tbuckley/cabot-search huggingface dataset:
Phenytoin-Theophylline Interaction
Authors: Jean-François Marquis, S. George Carruthers, J. David Spence, Yehoshua S. Brownstone, John H. Toogood
Journal: New England Journal of Medicine (1982)

Theophylline (1,3-dimethylxanthine) is a constituent of numerous bronchodilator preparations and is widely used in the treatment of patients with obstructive airways disease. Its metabolism is complex and incompletely understood, involving hepatic biotransformation to 3-methylxanthine, 1-methylxanthine, 1,3-dimethyluric acid, and 1-methyluric acid.1 , 2 Only 10 per cent is excreted as unchanged theophylline in urine.3 Phenytoin (diphenylhydantoin) is a widely used anticonvulsant with moderate ability to induce cytochrome P450 mixed-function oxidase activity.4 , 5 In this study, we found that phenytoin given for 10 to 15 days in doses that produced plasma concentrations in the usual therapeutic range decreased the half-life of theophylline and increased . . .
A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect
Authors: M R Law, A K Hackshaw
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To determine the magnitude and importance of the relation between smoking, bone mineral density, and risk of hip fracture according to age. <b>Design:</b> Meta-analysis of 29 published cross sectional studies reporting the difference in bone density in 2156 smokers and 9705 non-smokers according to age, and of 19 cohort and case-control studies recording 3889 hip fractures reporting risk in smokers relative to non-smokers. <b>Results:</b> In premenopausal women bone density was similar in smokers and non-smokers. Postmenopausal bone loss was greater in current smokers than non-smokers, bone density diminishing by about an additional 2% for every 10 year increase in age, with a difference of 6% at age 80. In current smokers relative to non-smokers the risk of hip fracture was similar at age 50 but greater thereafter by an estimated 17% at age 60, 41% at 70, 71% at 80, and 108% at 90. These estimates of relative risk by age, derived directly from a regression analysis of the studies of smoking and hip fracture, were close to estimates using the difference in bone density between smokers and non-smokers and the association between bone density and risk of hip fracture. The estimated cumulative risk of hip fracture in women in England was 19% in smokers and 12% in non-smokers to age 85; 37% and 22% to age 90. Among all women, one hip fracture in eight is attributable to smoking. Limited data in men suggest a similar proportionate effect of smoking as in women. The association was not explained by smokers being thinner, younger at menopause, and exercising less nor by actions of smoking on oestrogen, but smoking may have a direct action on bone. <b>Conclusions:</b> Hip fracture in old age is a major adverse effect of smoking after the menopause. The cumulative excess bone loss over decades is substantial, increasing the lifetime risk of hip fracture by about half <h3>Key messages</h3> Smoking has no material effect on bone density in premenopausal women Postmenopausal bone loss is greater in smokers—an additional 0.2% of bone mass each year. The cumulative effect of this over many years is substantial, with a difference of 6% at age 80 In current smokers relative to non-smokers the risk of hip fracture is estimated to be 17% greater at age 60, 41% greater at 70, 71% greater at 80, 108% greater at 90 The data in men are limited but suggest a similar proportionate effect in smokers The cumulative risk of hip fracture to age 85 in women is 19% in smokers and 12% in non-smokers; to age 90 it is 37% and 22% Among all women, one hip fracture in eight is attributable to smoking
An eye on insulin
Authors: Sarah K. Bronson, Chad E.N. Reiter, Thomas W. Gardner
Journal: Journal of Clinical Investigation (2003)

Diabetic retinopathy, the most frequent complication of diabetes and leading cause of vision loss, involves vascular and neural damage in the retina. Insulin and IGF-1 signaling are now shown to contribute to retinal neovascularization, in part, by modulating the expression of various vascular mediators.
Analysis of hydroxylated metabolites of PCBs (OH-PCBs) and other chlorinated phenolic compounds in whole blood from Canadian inuit.
Authors: C D Sandau, P Ayotte, E Dewailly, J Duffe, R J Norstrom
Journal: Environmental Health Perspectives (2000)

In this study, we identified the main hydroxylated polychlorinated biphenyls (OH-PCBs) and other chlorinated phenolic compounds and we determined their relative concentrations in whole blood from 13 male and 17 female Inuit from northern Quebec, Canada, and from a pooled whole blood sample from southern Quebec. We also determined concentrations of polychlorinated biphenyls (PCBs). Total OH-PCB concentrations were variable among the Inuit samples, ranging over 2 orders of magnitude (0.117-11.6 ng/g whole blood wet weight). These concentrations were equal to and up to 70 times those found for the southern Quebec pooled whole blood sample. Geometric mean concentrations of total OH-PCBs were 1.73 and 1.01 ng/g whole blood for Inuit men and women, respectively, and 0.161 ng/g whole blood for the southern population pool. There are limited data available for comparison, but the levels of OH-PCBs in Inuit are higher than those previously reported in the literature for other populations. There was a significant correlation (p < 0.005) between OH-PCBs and PCBs (r = 0.84) and both correlated significantly (p < 0.005) with age (r = 0.68 and 0.78, respectively). The ratio of OH-PCBs to PCBs was lower in Inuit (0.11) than in the southern Quebec pool (0.33). There is no apparent explanation for the difference. There was considerable variability in the congener pattern of the identified OH-PCBs. The main metabolite, 4-OH-CB109 (4-OH-2,3,3',4', 5-pentachlorobiphenyl), constituted 12-62% of the total OH-PCBs in the samples. Pentachlorophenol (PCP) was the dominant phenolic compound in blood, constituting 46% (geometric mean) of the total quantitated chlorinated phenolic compounds. PCP concentrations in Inuit blood ranged from 0.558 to 7.77 ng/g on a wet weight basis. All but two Inuit samples had lower concentrations than the southern Quebec pool (6.29 ng/g). The possible role of OH-PCBs in mediating PCB-induced adverse effects needs to be investigated further.
Technetium-99m Pyrophosphate Scintigraphy for the Detection of Acute Myocardial Infarction
Authors: Anil G. Desai, Bruce C. Berger, Yung W. Shin, Chan H. Park, Mark T. Madsen
Journal: Clinical Nuclear Medicine (1985)

To evaluate the contribution of Tc-99m pyrophosphate scintigraphy (TPS) on the overall management of patients suspected of having acute myocardial infarction (AMI), hospital records of 58 consecutive patients who underwent TPS, were evaluated in depth. The results indicate that TPS was essential for the diagnosis of AMI in 16% of the patients. TPS was most rewarding in perioperative patients and in patients with borderline or uninterpretable electrocardiographic and enzyme changes. Also, in some cases, TPS was able to confirm or exclude the diagnosis of AMI prior to the confirmation by serial electrocardiograms (ECG) and serial enzyme changes. TPS was less rewarding in patients with clinically low index of suspicion for AMI. It may also be confusing in patients with high clinical likelihood of AMI and a history of prior myocardial infarction because of the possibility of persistently positive TPS in some of these patients. Considering the limitations of ECGs, the cardiac enzymes, and atypical clinical presentations in the patient population we evaluated, TPS appears to be fairly accurate when the scintigraphic findings are compared with the final diagnosis at the time of discharge from the hospital.
Drugs taken by mothers in the puerperium
Authors: J. C Moffett
Journal: BMJ (1985)

Serum lipid levels at admission (day 0), and 2, 4, 6, 8, 10, and 30 days after acute myocardial infarction.Results are means (and SD) Days: 0 2 4 6 8 10 30 Total cholesterol (mmol/l) 4 53 (1 08) 4 14 (1 00) 4-44 (1-11) 4-67 (1-09) 4-94 (1 08) 5 16 (1-13) 5 94 (143)* HDL cholesterol(mmol'l) 0-97 (0 23) 0-88 (0 21) 0 85 (0 17) 0 87 (0 12) 0-94 (0 14) 0-99 (0-16) 1 09 (0 17)tTriglycerides (mmol,il) 1-29 (0-52) 1-38 (0 63) 1-49 (0-80) 1.53 (0-64) 1 62 (0 75) 1 86 (0-96)$ 2 13 (112)+ *Significantly raised compared with admission p<00025.tSignificantly raised compared with fourth day after admission p < 0-01.$Significantly raised compared with admission p < 0 05.Conversion: SI to traditional units-Cholesterol: 1 mmol/l 38-6 mg!100 ml.Triglycerides: 1 mmol/I 88-5 mg/ 100 ml.
Nocturnal blood pressure in normotensive subjects and those with white coat, primary, and secondary hypertension
Authors: M Middeke, J Schrader
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To compare the mean nocturnal blood pressure of patients with various forms of renal and endocrine hypertension with that in patients with primary and white coat hypertension, and normal blood pressure. <b>Design</b>: Ambulatory monitoring of blood pressure over 24 hours in a prospective study. Setting - Two German centres for outpatients with hypertension and kidney diseases. <b>Subjects</b>: 176 normotensive subjects, 490 patients with primary hypertension including mild and severe forms, 42 with white coat hypertension, 208 patients with renal and renovascular hypertension, 43 with hypertension and endocrine disorders, and three with coarctation of the aorta. <b>Main outcome measures</b>: Fall in nocturnal blood pressure. Results - Blood pressure in normotensive subjects fell by a mean of 14 mm Hg (11%) systolic and 13 mm Hg (17%) diastolic overnight (2200 to 0600). The falls in patients with primary and white coat hypertension were not significantly different. In all patients with renal and renovascular hypertension, however, the fall was significantly reduced (range of fall from 3/3 mm Hg to 7/9 mm Hg). In patients with hypertension and endocrine disorders the pattern of night time blood pressure was not uniform: patients with hyperthyroidism, primary hyperaldosteronism, and Cushing9s syndrome had significantly smaller reductions in blood pressure (6/8, 4/7, 3/6 mm Hg, respectively). In patients with phaeochromocytoma the mean night time blood pressure increased by 4/2 mm Hg. In patients with hypertension, primary hyperparathyroidism, and unoperated coarctation of the aorta the falls in blood pressure were normal. <b>Conclusions</b>: In normotensive subjects and those with primary hypertension there is usually a reduction in blood pressure at night. In all renal forms of secondary hypertension and in most endocrine forms the reduction in blood pressure is only a third to a half of normal. Patients with primary hyperparathyroidism and unoperated coarctation of the aorta show a normal reduction.
Tetrabenazine in Huntington's chorea
Authors: C Y Huang, C Elliott
Journal: BMJ (1977)

<h3>Background</h3> Tobacco smoking can have negative health outcomes on recovery from surgery. Although it is recommended best practice to provide patients with advice to quit and follow-up support, provision of post-discharge support is rare. Developing an online smoking cessation program may help address this gap. <h3>Objectives</h3> This paper describes the development and pretesting of an online smoking cessation program (smoke-free recovery, SFR) tailored to the orthopaedic trauma population for use while in hospital and post-discharge. <h3>Methods</h3> Drawing on the DoTTI framework for developing an online program, the following steps were followed for program development: (1) design and development; (2) testing early iteration; (3) testing for effectiveness and (4) integration and implementation. This article describes the first two stages of SFR program development. <h3>Results</h3> SFR is a 10-module online smoking cessation program tailored for patients with orthopaedic trauma. Of the participants who completed testing early iterations, none reported any difficulties orientating themselves to the program or understanding program content. The main themes were that it was ‘helpful’, provision of ‘help to quit’ was low and SFR increased thoughts of ‘staying quit post-discharge’. <h3>Conclusions</h3> This study found that a theory and evidence-based approach as the basis for an online smoking cessation program for patients with orthopaedic trauma was acceptable to users. A randomised controlled trial will be conducted to examine whether the online smoking cessation program is effective in increasing smoking cessation and how it can be integrated and implemented into hospital practice (stages three and four of the DoTTI framework).
New drug for hepatitis C contributes to 13% rise in spending on prescription drugs in US
Authors: M. McCarthy
Journal: BMJ (2015)

Spending on prescription drugs in the United States rose by $43.4bn (£28.9bn; €40.1bn) in 2014 to reach $373.9bn—a 13.1% increase from 2013—says a report by the IMS Institute of Healthcare Informatics, a consulting group.1

The cost of new drugs to treat hepatitis C, cancer, multiple sclerosis, and diabetes, as well as higher prices for diabetes drugs, contributed the most to the growth in spending, the report said. The increase is the largest since 2001, when spending jumped by 17%.

Spending on the costlier new drugs alone contributed $20.2bn to spending growth in 2014, the report added. More than half of this increase, $11.3bn, went to pay for four new hepatitis C drugs as the number of patients receiving such treatments rose to 161 000, a 10-fold increase from 2013. A 12 week course of …
Delivery of infants with Glanzmann thrombasthenia and subsequent blood transfusion requirements: A follow‐up of 39 patients
Authors: Abdalla S. Awidi
Journal: American Journal of Hematology (1992)

The delivery and transfusion requirements of 39 patients with Glanzmann thrombasthenia are described. Of these, type I thrombasthenia was found in 21 females and 12 males, and type II thrombasthenia was found in four females and two males. Eighteen of these patients were born in the hospital and 21 at home. All were delivered vaginally. Absence of excessive hemorrhagic symptoms was noted in neonates affected with thrombasthenia. The patients were followed for a total of 220 patient years and received a total of 276 units of blood during this period. In females, the dominant reason for transfusion was menorrhagia followed by gum bleeding and epistaxis, while in males epistaxis, gum bleeding, and circumcision accounted for most of the transfusions.
Erythema chronicum migrans in Britain.
Authors: D Goldin, R H Champion, A Rook, S O Roberts
Journal: BMJ (1978)

Further investigation has shown that the incorrect Reflomat result may have resulted from inserting the Reflomat strip into the machine upside down, which can give spurious readings up to 4 0 mmol/l.Incorrect insertion of the strip is, of course, more likely when testing for hypoglycaemia since the test surface fails to show significant colour change in this situation.This problem does not appear to be significant with the more recently available Reflotest-Hypoglycemie strips, though false results may occur.if either of the strips is not fully inserted into the machine.Although all laboratory results should be interpreted in the context of the clinical findings, we should like to alert your readers to this potential cause of error and suggest that the manufacturers alter the colour of the blank reverse side of the strip to obviate this risk.
An immunologic homunculus for type 1 diabetes
Authors: D. Homann
Journal: Journal of Clinical Investigation (2006)

Autoimmune diseases such as the diabetes that develops in NOD mice depend on immunologic recognition of specific autoantigens, but recognition can result in a pathogenic or protective T cell response. A study by Du et al. in this issue of the JCI demonstrates that TGF-β signaling by T cells recognizing the insulin peptide B:9–23 is essential for such protection and that this inhibitory cytokine functions in both a paracrine and an autocrine manner (see the related article beginning on page 1360). We propose that the insulin peptide B:9–23 and a conserved TCR motif form an “immunologic homunculus” underlying the relatively common targeting of insulin by T cells that, as demonstrated by the study of Du and coworkers, results in a protective T cell response, or diabetes, as shown by other investigators, for related T cell receptors.
Spontaneous Amputation of the Forearm
Authors: J. R. Swanton
Journal: BMJ (1867)

posed.Tubercle occurs in little rounded masses, whose size rarely ex- ceeds that of a hempseed, and each of these masses has been formed, as it were, from several separate centres; so that we see (in transverse sec- tions through a granulation) what appears to be a section through a small tumour whose elements are more or less concentrically arranged around several centres.This concentric arrangement of elements is fre-
922 RESCUE THERAPY WITH COMBINATION OF ENTECAVIR AND TENOFOVIR IN PATIENTS WITH CHRONIC HBV, ADVANCED FIBROSIS AND MULTIPLE PREVIOUS TREATMENT FAILURES IS SAFE AND HIGHLY EFFICIENT
Authors: M. Lütgehetmann, J. Schollmeyer, T. Volz, A. Lohse, P. Buggisch, M. Sterneck, T. Meyer, C. Sarrazin, M. Dandri, J. Petersen
Journal: Journal of Hepatology (2009)
The identification of a heparin binding domain peptide from bone morphogenetic protein-4 and its role on osteogenesis
Authors: Yoon Jung Choi, Jue Yeon Lee, Jung Hyun Park, Jun Beom Park, Jin Sook Suh, Young Suk Choi, Seung Jin Lee, Chong-Pyoung Chung, Yoon Jeong Park
Journal: Biomaterials (2010)
Screening Mammography — Potential Problems on the Horizon
Authors: Ferris M. Hall
Journal: New England Journal of Medicine (1986)

There is general agreement in the medical community with the recommendations of the American Cancer Society and the American College of Radiology (ACS/ACR) that all women have a base-line mammogram at the age of 35 to 40, with follow-up examinations annually or biennially until the age of 50 and then annually thereafter. The Breast Cancer Detection Demonstration Project showed a breast cancer prevalence of 7 per 1000, with an annual incidence of 3 per 1000. Forty-two percent of these neoplasms were nonpalpable and detected only by mammography. Only 9 percent were mammographically negative and detected only on physical examination.1 A . . .
The Genome of Th17 Cell-Inducing Segmented Filamentous Bacteria Reveals Extensive Auxotrophy and Adaptations to the Intestinal Environment
Authors: Andrew Sczesnak, Nicola Segata, Xiang Qin, Dirk Gevers, Joseph F. Petrosino, Curtis Huttenhower, Dan R. Littman, Ivaylo I. Ivanov
Journal: Cell Host & Microbe (2011)
Warm water infusion colonoscopy: a review and meta-analysis
Authors: T. Rabenstein, F. Radaelli, O. Zolk
Journal: Endoscopy (2012)

<b>Background and study aims:</b> Warm water infusion instead of traditional air insufflation during the insertion phase of colonoscopy has been proposed to reduce pain and improve patient acceptance of the procedure. This systematic review aimed to compare warm water infusion with standard air insufflation according to findings from randomized controlled trials (RCTs). <b>Methods:</b> In a systematic review and meta-analysis of RCTs comparing warm water infusion with standard air insufflation, primary outcome measures were procedure-related (cecal intubation, time to cecal intubation, and adenoma detection rates) and patient-related (pain). <b>Results:</b> Nine studies (1283 patients) were included. Warm water infusion, as sole modality for facilitating insertion, was associated with a fourfold higher risk of cecal intubation failure compared with air insufflation (risk ratio [RR] 4.01, confidence interval [CI] 1.17 to 13.78, <i>P</i> = 0.03), but this risk did not significantly differ between warm water infusion and air insufflation with the hybrid technique (i. e., brief use of air when difficulty, e. g. poor view, was encountered). Warm water infusion and air insufflation were associated with similar cecal intubation times (<i>P</i> = 0.62) and adenoma detection rates (<i>P</i> = 0.49), but with warm water infusion patients experienced significantly less pain (<i>P</i> < 0.00001) and a significantly lower proportion requested sedation and/or analgesia (RR 0.48, CI 0.35 to 0.66, <i>P</i> < 0.00001). <b>Conclusions:</b> Although failure of cecal intubation is more frequent with warm water infusion, technical modifications, i. e., short air insufflations, can abolish this. Warm water infusion is less painful than standard air insufflation, reduces the need for sedation/analgesia, and improves patient acceptance of colonoscopy, without additional adverse reactions.
Basic physiopathological patterns of perfusion and inhalation pulmonary scintigraphy
Authors: M. Ferrari, A. Paez, C. L. Soto, E. Touya, R. Burgos, J. J. Y Touya H
Journal: Thorax (1969)

<sup>113m</sup>In is an excellent radiopharmaceutical for pulmonary scanning. Seven physiopathological patterns are described after the study of the results of successive perfusion and inhalation pulmonary scans—pulmonary artery obstruction, complete bronchial obstruction, partial bronchial obstruction, bronchiolar obstruction, anatomical changes in the pulmonary parenchyma, pathological pulmonary dead space, and intrapulmonary arterio-venous shunting. Pulmonary artery obstruction can be diagnosed early, precisely, and safely by this method. Pathological pulmonary dead space and intrapulmonary shunting have well-defined characteristics; the ability to demonstrate their topography and size in patients with pulmonary emphysema may lead to surgical removal of the affected regions, thus improving overall pulmonary function. The scintigraphic procedures used revealed that bronchial obstruction is associated with absent pulmonary arterial perfusion in the corresponding bronchial territory; this finding is of the utmost importance, as it may permit the diagnosis of bronchial carcinoma before any radiological changes occur.
VESSEL-BASED BINARY CLASSIFICATION OF CORONARY REMODELING AS POSITIVE OR NON-POSITIVE DOES NOT FULLY REFLECT VESSEL BEHAVIOR: A LONGITUDINAL 3-D IVUS/ANGIOGRAPHY STUDY WITH THREE REMODELING GROUPS
Authors: Andreas Wahle, Zhi Chen, Michael Wilk, Richard Downe, Tatiana Masiarova, Hana Skalicka, Ales Kral, Stepan Jerabek, Milan Sonka, John Lopez, Tomas Kovarnik
Journal: Journal of the American College of Cardiology (2014)
THE TOXIC PROPERTIES OF SERUM EXTRACTS OF HEMOLYTIC STREPTOCOCCI
Authors: Julia T. Weld
Journal: The Journal of Experimental Medicine (1934)

1. A method is described whereby toxic substances may be extracted from hemolytic streptococci with inactivated serum. 2. Such extracts contain large amounts of hemotoxin and leucocidin. 3. Their intravenous injection into mice causes marked hemoglobinuria, anemia, and death. 4. There is evidence that this anemia is not the only cause of death of these animals. 5. Incomplete work seems to indicate that the hemotoxin and the lethal poisons are not antigenic. 6. Certain biological properties of the extract are described.
1121-61 Characterization of neointimal hyperplasia after sirolimus-eluting stent implantation in patients with previous brachytherapy failure: Insights from the SECURE study
Authors: Marco Costa, Kuldeep Talwar, Neeta Panse, Paul Teirstein, Yakubov S Carter Theodore, A.J Bass, Paul Gilmore
Journal: Journal of the American College of Cardiology (2004)
Fatal irreversible hypercalcaemia in breast cancer.
Authors: M Cornbleet, P K Bondy, T J Powles
Journal: BMJ (1977)

Fatal irreversible hypercalcaemia in breast cancerOsteolytic bone metastases may cause excessive release of calcium from the skeleton and result in progressive, fatal hypercalcaemia.1 2 Oestrogen treatment for metastatic disease may precipitate this.3We describe two patients who developed fatal hypercalcaemia within days of starting oestrogen treatment.