz, Lori Carria, Gayane Voskanyan, Anirban Roy, William V. Tamborlane
Journal: Diabetes Care (2012)

OBJECTIVE Even under closed-loop (CL) conditions, meal-related blood glucose (BG) excursions frequently exceed target levels as a result of delays in absorption of insulin from the subcutaneous site of infusion. We hypothesized that delaying gastric emptying with preprandial injections of pramlintide would improve postprandial glycemia by allowing a better match between carbohydrate and insulin absorptions. RESEARCH DESIGN AND METHODS Eight subjects (4 female; age, 15–28 years; A1C, 7.5 ± 0.7%) were studied for 48 h on a CL insulin-delivery system with a proportional integral derivative algorithm with insulin feedback: 24 h on CL control alone (CL) and 24 h on CL control plus 30-μg premeal injections of pramlintide (CLP). Target glucose was set at 120 mg/dL; timing and contents of meals were identical on both study days. No premeal manual boluses were given. Differences in reference BG excursions, defined as the incremental glucose rise from premeal to peak, were compared between conditions for each meal. RESULTS CLP was associated with overall delayed time to peak BG (2.5 ± 0.9 vs. 1.5 ± 0.5 h; P &amp;lt; 0.0001) and reduced magnitude of glycemic excursion (88 ± 42 vs. 113 ± 32 mg/dL; P = 0.006) compared with CL alone. Pramlintide effects on glycemic excursions were particularly evident at lunch and dinner, in association with higher premeal insulin concentrations at those mealtimes. CONCLUSIONS Pramlintide delayed the time to peak postprandial BG and reduced the magnitude of prandial BG excursions. Beneficial effects of pramlintide on CL may in part be related to higher premeal insulin levels at lunch and dinner compared with breakfast.
Pressure Ulcer Prevention With Low-Air-Loss Beds-Reply
Authors: Kevin J. Inman
Journal: JAMA (1993)

<h3>In Reply.</h3> —Thank you for allowing us to respond to concerns expressed by Dr Verdery regarding our article, which examined the clinical utility and cost-effectiveness of an air suspension bed in the prevention of pressure ulcers. First, he was concerned about the lack of blinding in the diagnosis and categorization of stage I ulcers. As stated in our methods, blinding was impossible. Therefore, we instituted a process to minimize this bias as much as possible. Specifically, with detection and staging of a pressure ulcer by the study nurse, our hospital's skin care team was consulted. The consultant dermatologist then independently addressed the issue of presence or absence of pressure ulcers and staged them when applicable. Our interrater agreement was good (κ&gt;0.80). Second, Verdery noted we had not mentioned whether a specific treatment protocol was instituted. The study's objective was to address prevention, not treatment. Thus, treatment of established ulcers was
Inadvertent toxic drug reaction in the management of atrial fibrillation
Authors: Susannah K Leaver, Timothy B L Ho
Journal: Journal of the Royal Society of Medicine (2006)

When changing medications for atrial fibrillation, sufficient time should be allowed for the elimination of drugs being stopped in order to prevent inadvertent drug interactions. CASE HISTORYA 64-year-old woman presented with a 3-day history of cough, breathlessness and vague abdominal pain.She had appeared well that morning when woken by her husband in order to give her morning medication.He returned 45 minutes later to find the patient semi-conscious.The patient was known to suffer with atrial fibrillation, was awaiting cardioversion, and had been on long-term sotalol, digoxin and warfarin.On the previous day, she had complained of increasing breathlessness and was seen by her general practitioner, who noted that she was in fast atrial fibrillation at 140 beats/min (bpm).He advised stopping the digoxin and sotalol immediately and prescribed verapamil 80 mg three times a day, co-amilofruse and perindopril.These were started on the morning of admission.The initial examination revealed a Glasgow coma score (GCS) of 14/15, heart rate was 50 bpm atrial fibrillation, blood pressure 120/80 mmHg on the left arm and 90/ 60 mmHg on the right, with normal heart sounds and a clear chest.Her respiratory rate was 22 bpm and she was apyrexial.There was some mild upper abdominal tenderness with audible bowel sounds but no palpable abdominal aortic aneurysm.A chest radiograph showed cardiomegaly, but clear lung fields and no air under the diaphragm.An electrocardiogram (ECG, Figure 1) demonstrated slow atrial fibrillation, but no evidence of acute ischaemia or infarction.Arterial blood gases revealed a compensated metabolic acidosis (pH 7.40, PO 2 31.9kPa PCO 2 2.04 kPa HCO 3 9.8 mmol/L, lactate 5.8 mmol/L).A digoxin level at this time was sub-therapeutic at 0.9 nmol/L (normal range 1-2 nmol/L) and the electrolyte results were as follows: sodium 136 mmol/L, potassium
Mitral Stenosis in an Atypical Case of Gargoylism: A Case Report with Pathologic and Histochemical Studies of the Cardiac Tissues
Authors: PETER W. VANACE, SIDNEY FRIEDMAN, BERNARD M. WAGNER
Journal: Circulation (1960)

Severe alterations of cardiac tissue occur in association with complete and incomplete forms of gargoylism. It is the purpose of this paper to record the clinical, pathologic, and histochemical findings in the cardiovascular system of a child with an atypical form of gargoylism and mitral stenosis.
Effect of Mechanical Loading on Ventilatory Response to CO2 and CO2 Excretion
Authors: T. J. H. Clark, G. M. Cochrane
Journal: BMJ (1972)

The ventilatory response to CO(2) (S) and respiratory exchange ratio have been measured in 10 healthy subjects breathing naturally and through added resistive loads. The changes in these values produced by the added loads were shown to be correlated with the unloaded CO(2) responsiveness. The results indicated that poorly responsive individuals had a greater depression of ventilatory response to CO(2) and were more liable to retain CO(2).These observations raise the possibility that the constitutional CO(2) responsiveness of an individual influences the alveolar ventilation achieved in the presence of airways obstruction. The propensity to develop respiratory failure may thus be conditioned by the premorbid CO(2) responsiveness.
Abstract 1335: Phosphorylation of serine 9 is required for benzo(a)pyrene induced GNMT nuclear translocation
Authors: Yao-Cheng Lu, Chia-Hung Yen, Xiu-Ting Lai, Yi-Ming A. Chen
Journal: Cancer Research (2011)

Abstract Glycine-N-methyltransferase (GNMT) is a protein with multiple functions. It can affect genetic stability by (1) regulating the ratio of S-adenosylmethionine to S-adenosylhomocystine and (2) binding to folate. In addition to act as a tumor suppressor for liver cancer, GNMT participated in the detoxification pathway by interacting with environmental carcinogens [such as benzo(a)pyrene (BaP), aflatoxin B1 (AFB1)] and decreasing subsequent DNA adducts formation and cytotoxicity. GNMT was primarily expressed in cytoplasm and partially translocated to cell nuclei after BaP treatment. Despite the mechanism of GNMT nuclear translocation remains unclear, it has been shown that the phosphorylation modification is important for GNMT nuclear translocation. The results from LC-MS/MS (liquid chromatography-tandem mass spectrometry) analysis showed that serine 9 of GNMT was phosphorylated after BaP treatment. The GNMTS9A mutant did not undergo nuclear translocation after BaP treatment by using indirect immunofluorescence assay. GNMT serine 9 was identified within an Akt1 consensus site by Scansite program. The co-immunoprecipitaion assay demonstrated that GNMT interacts with Akt. Akt phosphorylated GNMT only on serine 9 in vitro. Furthermore, BaP induced GNMT nuclear translocation was blocked by LY294002 treatment. In conclusion, the results suggested that the Serine 9, can be phosphorylated by Akt1, is an important phosphorylation site responsible for GNMT nuclear translocation after BaP treatment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1335. doi:10.1158/1538-7445.AM2011-1335
In vitro analysis of multistage carcinogenesis.
Authors: P Nettesheim, D J Fitzgerald, H Kitamura, C L Walker, T M Gilmer, J C Barrett, T E Gray
Journal: Environmental Health Perspectives (1987)

Several key events in the multistep process of neoplastic transformation of rat tracheal epithelium (RTE) are described. Whether tracheal epithelium is exposed in vivo to carcinogenic agents or whether primary tracheal epithelial cells are exposed in vitro to carcinogens, initiated stem cells can be detected soon after the exposure by their ability to grow under selective conditions in culture. These initiated stem cells differ fundamentally from normal stem cells in their response to factors normally constraining proliferation and self-renewal. Thus, disruption of inhibitory control mechanisms of stem cell replication appears to be the first event in RTE cell transformation. While the probability of self-renewal (PSR) is clearly increased in initiated stem cells, most of the descendants derived from such stem cells differentiate and become terminal and do not express transformed characteristics. Progression from the first to the second stage of RTE cell transformation, the stage of the immortal growth variant (IGV), is characterized by loss of responsiveness to the growth-restraining effects of retinoic acid. In the third stage of neoplastic transformation, the stage during which neoplastic growth variants (NGV) appear, a growth factor receptor gene is inappropriately expressed in some of the transformants. Thus, it appears that loss of growth-restraining mechanisms may be an early event, and activation of a growth stimulatory mechanism a late event, in neoplastic transformation of RTE cells.
As number of uninsured falls, more US people report they can afford care, survey finds
Authors: M. McCarthy
Journal: BMJ (2015)

With the implementation of the Affordable Care Act in 2014, the number of people aged 19-64 years without healthcare coverage in the United States fell to 29 million, or 16% of that population, from a high in 2010 of 37 million (20%), a reduction that has brought the proportion to its lowest since 2003, a new survey has found.1

At the same time, the number of adults who reported they did not get care they needed in the past 12 months because of cost fell from 80 million in 2012 to 66 million in 2014, a fall from 43% to 36% of the …
TWO CASES OF INFECTION WITH TÆNIA NANA IN THE PHILIPPINE ISLANDS.
Authors: CHARLES L. FOSTER
Journal: JAMA (1906)

During my tour of duty in the Philippines, two cases of infection with<i>Tænia nana</i>(<i>Hymenolepis nana</i>) came under my care, and a brief outline of the symptomatology in these cases and a description of the ova of the parasite may be of interest, especially in demonstrating the fact that infection with this tapeworm is not infrequent in the Island of Luzon and that the damage to the host may be severe. <h3>NARRATION OF CASE.</h3> The first case under observation was a private of E troop, 8th U. S. Cavalry. After the recent epidemic of Asiatic cholera in and around Manila, one squadron of the 8th cavalry was stationed along the Mariquina river, from which stream is derived the water supply of Manila, to guard the river from pollution. E troop took station at Mariquina, a town five miles from San Mateo. <h3>Case 1.</h3> —The patient had marched with his
Are Anticapsular Antibodies the Primary Mechanism of Protection against Invasive Pneumococcal Disease?
Authors: Marc Lipsitch, Cynthia G Whitney, Elizabeth Zell, Tarja Kaijalainen, Ron Dagan, Richard Malley
Journal: PLoS Medicine (2005)

Background Antibody to capsular polysaccharide has been the basis of several vaccines that offer protection against invasive disease from Streptococcus pneumoniae. The success of such vaccines has led to the inference that natural protection against invasive pneumococcal disease is largely conferred by anticapsular antibody. If this is so, one would expect that the decline in disease from different serotypes would vary significantly, and that the appearance of substantial concentrations of anticapsular antibodies would coincide temporally with the decline in age-specific incidence. Methods and Findings Using incidence data from the United States, we show that, on the contrary, the decline in incidence with age is quite similar for the seven most important serogroups, despite large differences in exposure in the population. Moreover, only modest increases in antibody concentration occur over the second and third years of life, a period in which serotype-specific incidence declines to less than 25% of its peak. We also present detailed data on the distribution of antibody concentrations in Israeli toddlers, which are consistent with the United States findings. The same conclusion is supported by new data on age-specific incidence in Finland, which is compared with published data on antibody acquisition in Finnish toddlers. Conclusion We suggest some additional studies of the mechanisms of protection that could distinguish among potential alternative mechanisms, including acquired immunity to noncapsular antigens, maturation of nonspecific immune responses, or changes in anatomy or exposure.
Excluding immigrants from primary care brings no savings to NHS, charity claims
Authors: Peter Moszynski
Journal: BMJ (2008)

More than 40% of immigrant patients were unable to access the health care to which they were entitled, says a report of the experiences of one clinic in London. It claims that no evidence exists of migrant “health tourism”—the widely held belief that many immigrants come to the United Kingdom specifically to access free treatment on the NHS that would be expensive elsewhere.

Two years ago the humanitarian aid organisation Medecins du Monde UK began a new healthcare programme in east London for refugees and migrants. Its free clinic provides temporary health care while it helps migrants, many …
Increase in cardiac muscle fructose content in streptozotocin-induced diabetic rats
Authors: Atsunori Kashiwagi, Toshiyuki Obata, Masashi Suzaki, Yoshifumi Takagi, Yasuo Kida, Tsutomu Ogawa, Yasushi Tanaka, Takayuki Asahina, Motoyoshi Ikebuchi, Yoshikazu Saeki, Ryuichi Kikkawa, Yukio Shigeta
Journal: Metabolism (1992)
SOME FURTHER OBSERVATIONS ON THE ELECTRIC BREAST PUMP
Authors: Isaac A. Abt
Journal: JAMA (1923)

For several years it has been my desire to construct a motor-driven milking machine which would be more efficient than the pumps that are offered for sale. Two years ago I exhibited the first model at a meeting of the American Pediatric Society. Since that time, many improvements and modifications have been made in the original model, and numerous clinical tests have been conducted. The new apparatus is much smaller, less complicated, and readily portable. <h3>DESCRIPTION</h3> Suction is obtained by an electrically driven, reciprocating pump with the aid of a vacuum chamber, combined with a special glass nipple shield (Fig. 1). The suction produced is not continuous, but alternates with expulsion. The degree of suction is registered by a gage which may be readily regulated to suit the convenience of the patient by a relief valve at the top of the pump. The vacuum may be increased by turning the
Pulmonary vein wedge angiography.
Authors: S P Singh, R Astley, M L Rigby
Journal: Circulation (1979)

To the Editor: Dr. Friedman believes that uremic patients with elevated rightsided pressures and pericardial effusion but without pulsus paradoxus have congestive heart failure and/or hypervolemia and he doubts the existence of isolated "right-sided tamponade."He, therefore, believes that all such patients can be managed by volume depletion and/or vasodilator therapy rather than pericardiocentesis.We agree with Dr. Friedman that there are uremic patients who have elevated right-sided pressures on the basis of congestive heart failure and/or hypervolemia.These patients may also have varying amounts of pericardial effusion associated with an elevated pericardial pressure.Although pericardial pressure may be elevated, it will not be equal to right ventricular filling pressures.This is well il- lustrated by our case 15, figure 1. Pericardiocentesis in such patients may result in a significant decrease in pericardial pressure, but right ventricular diastolic pressure will not fall, since the latter is not be- ing determined by the compliance characteristics of the pericar- dium.We agree that these patients can be treated by volume depletion and/or vasodilator therapy rather than pericardiocentesis.The case illustrated by Friedman belongs in this category.However, it is important to distinguish these patients from patients who have elevated right-sided pressures due to cardiac tam- ponade, yet do not have pulsus paradoxus.In this latter group (as il- lustrated in fig. 6of the paper), pericardial pressures are not only elevated but are equilibrated with right ventricular diastolic pressures.Pericardiocentesis in such patients not only results in a significant fall in pericardial but also in right ventricular filling pressures.The fall in pressure is also associated with a significant in-
α1-Antitrypsin deficiency in severe psoriasis
Authors: MADALENE C.Y. HENG, R. L. MOY, J. LIEBERMAN
Journal: British Journal of Dermatology (1985)

alpha 1-Antitrypsin phenotypes and trypsin-inhibitory capacities were measured in fifty-one patients with psoriasis. An increased number of variant phenotypes (MS, MZ, and SS) were found only in those patients with severe psoriasis (20% or more skin involvement) and not in those with lesser involvement. The psoriatic patients with variant phenotypes had an earlier disease onset than those psoriatic individuals (both mild and severe) without this association. Protease inhibitors may play a role in modifying disease activity in psoriasis.
Targeting Janus Kinase 2 in Her2/neu-Expressing Mammary Cancer: Implications for Cancer Prevention and Therapy
Authors: Kazuhito Sakamoto, Wan-chi Lin, Aleata A. Triplett, Kay-Uwe Wagner
Journal: Cancer Research (2009)

The Janus kinase 2 (Jak2) is essential for normal mammary gland development, but this tyrosine kinase and its main effector, signal transducer and activator of transcription 5, are also active in a significant subset of human breast cancers. We have recently reported that Jak2 controls the expression and nuclear accumulation of cyclin D1. Because this particular D-type cyclin has been suggested to be a key mediator for ErbB2-associated mammary tumorigenesis, we deleted Jak2 from ErbB2-expressing mammary epithelial cells prior to tumor onset and in neoplastic cells to address whether this tyrosine kinase plays a role in the initiation as well as progression of mammary cancer. Similar to cyclin D1-deficient mice, the functional ablation of Jak2 protects against the onset of mammary tumorigenesis. In contrast, the deletion of Jak2 from neoplastic cells or the acute, ligand-inducible down-regulation of this tyrosine kinase in an orthotopic transplant model did not affect the growth and survival of cancer cells. The constitutive activation of ErbB2 signaling, which is an initial event in the formation of mammary cancer, was able to override the functional role of Jak2 in regulating the expression of Akt1 and cyclin D1. This might be a compensatory mechanism that explains why Jak2 is a relevant target for preventing the initiation but not the progression of ErbB2-associated mammary cancer.
XIAP deficiency: a unique primary immunodeficiency best classified as X-linked familial hemophagocytic lymphohistiocytosis and not as X-linked lymphoproliferative disease
Authors: Rebecca A. Marsh, Lisa Madden, Brenda J. Kitchen, Rajen Mody, Brad McClimon, Michael B. Jordan, Jack J. Bleesing, Kejian Zhang, Alexandra H. Filipovich
Journal: Blood (2010)
Treatment of Crohn's Disease at the Turn of the Century
Authors: Stephen J. Bickston, Fabio Cominelli
Journal: New England Journal of Medicine (1998)

Inflammatory bowel diseases are the second most common chronic inflammatory disorder after rheumatoid arthritis. Of these, Crohn's disease afflicts hundreds of thousands of patients, particularly in developed countries, and its incidence is increasing.1 The cause is unknown. Although the terminal ileum and ascending colon are the most common sites of inflammation, the disease can involve any part of the digestive tract, and extraintestinal manifestations are common. The clinical phenotype of Crohn's disease, including the severity and location of the disease, differs among patients, suggesting a multifactorial origin. This has important implications for both the care of individual patients and clinical . . .
Clinical Usefulness of <i>EGFR</i> Gene Copy Number as a Predictive Marker in Colorectal Cancer Patients Treated with Cetuximab: A Fluorescent <i>In situ</i> Hybridization Study
Authors: Nicola Personeni, Steffen Fieuws, Hubert Piessevaux, Gert De Hertogh, Jef De Schutter, Bart Biesmans, Wendy De Roock, An Capoen, Maria Debiec-Rychter, Jean-Luc Van Laethem, Marc Peeters, Yves Humblet, Eric Van Cutsem, Sabine Tejpar
Journal: Clinical Cancer Research (2008)

To evaluate the usefulness and the pitfalls inherent to the assessment of the epidermal growth factor receptor (EGFR) gene copy number (GCN) by fluorescence in situ hybridization (FISH) for outcome prediction to cetuximab in metastatic colorectal cancer. The value of testing KRAS mutation status, in addition to EGFR GCN, was also explored.FISH analysis of 87 metastatic colorectal cancer patients treated with cetuximab was done, recording individual GCN per cell and using different samples per tumor. Performances of published cutoff points and different summaries of EGFR GCN distribution were assessed for response prediction.In our data set, two published cutoff points performed less well than in their training set, yielding positive predictive values and negative predictive values between 40.0% and 48.3% and between 81.0% and 86.5%, respectively. Among summaries of GCN distribution explored, mean and right-tailed distribution of GCN yielded the highest performances. A mean EGFR GCN > or = 2.83 provided an area under the curve of 0.71. Important heterogeneity of repeated measures of mean EGFR GCN was observed within tumors (intraclass correlation, 0.61; within-class SD, 0.40), leading to potential misclassifications of FISH status in 7 of 18 (38.8%) patients if a cutoff point were used. In multivariable analysis, EGFR GCN testing provided significant information independent of the KRAS status to predict response (P = 0.016) and overall survival (P = 0.005).We confirm the association between increased EGFR GCN and outcome after cetuximab. However, because of reproducibility concerns, any decision making based on published cutoff points is not warranted.