tbuckley/cabot-search huggingface dataset:
Outbreaks among travellers linked to almost twofold rise in measles cases
Authors: M. Limb
Journal: BMJ (2012)

Almost twice as many measles cases were reported in England and Wales for the first six months of 2012 as during the same period last year, and outbreaks among travelling communities are partly responsible, the Health Protection Agency (HPA) says.

There have been 964 confirmed cases of measles reported to the HPA in the first six months of 2012, which is almost twice that reported during the same period in 2011 (494 cases).

The measles cases identified so far this year have been associated with ongoing outbreaks in Merseyside and Sussex, as well as …
Impact of obesity on treatment of chronic hepatitis C
Authors: Michael R. Charlton, Paul J. Pockros, Stephen A. Harrison
Journal: Hepatology (2006)

Obesity and the metabolic syndrome have hepatic manifestations, including steatosis and progression of fibrosis. In individuals with chronic hepatitis C, obesity is associated with inflammation, insulin resistance, steatosis, progression of fibrosis, and nonresponse to treatment with interferon or peginterferon alpha and ribavirin. Patients with both hepatitis C and obesity-related nonalcoholic fatty liver disease are at greater risk for more advanced liver disease. We review the mechanisms by which obesity may be associated with decreased efficacy of interferon-based therapies in individuals with chronic hepatitis C and the therapeutic strategies that may increase the effectiveness of these therapies in obese individuals.
SUPERIORITY OF CORONARY SINUS CARDIAC BIOMARKER SAMPLING OVER PERIPHERAL VENOUS BLOOD FOR PROGNOSTICATION IN CARDIAC RESYNCHRONIZATION THERAPY: THE BIOCRT STUDY
Authors: Quynh A. Truong, James Januzzi, Jackie Szymonifka, Wai-ee Thai, Bryan Wai, Umesh Sharma, Ryan Sandoval, Zachary Grunau, Sandeep Basnet, Adefolakemi Babatunde, Olujimi Ajijola, Jagmeet Singh
Journal: Journal of the American College of Cardiology (2014)
Observations on the Employment of the Alcoholic Extract of Nux Vomica
Authors: E. Boult
Journal: BMJ (1848)

Vith "a painful sensation and stricture about the fknum.These symptoms usually take place when in bed.Some persons rarely have the second species without chordee.Gonorrhea generally makes its appearance on the third or fourth day after infection.It has been known to take place twelve hours after; and on the other hand itnaiy not appear In some instances till a fortnight or even a month after the application of the matter.In general the complaint is more severe where the indtval is long; tbis, however, is not an invariable rile; the degree of the disease, and the interval between the infection and its development, very much depend upon the nature of the constitution, and in some measure also upon the particular state in which the patient happened to be at the time of contracting the disease.
Direct determination of PCO2 in the rat renal cortex.
Authors: T D DuBose, L R Pucacco, D W Seldin, N W Carter
Journal: Journal of Clinical Investigation (1978)

The mechanism by which the kidney reabsorbs sodium bicarbonate could be a result of (a) H+ secretion, (b) direct HCO3- reabsorption, or (c) a combination of both processes. Most of the studies which have supported the H+ secretory theory have involved the assumption that tubular fluid and arterial PCO2 were equal. We have utilized a new PCO2 microelectrode to directly determine in situ PCO2 of tubular fluid and stellate vessel blood in the cortex of the rat kidney during control conditions and after alterations in acid-base status. In 21 control rats, proximal tubular fluid PCO2 exceeded systemic arterial PCO2 (deltaCO2) by 25.9 +/- 0.92 mm Hg (P less than 0.001). The values obtained for both distal tubular fluid and stellate vessel blood were not significantly different from proximal tubular PCO2. Evaluation of PCO2 in the proximal tubules of Munich-Wistar rats did not reveal evidence for a declining profile for PCO2 along the length of the nephron. When proximal bicarbonate reabsorption was increased or decreased acutely by alterations in acid-base status, deltaPCO2 changed in paralle. Furthermore, benzolamide administration significantly reduced deltaPCO2. We conclude: (a) that the PCO2 in tubular fluid is significantly greater than systemic arterial PCO2, (b) that there is no tendency for the observed PCO2 to fall along the proximal tubule, (c) the mean PCO2 in the proximal and distal tubules as well as the stellate vessle is not significantly different, thereby rendering the concept of a "diffusion barrier" for CO2 in the proximal tubule unlikely, and (d) the level of renal cortical PCO2 appears to vary directly with the magnitude of bicarbonate reabsorption.
Phonocardiography in Patent Ductus Arteriosus
Authors: OLGA M. HARING, ALDO A. LUISADA, BENJAMIN M. GASUL
Journal: Circulation (1954)

The study of 28 patients proved that patients with uncomplicated patent ductus arteriosus have a typical phonocardiographic picture. This consists of a single late systolic-early diastolic murmur which may be either continuous or noncontinuous. These patients also have no electrocardiographic evidence of right ventricular hypertrophy and no elevation of pulmonary arterial pressure. Atypical murmurs are found only when additional aortic or pulmonic lesions or severely elevated pulmonary pressure due to intrapulmonary vascular changes is present. The high percentage of atypical or complicated ducti in infancy explains why infants frequently have atypical murmurs. Phonocardiography increases the accuracy of diagnosis.
Good not bad medicine
Authors: J. Butler, D. Barton, J. Shepherd, K. Reynolds, S. Kehoe
Journal: BMJ (2011)

We read with interest Dr Spence’s article “Bad medicine: gynaecological examinations” and agree with the assessment of the low sensitivity and specificity of bimanual pelvic examination and the importance of ultrasound imaging for patients with pelvic or abdominal symptoms.1 

We read with great concern, however, the recommendation that …
Cost Effectiveness of Lead Screening
Authors: Donald M. Berwick, Anthony L. Komaroff
Journal: New England Journal of Medicine (1982)

Abstract Lead-screening programs may reduce childhood disabilities, but at what cost? Through a review of the literature, we performed a cost-effectiveness analysis in which the costs, savings, and health benefits of two lead-screening strategies — employing either a free erythrocyte protoporphyrin assay or blood lead measurement — were compared with each other and with a strategy of no screening in a population of three-year-old children. When the prevalence of lead poisoning among the children screened is 7 per cent or more, we estimate that free erythrocyte protoporphyrin screening averts morbidity and results In net savings: It is both better and cheaper than no screening. At prevalences below 7 per cent, the net positive costs from screening and early treatment must be weighed against the noneconomic benefits of improved quality of life and considered in relation to other investments that could be made to benefit society. At all prevalence rates, free erythrocyte protoporphyrin screening is more cost effective than blood lead screening. (N Engl J Med. 1982; 306:1392–8.)
Novel receptor-mediated gene delivery system comprising plasmid/protamine/sugar-containing polyanion ternary complex
Authors: Kazuo Maruyama, Fumito Iwasaki, Tomoko Takizawa, Hironobu Yanagie, Takuro Niidome, Etsuko Yamada, Tomoko Ito, Yoshiyuki Koyama
Journal: Biomaterials (2003)
Sirolimus as Primary Immunosuppression Attenuates Allograft Vasculopathy With Improved Late Survival and Decreased Cardiac Events After Cardiac Transplantation
Authors: Yan Topilsky, Tal Hasin, Eugenia Raichlin, Barry A. Boilson, John A. Schirger, Naveen L. Pereira, Brooks S. Edwards, Alfredo L. Clavell, Richard J. Rodeheffer, Robert P. Frantz, Simon Maltais, Soon J. Park, Richard C. Daly, Amir Lerman, Sudhir S. Kushwaha
Journal: Circulation (2011)

We retrospectively analyzed the potential of sirolimus as a primary immunosuppressant in the long-term attenuation of cardiac allograft vasculopathy progression and the effects on cardiac-related morbidity and mortality.Forty-five cardiac transplant recipients were converted to sirolimus 1.2 years (0.2, 4.0) after transplantation with complete calcineurin inhibitor withdrawal. Fifty-eight control subjects 2.0 years (0.2, 6.5 years) from transplantation were maintained on calcineurin inhibitors. Age, sex, ejection fraction, and time from transplantation to baseline intravascular ultrasound study were not different (P>0.2 for all) between the groups; neither were secondary immunosuppressants and use of steroids. Three-dimensional intravascular ultrasound studies were performed at baseline and 3.1 years (1.3, 4.6 years) later. Plaque index progression (plaque volume/vessel volume) was attenuated in the sirolimus group (0.7±10.5% versus 9.3±10.8%; P=0.0003) owing to reduced plaque volume in patients converted to sirolimus early (<2 years) after transplantation (P=0.05) and improved positive vascular remodeling (P=0.01) in patients analyzed late (>2 years) after transplantation. Outcome analysis in 160 consecutive patients maintained on 1 therapy was performed regardless of performance of intravascular ultrasound examinations. Five-year survival was improved with sirolimus (97.4±1.8% versus 81.8±4.9%; P=0.006), as was freedom from cardiac-related events (93.6±3.2% versus 76.9±5.5%; P=0.002).Substituting calcineurin inhibitor with sirolimus as primary immunosuppressant attenuates long-term cardiac allograft vasculopathy progression and may improve long-term allograft survival owing to favorable coronary remodeling. Because of the lack of randomization and retrospective nature of our analysis, the differences in outcome should be interpreted cautiously, and prospective clinical trials are required.
Occupational infections in the Edinburgh abattoir.
Authors: M. E. Schonell, J. G. Brotherston, R. C. Burnett, J. Campbell, J. D. Coghlan, M. A. Moffat, J. Norval, J. A. Sutherland
Journal: BMJ (1966)

MEDICALJ, DiscussionOur success rate has been at least as good as the average reported with the use of other diverse techniques.However, this would not be sufficient recommendation for widespread adoption of the method, were it not for the additional important advantage of greatly increased comfort, particularly for acutely ill patients.The use of a sandbag, which is necessary with the patient prone, has been avoided, with its accompaniments of discomfort, nausea in susceptible patients, and occasional syncope from obstruction of the venous return.Patients cooperate well, and the tendency to transfix the kidney with the production of a painful anterior haematoma is minimized.Haemorrhage sufficient to require blood trans- fusion was not encountered, and surgical intervention has never been called for.The operator's comfort is ensured, since he too is sitting.Possible disadvantages of the method stem from the fact that the kidney is not held against the diaphragm.Respiration therefore produces little swing in the exploring needle, so that the operator may be less confident of the depth of the kidney.Further, a sclerotic kidney may escape anteriorly at the moment of biopsy.However, these difficulties are in some degree common to all percutaneous techniques. SummaryThe technique of renal biopsy in the sitting position is described.In a consecutive series of 164 biopsies taken in the sitting position, 138 (84 %) satisfactory specimens were obtained.Grateful acknowledgement is made to Dr. M. McConnell, Con- sultant Pathologist, and Mr.
Blood Flow Failure as a Major Determinant in the Antitumor Action of Flavone Acetic Acid
Authors: L. Jonathan Zwi, Bruce C. Baguley, John B. Gavin, William R. Wilson
Journal: JNCI Journal of the National Cancer Institute (1989)

Journal Article Blood Flow Failure as a Major Determinant in the Antitumor Action of Flavone Acetic Acid Get access L. Jonathan Zwi, L. Jonathan Zwi Search for other works by this author on: Oxford Academic PubMed Google Scholar Bruce C. Baguley, Bruce C. Baguley Search for other works by this author on: Oxford Academic PubMed Google Scholar John B. Gavin, John B. Gavin Search for other works by this author on: Oxford Academic PubMed Google Scholar William R. Wilson William R. Wilson Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 81, Issue 13, 5 July 1989, Pages 1005–1013, https://doi.org/10.1093/jnci/81.13.1005 Published: 05 July 1989 Article history Received: 19 January 1989 Revision received: 27 March 1989 Accepted: 04 April 1989 Published: 05 July 1989
A Before-and-After Study of Fracture Risk Reporting and Osteoporosis Treatment Initiation
Authors: William D. Leslie, Suzanne Morin, Lisa M. Lix
Journal: Annals of Internal Medicine (2010)

Background: Several national organizations recommend that fracture risk assessment and osteoporotic treatment be based on estimated absolute 10-year fracture risk rather than bone mineral density (BMD) alone. Objective: To assess the changes in physician prescribing behavior after introduction of absolute 10-year fracture risk reporting. Design: Before-and-after study. Setting: Manitoba, Canada, which has an integrated BMD program in which tests are linkable to a population-based administrative health database repository. Patients: Women 50 years or older who were not receiving osteoporosis medication (2042 before and 3889 after intervention). Intervention: Introduction of a system reporting absolute 10-year fracture risk along with dual-energy x-ray absorptiometry results. Measurements: The proportion of untreated women who were prescribed osteoporosis medications in the year after baseline BMD measurement. Results: Absolute fracture risk reporting reclassified more women (32.7%) into lower-risk categories than into higher-risk categories (10%). This effect was more prominent in women younger than 65 years. Fewer women per physician were prescribed osteoporosis drugs after introduction of absolute fracture risk reporting. The absolute fracture risk reporting system was associated with an overall reduction in osteoporosis medications dispensed (adjusted absolute reduction, 9.0 percentage points [95% CI, 3.9 to 14.2 percentage points]; relative reduction, 21.3% [CI, 9.2% to 33.5%]; P < 0.001). The reduction was attributed to fewer drugs dispensed to women at low and moderate risk for fracture. No differences in fracture rates were observed. Limitations: This was a nonrandomized study. The risk assessment system studied differs slightly from other 10-year fracture risk assessment models. Conclusion: Change from a T-score–based fracture risk reporting system to a system based on absolute 10-year fracture risk was associated with appropriate, guideline-based changes in prescription of osteoporosis medications. Primary Funding Source: None.
Mixed lymphocyte reactivity and cell-mediated lympholysis to trinitrophenyl-modified autologous lymphocytes in C57BL/10 congenic and B10.A recombinant mouse strains
Authors: GM Shearer, EC Lozner, TG Rehn, A Schmitt-Verhulst
Journal: The Journal of Experimental Medicine (1975)

When L cells were treated with anti-L-cell antibody in medium containing heat-inactivated fetal calf serum, nucleoside uptake and cell growth were stimulated. The response was markedly increased when fresh, unheated sera from calves, guinea pigs, humans, mice, or rabbits were also present. The factors in unheated serum responsible for the enhancement of immunostimulation were studied. Using low concentrations of sera deficient in various complement (C) components and low concentrations of antibody no augmentation of immunostimulation was seen with Clr-deficient human serum, C2-deficient human serum, C2,4-deficient human serum, C4-deficient guinea pig serum, C3-C9-depleted guinea pig serum (by administration of cobra venom factor to animals), but stimulation was observed with C5-deficient human serum, C5-deficient mouse serum, and C6-deficient rabbit serum. When the concentration of anti-serum was raised, however, augmentation was observed with C4-deficient guinea pig serum. Thus, at low concentrations of antiserum enhancement appeared to occur through the classical C pathway, whereas at high concentrations of antibody either the classical or alternate C pathways appeared to be involved. Stimulation was specifically restored by purified C2 in C2-deficient serum and by C3 in C3-C9-deficient serum. Under the usual reaction conditions consumption of guinea pig C component C4 could be demonstrated which provided direct evidence for activation of the classical C pathway under conditions leading to immunostimulation. By immunofluorescence, cells treated with antibody and normal human serum had human C3 deposited at the cell surface. Taken together these observations suggest that C activated through C3 by either the classical or alternate pathways has the potential to enhance nucleoside incorporation into DNA and cell growth of cells exposed to limiting amounts of antibody. Although the mechanism of stimulation is unknown, it is likely to involve a direct effect of C3 at the level of the cell membrane.
ON LIMITATION OF EFFORT IN HEART DISEASE
Authors: C. Wilson
Journal: BMJ (1923)

RSCL ORA ducing the condition.That constriction of the smaller veinis occurs irregularly when the shock is already well advanced vtnd the circulation is reduced to a slow trickle, was observed by Laidlaw and myself.The venules, properly so called, are shown by the microscopic observations of Hooker and of Rich, as well as by our own naked-eye descrlptioln, to be dilated and full of blood.When once the peripheral stagnation has occurred, it is obvious that a constriction of the arteries, on the one hand, and of the veins on the other, if it occurs, will intensify the conditlon and render recovery fromn it more difficult; but I am still conyinced that the primary and essential factor is the loss of the tone of the capillaries.
Screening tests IV
Authors: P. Sedgwick
Journal: BMJ (2009)

A study investigated the performance of the CAGE questionnaire as a screening tool for alcohol abuse or alcohol dependency in primary care. The CAGE questionnaire consists of four questions about alcohol behaviour, each with a “yes” or “no” response. Clinical interview was used as the diagnostic test (“gold standard”) for alcohol abuse or alcohol dependency. A total of 1970 individuals were investigated and the results obtained are shown in table 1.⇓ 1

View this table:

Table 1 
 Cross tabulation of the number of “yes” responses on CAGE questionnaire against clinical diagnosis



A minimum number of “yes” responses is required for the screening test to identify an individual as screen “positive” and subsequently recommend clinical interview. If the threshold for “positive” on …
Aortic valve calcium measured by electron beam computed tomography: a potential new measure of aortic stenosis severity
Authors: David Shavelle, Matthew J. Budoff, Nediljka Buljubasic, J.Michael Criley, Junichuro Takasu, SongShou Mac, Xue-Qiao Zhao, Kevin O'Brien
Journal: Journal of the American College of Cardiology (2002)
The effect of prostaglandin E1 on liver adenine nucleotides and cytoplasmic enzymes in a porcine model of normothermic hepatic ischemia
Authors: Thomas S. Helling, Brent M. Wogahn, Steve A. Olson, Laurie S. Evans, Bokka R. Reddy, Charles Vanway
Journal: Hepatology (1995)

The liver has been judged relatively resistant to ischemia, but prolonged inflow occlusion at normothermic conditions can produce evidence of reversible or irreversible hepatocellular damage. Cytoprotective agents have been used both experimentally and clinically to afford extended viability of hepatocytes under reduced perfusion. One agent, prostaglandin E1, has been described clinically as effective in sustaining liver function under ischemic conditions. We have sought to verify this observation in an experimental model using prolonged normothermic inflow occlusion. Twenty miniature pigs were anesthetized and subjected to subtotal normothermic hepatic inflow occlusion (portal vein, hepatic artery, choledochal vessels) to allow for sufficient splanchnic decompression. Half of the animals received pretreatment with prostaglandin E1 (alprostadil) 500 micrograms intravenously. Inflow occlusion was maintained for 2 hours followed by reperfusion and killing 24 hours later. As a measure of functional preservation, the tissue adenine nucleotides adenosine monophosphate, diphosphate, and triphosphate (AMP, ADP, ATP) were measured in ischemic liver by freeze-clamping and high-performance liquid chromatography during occlusion and after reperfusion. Cytosolic enzyme determinations (aspartate transaminase, alanine transaminase, lactate dehydrogenase) were also made before occlusion and after reperfusion. As a possible indicator of cellular injury, blood ionized Ca++ was measured before inflow occlusion and after reperfusion. Although no difference was found in levels of AMP and ADP between prostaglandin E1 and control animals, ATP levels rose significantly higher during recovery in prostaglandin E1 animals at 60 minutes and 24 hours after reperfusion (13.97 +/- 1.29 and 13.60 +/- 0.91 mumoles/gm dry weight prostaglandin E1 vs. 9.25 +/- 0.97 and 9.80 +/- 0.85 mumoles/gm dry weight co control, P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)
Diagnosis of Sleep Apnea by Automatic Analysis of Nasal Pressure and Forced Oscillation Impedance
Authors: Holger Steltner, Richard Staats, Jens Timmer, Michael Vogel, Josef Guttmann, Heinrich Matthys, J. Christian Virchow
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Detecting and differentiating central and obstructive respiratory events is an important aspect of the diagnosis of sleep-related breathing disorders with respect to the choice of an appropriate treatment. The purpose of this study was to evaluate the performance of a new algorithm for automated detection and classification of apneas and hypopneas, compared with visual analysis of standard polysomnographic signals. The algorithm is based on time series analysis of nasal mask pressure and a forced oscillation signal related to mechanical respiratory input impedance, measured at a frequency of 20 Hz throughout the night. The method was applied to all-night measurements on 19 subjects. Two experts in sleep medicine independently scored the corresponding simultaneously recorded polysomnographic signals. Evaluating the agreement between two scorers by a weighted kappa statistic on a second-by-second basis, we found that inter-expert variability and the discrepancy between automatic analysis and visual analysis performed by an expert were not significantly different. Implementation of this algorithm in a device for home monitoring of breathing during sleep might aid in the differential diagnosis of sleep-related breathing disorders and/or as a means for follow-up and treatment control.