tbuckley/cabot-search huggingface dataset:
Ethnicity and prescription of analgesia in an accident and emergency department: cross sectional study
Authors: D. M A Choi
Journal: BMJ (2000)

needs.However, greater involvement of stakeholders and the application of clear method have a cost.We estimate that the whole process of organising, running, and analysing the nominal group cost about £10 000 (including about £5000 for the time of all the clinical participants).We believe that the clear benefits of the approach make this highly cost effective.
FGF-21 as a novel metabolic regulator
Authors: Alexei Kharitonenkov, Tatiyana L. Shiyanova, Anja Koester, Amy M. Ford, Radmila Micanovic, Elizabeth J. Galbreath, George E. Sandusky, Lisa J. Hammond, Julie S. Moyers, Rebecca A. Owens, Jesper Gromada, Joseph T. Brozinick, Eric D. Hawkins, Victor J. Wroblewski, De-Shan Li, Farrokh Mehrbod, S. Richard Jaskunas, Armen B. Shanafelt
Journal: Journal of Clinical Investigation (2005)

Diabetes mellitus is a major health concern, affecting more than 5% of the population. Here we describe a potential novel therapeutic agent for this disease, FGF-21, which was discovered to be a potent regulator of glucose uptake in mouse 3T3-L1 and primary human adipocytes. FGF-21-transgenic mice were viable and resistant to diet-induced obesity. Therapeutic administration of FGF-21 reduced plasma glucose and triglycerides to near normal levels in both ob/ob and db/db mice. These effects persisted for at least 24 hours following the cessation of FGF-21 administration. Importantly, FGF-21 did not induce mitogenicity, hypoglycemia, or weight gain at any dose tested in diabetic or healthy animals or when overexpressed in transgenic mice. Thus, we conclude that FGF-21, which we have identified as a novel metabolic factor, exhibits the therapeutic characteristics necessary for an effective treatment of diabetes.
PASSAGE OF NINETY-ONE GALL-STONES THROUGH A SUPPOSED ULCERATED OPENING OF THE GALL-BLADDER INTO THE INTESTINE
Authors: F. W. P. Jago
Journal: BMJ (1854)

f%aA OOWNICATIONS.147 :no c0hat 1mptoms, and profs piration.In famer cae, the pulse was 110, gd -so respiration 40.On the fellowing day, the pulse was 100, and the respirt 32.In thee days, the pulse had fllen to 76, while the respiration was still 32.During convalescnce, the pulse remainediteady, while the respiration radually subsided to 17.In the last case, where lemon-jiuice was *ven, the puls was at first 120, and the respiration 36.and tumour over the gall-bladder being very great.
Population based cost utility study of interferon beta-1b in secondary progressive multiple sclerosis
Authors: R. B Forbes, A. Lees, N. Waugh, R. J Swingler
Journal: BMJ (1999)

To evaluate the cost utility of interferon beta-1b in secondary progressive multiple sclerosis.Population based cost utility model (healthcare perspective). Data on use of health services were obtained from case records and routine morbidity data and utility values from a EuroQol survey. Local and published costs were used. Effectiveness was modelled using data on relative risk reductions from a randomised trial of interferon beta-1b.Tayside region, 1993-5.132 ambulatory people with secondary progressive multiple sclerosis.Cost per quality adjusted life year (QALY) gained. Rate of relapse and proportion becoming wheelchair dependent over three years.The number needed to treat for 30 months to delay time to wheelchair dependence in one person by nine months was 18 (95% confidence interval 5 to 26). For every 18 people treated for 30 months, six relapses would be prevented, gaining 0.397 discounted QALYs. The cost per QALY gained was 1 024 667 pounds sterling (276 466 pounds sterling to 485 499 pound sterling). If treatment was restricted to patients attending neurology services, the number needed to treat was 14 (cost per QALY gained 833 pounds sterling 514 (161 358 pounds sterling to infinity)). The cost per QALY gained was not sensitive to changes in cost which took account of a societal perspective.The cost per QALY gained from interferon beta is high because of the high drug cost and modest clinical effect. Resources could be used more efficiently elsewhere.
Angina Pectoris Associated With Use of Terbutaline for Premature Labor
Authors: Kuang-Hung Tye
Journal: JAMA (1980)

Terbutaline sulfate was administered intravenously and orally to an 18-year-old woman because of premature labor. This therapy resulted in retrosternal chest pain associated with major ST segment depression on the ECG. Sublingual nitroglycerin abated the chest pain and produced resolution of the previously noted ST segment depression. Pharmacologic effects of terbutaline in concert with the stress imposed by pregnancy may provide a hemodynamic setting conducive to a disturbance in the myocardial oxygen supply and demand relationship. (<i>JAMA</i>244:692-693, 1980)
Evagination of smooth muscle cells in the hypoxic pulmonary trunk.
Authors: P Smith, D Heath, F Padula
Journal: Thorax (1978)

Six female Wistar albino rats were exposed to the hypoxia of a simulated altitude of 5500 m, three for a period of one week and three for a month. They developed ultrastructural changes in the pulmonary trunk consisting of evaginations of muscle cells of its media through gaps in the internal elastic lamina to press into the underlying endothelial cells. Such evaginations were usually devoid of myofilaments and organelles. Some appeared so electron-lucent as to be unrecognisable as muscle apart from the unequivocal connection with the parent smooth muscle cells. Elsewhere we have demonstrated that muscular evaginations in normal pulmonary blood vessels are an artefact brought about by collapse of lung tissue and that they can be avoided by distending the lung. Hence in the present investigation, in which the pulmonary trunk was fixed in distension, the evaginations are interpreted as indicating contraction of the muscle cells able to overcome the distending force. We interpret them as evidence of constriction of muscle cells in the media of the pulmonary trunk in response to hypoxia.
Metabolism of Orally Administered L-(C^14)-DOPA in Patients with Parkinson's Disease.
Authors: J. R. Bianchine
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Metabolism of Orally Administered L-(C14)-DOPA in Patients with Parkinson's Disease.J. R. Bianchine, M.D., M. J. T. Peaston, M.D.J. R. Bianchine, M.D.Search for more papers by this author, M. J. T. Peaston, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-806_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe therapeutic efficacy of large oral doses of L-3:4 dihydroxyphenylalanine (DOPA) in selected patients with Parkinson's disease has been made clear by Cotzias and others. The purpose of this study is to determine the metabolic fate of orally administered L-DOPA. Six men with uncomplicated Parkinson's disease were selected for study. All patients were hospitalized and fasted overnight prior to study. A gelatin capsule containing 100 µc L-[C14]-DOPA (Hoffman-La Roche) labelled in beta position and a total of 500 mg L-DOPA were administered orally at time zero. Serum, expired air, urine, and stool were sampled, first at hourly, then at longer... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Baltimore, Md. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 806-806KeywordsLevodopaParkinson diseaseUrine Issue Published: 1 May 1970 PDF downloadLoading ...
Estimation of the Risk of Thrombocytopenia in the Offspring of Pregnant Women with Presumed Immune Thrombocytopenic Purpura
Authors: Philip Samuels, James B. Bussel, Leonard E. Braitman, Anne Tomaski, Maurice L. Druzin, Michael T. Mennuti, Douglas B. Cines
Journal: New England Journal of Medicine (1990)

The optimal management of immune thrombocytopenic purpura during pregnancy remains controversial because the risk of severe neonatal thrombocytopenia remains uncertain. We studied the outcome of the index pregnancy in 162 women with a presumptive diagnosis of immune thrombocytopenic purpura to determine the frequency of neonatal thrombocytopenia and to determine whether neonatal risk could be predicted antenatally by history or platelet-antibody testing.
ALCOHOL AND AUTOMOBILE ACCIDENTS
Authors: HERMAN A. HEISE
Journal: JAMA (1934)

That the problem of controlling the drinking driver and pedestrian is far from being solved may be due, in part, to the fact that no accurate statistics are available regarding the relationship of alcohol to automobile accidents, as well as to the fact that the diagnosis of drunkenness is, to a great extent, still made through unreliable physical observations. In a previous paper<sup>1</sup>the chemical test for alcohol in body fluids has been shown to be specific and a practical method for confirming a diagnosis of drunkenness, thus aiding in the conviction of drunken drivers. In the present paper a further study has been made of the subjective and objective symptoms due to a consumption of alcohol correlated with the chemical examinations, and an analysis of 119 automobile accidents involving injury or death to 216 persons has been made in an effort to obtain a closer estimate of the
Improvements in simulated real‐world relevant performance for patients with seasonal allergic rhinitis: impact of desloratadine
Authors: U. Satish, S. Streufert, M. Dewan, S. Vande Voort
Journal: Allergy (2004)

Background: Seasonal allergic rhinitis (SAR) diminishes task performance and decreases quality of life. Antihistamines are frequently used to treat the symptoms of SAR. First generation antihistamines often have their own detrimental effects upon human functioning while second generation antihistamines appear to have fewer or no undesirable side‐effects. Objective: This study evaluated the impact of desloratadine on simulated real‐world performance demands in individuals suffering from SAR. Methods: This was a randomized, double‐blind, cross‐over study where asymptomatic participants were treated with placebo and symptomatic participants were treated with desloratadine or placebo. They then participated in a real‐world equivalent task performance simulation that assessed information processing capacity at multiple levels of task difficulty ranging from easy to difficult decision‐making tasks. Results: Desloratadine either completely restored performance to the level of the asymptomatic placebo control or improved performance in six of the nine performance categories, where it had been diminished by the presence of SAR. Conclusions: These findings suggest that treatment with desloratadine has considerable beneficial effects on work place performance when individuals suffer from SAR.
Atlas of Nuclear Cardiology: Imaging Companion to Braunwald’s Heart DiseaseAmi E. Iskandrian, MD, MACC, FASNC, FAHA, and Ernest V. Garcia, PhD, FASNC, FAHA, eds 453 pages. Philadelphia, PA: Elsevier Saunders; 2012. $179.00. ISBN: 978-1-4160-6134-2
Authors: George A. Beller
Journal: Circulation (2013)
Antidoping programme and biological monitoring before and during the 2014 FIFA World Cup Brazil
Authors: Norbert Baume, Nicolas Jan, Caroline Emery, Béatrice Mandanis, Carine Schweizer, Sylvain Giraud, Nicolas Leuenberger, François Marclay, Raul Nicoli, Laurent Perrenoud, Neil Robinson, Jiri Dvorak, Martial Saugy
Journal: British Journal of Sports Medicine (2015)

The FIFA has implemented an important antidoping programme for the 2014 FIFA World Cup.To perform the analyses before and during the World Cup with biological monitoring of blood and urine samples.All qualified players from the 32 teams participating in the World Cup were tested out-of-competition. During the World Cup, 2-8 players per match were tested. Over 1000 samples were collected in total and analysed in the WADA accredited Laboratory of Lausanne.The quality of the analyses was at the required level as described in the WADA technical documents. The urinary steroid profiles of the players were stable and consistent with previously published papers on football players. During the competition, amphetamine was detected in a sample collected on a player who had a therapeutic use exemption for attention deficit hyperactivity disorder. The blood passport data showed no significant difference in haemoglobin values between out-of-competition and postmatch samples.Logistical issues linked to biological samples collection, and the overseas shipment during the World Cup did not impair the quality of the analyses, especially when used as the biological passport of football players.
377. Intravascular Delivery of Adenovirus Vectors Rapidly Targets Platelets to the Reticuloendothelial System
Authors: Daniel Stone, Shaoheng Ni, Zong-Yi Li, Dmitry Shayakhmetov, Andre Lieber
Journal: Molecular Therapy (2006)

Following intravenous (iv) delivery of an adenovirus (Ad) vector a severely adverse event was seen in a phase I clinical trial. Systemic inflammatory response syndrome (SIRS) and biochemically detectable disseminated intravascular coagulation (DIC) were among complications that ultimately resulted in multiple organ system failure 98 hours after iv delivery of a dose of 6 × 1011 viral particles/kg. DIC is a complex clinical syndrome characterized by a systemic activation of coagulation leading to the intravascular deposition of fibrin in the (micro) vasculature and the simultaneous consumption of coagulation factors and platelets. Since platelet consumption is a symptom of DIC and Ad vectors are known to induce thrombocytopenia after iv delivery we decided to investigate Ad_ platelet interactions as part of a safety and toxicity study. We investigated the interactions of an Ad5 vector, chimeric Ad5 vectors possessing the CD46 interacting Ad11 or Ad35 fibers (Ad5/F11 or Ad5/F35), and an Ad11 vector, early after iv delivery to mice. Transgenic mice that express human CD46 were injected in the tail vein with a total of 1011 viral particles of each vector. Within 10 minutes of iv delivery we found Ad particles associated with circulating platelets, with the highest levels seen with Ad11 vectors. Subsequently, different organs where monitored by immunohistochemistry and transmission electron microscopy (TEM) for evidence of in vivo Ad_platelet interactions. Within 5 minutes of administration degranulated platelets containing Ad5, Ad5/F11, Ad5/F35 or Ad11 vector particles could be seen directly interacting with endothelial cells within the liver sinusoids by TEM. Ad particles could also be seen within platelet aggregates and inside Kupffer cells. Triple label immunohistochemistry revealed widespread co_labeling of platelets (CD41), Kupffer cells (F4/80) and Ad (hexon) throughout the liver. In the spleen immunohistochemistry showed Ad particles in macrophage and platelet_rich areas of the marginal zone within 5 minutes. In the lung Ad genomes were found within 5 minutes with higher numbers of Ad11 genomes present. Widespread platelet accumulation was seen after delivery of all Ad vectors, with platelet_endothelial interaction and platelet aggregates visible throughout the pulmonary vasculature by immunohistochemistry and TEM. Polymorphonuclear cells and leukocytes within the pulmonary vasculature were also seen interacting with platelet aggregates. These data suggest that Ad and platelets interact rapidly after iv Ad delivery and that this interaction causes rapid targeting of platelets to the reticuloendothelial system. We are currently investigating the mechanisms of Ad_platelet interaction and subsequent platelet reticuloendothelial targeting.
Nitric oxide and prostacyclin as test agents of vasoreactivity in severe precapillary pulmonary hypertension: predictive ability and consequences on haemodynamics and gas exchange
Authors: P. Jolliet, P. Bulpa, J. B. Thorens, M. Ritz, J. C. Chevrolet
Journal: Thorax (1997)

In patients with primary pulmonary hypertension who respond to vasodilators acutely, survival can be improved by the long term use of calcium channel blockers. However, testing for such a response with calcium channel blockers or prostacyclin (PGI2) may cause hypotension and adversely affect gas exchange. Nitric oxide (NO), which does not have these effects, could be a better test agent.NO (10, 20, and 40 ppm for 15 minutes), PGI2 (1-->10 ng/kg/min), and oral nifedipine (10 mg, then 20 mg/h) were administered sequentially to 10 patients after determination of the 24 hour spontaneous variability of their pulmonary and systemic mean arterial pressures. Patients were considered responders if the mean pulmonary artery pressure or pulmonary vascular resistance decreased by 20% or more.Six patients (60%) responded to all three agents, and three to none of the agents. One patient responded to PGI2 only. In those who responded to vasodilators, NO had no major effect on gas exchange or systemic haemodynamics, while PGI2 and nifedipine both induced systemic hypotension (mean (SD) systemic arterial pressure 72 (14) versus 89 (19) mm Hg with PGI2 and 72 (15) versus 86 (17) mm Hg with nifedipine, p < 0.05) and hypoxaemia (PaO2 8.7 (1.4) versus 10.8 (1.0) kPa with PGI2 and 8.6 (1.4) versus 10.2 (1.5) kPa with nifedipine, p < 0.05) and increased venous admixture (28 (9) versus 14 (4)% with PGI2 and 22 (9) versus 13 (5)% with nifedipine, p < 0.05).NO inhalation can accurately predict a vasodilator response to nifedipine in patients with severe pulmonary hypertension without adverse effects on systemic haemodynamics and gas exchange. This absence of side effects may make it a more appropriate agent for testing the vasodilator response.
Use of Corticosteroids After Hepatoportoenterostomy for Bile Drainage in Infants With Biliary Atresia
Authors: Jorge A. Bezerra, Cathie Spino, John C. Magee, Benjamin L. Shneider, Philip Rosenthal, Kasper S. Wang, Jessi Erlichman, Barbara Haber, Paula M. Hertel, Saul J. Karpen, Nanda Kerkar, Kathleen M. Loomes, Jean P. Molleston, Karen F. Murray, Rene Romero, Kathleen B. Schwarz, Ross Shepherd, Frederick J. Suchy, Yumirle P. Turmelle, Peter F. Whitington, Jeffrey Moore, Averell H. Sherker, Patricia R. Robuck, Ronald J. Sokol
Journal: JAMA (2014)

Biliary atresia is the most common cause of end-stage liver disease in children. Controversy exists as to whether use of steroids after hepatoportoenterostomy improves clinical outcome.
Risk Factors for Chronic Kidney Disease in Adults with Cystic Fibrosis
Authors: Bradley S. Quon, Nicole Mayer-Hamblett, Moira L. Aitken, Alan R. Smyth, Christopher H. Goss
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Rationale: Adults with cystic fibrosis (CF) possess multiple potential risk factors for chronic kidney disease, including CF-related diabetes (CFRD) and lifetime nephrotoxic drug exposure.Objectives: To determine whether cumulative intravenous (IV) aminoglycoside exposure and CFRD increase the risk of chronic kidney disease in adults with CF.Methods: This was a cohort study using adults (≥ 18 yr) in the CF Foundation registry from 2001–2008. Chronic kidney disease (stage 3 or greater) was defined by an estimated glomerular filtration rate of less than 60 ml/min/1.73 m2. Time-dependent multivariable Cox proportional hazards models were used to determine whether cumulative number of acute pulmonary exacerbations (surrogate for IV aminoglycoside exposure) and CFRD requiring insulin increase the risk of chronic kidney disease, adjusting for confounders.Measurements and Main Results: The study cohort included 11,912 adults with a median follow-up of 4 years. During the study period, 204 subjects had chronic kidney disease, with an annual disease prevalence of 2.3%. Disease prevalence doubled with every 10-year increase in age. CFRD requiring insulin therapy substantially increased the risk of chronic kidney disease (1–4 yr of CFRD requiring insulin vs. no CFRD, hazard ratio [HR] = 2.40, 95% confidence interval [CI] 1.74–3.32; ≥ 5 yr, HR = 4.56, 95% CI 2.84–7.31). Pulmonary exacerbations did not significantly increase the risk of chronic kidney disease (one to five exacerbations vs. none, HR = 0.79, 95% CI 0.56–1.11; six to nine exacerbations, HR = 0.92, 95% CI 0.58–1.46; ≥ 10 exacerbations, HR = 1.16, 95% CI 0.75–1.81).Conclusions: CF-related diabetes is a significant risk factor for chronic kidney disease in adults with CF, but additional studies examining IV aminoglycoside exposure directly are required.
Responding to Requests for Physician-Assisted Suicide
Authors: Paul B. Bascom, Susan W. Tolle
Journal: JAMA (2002)

Studies of dying patients have shown that about half would like the option of physician-assisted suicide (PAS) to be available for possible future use. Those percentages decrease significantly with each step patients take toward action. Studies show that although about 10% of patients seriously consider PAS, only 1% of dying patients specifically request it, and 1 in 10 of those patients actually receive and take a lethal prescription. However, most patients' desires for PAS diminish as their underlying concerns are identified and addressed directly. To help identify concerns motivating a patient's request for PAS, physicians should talk with patients about their expectations and fears, options for end-of-life care, goals, family concerns and burdens, suffering or physical symptoms, sense of meaning and quality of life, and symptoms of depression. A patient with advanced amyotrophic lateral sclerosis (ALS) who requested PAS illustrates how a hasty response may adversely affect patient care and the health care team. Although physicians should remain mindful of their personal, moral, and legal concerns, these concerns should not override their willingness to explore what motivates a patient to make this request. When this approach is taken, suffering can be optimally alleviated and, in almost all cases, the patient's wishes can be met without PAS.
Intercurrent Hepatitis A in Chronic B Viral Hepatitis-Reply
Authors: Richard A. Willson
Journal: JAMA (1982)

In Reply.—  I appreciate Dr Casey's interest in my report of intercurrent hepatitis A in chronic B viral hepatitis. It is true that newer viral hepatitis serological tests are being rapidly generated. Inasmuch as viral hepatitis A, B, and non-A, non-B are more accurately defined by serological testing, such would be anticipated. Nevertheless, both radioimmunoassays employed in the patient reported were current at the time of study. 1,2 Without documentation of the unreliability of the various serological tests, it is difficult to interpret Dr Casey's impressions fully. Indeed, two recent reports using older-generation and newer-generation radioimmunoassays arrive at similar conclusions in their serological sorting of hepatitis A and hepatitis B in a population at high risk for both. 3,4 Consequently, based on the methods used at the time, the serological interpretation remains most consistent with an intercurrent viral hepatitis A.
THE INDICATIONS AND CONTRAINDICATIONS FOR ARTIFICIAL PNEUMOTHORAX
Authors: F. G. Chandler
Journal: BMJ (1924)

b_~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~A J_WA TYPE IV.Thle patient is sent to the x-ray department for examina- tioni of the chest for a suspected tuberculous lesion at onie apex.The radiogiraph on the suspected side showrs a cervical rib of the type which as a rule joins the first true rib jiear its sternal end, bult the lung itself gives no suggestion of tuberculous disease.One oase will illustrate this type. CASE VII.A female, aged 25, was sent for radiological examiination of the clhest with the diagniosis " phthisis right apex."Slhe complainied of pain in the right side of the chest, loss of weight, slight cough and expectoration, following influenza eighteen months before.The sputum was negative.