tbuckley/cabot-search huggingface dataset:
Influence of circulating alpha adrenoceptor agonists on lung function in patients with exercise induced asthma and healthy subjects.
Authors: K Larsson, A Martinsson, P Hjemdahl
Journal: Thorax (1986)

The influence of circulating noradrenaline (in this context primarily a non-selective alpha agonist) and the alpha 1 selective agonist phenylephrine on bronchial tone, blood pressure, and heart rate was studied in eight patients with exercise induced asthma and eight age and sex matched controls. All subjects refrained from taking treatment for at least one week before the trial. The agonists were infused intravenously in stepwise increasing doses of 0.04, 0.085, 0.17, and 0.34 micrograms/kg a minute for noradrenaline and 0.5, 1.0, 2.0, and 4.0 micrograms/kg a minute for phenylephrine. At the highest dose the plasma concentration of noradrenaline was about 30 nmol/l, resembling the concentrations found during intense exercise, and that of phenylephrine was about 400 nmol/l. Both agonists caused dose dependent and similar increases in blood pressure in the two groups. Despite clearcut cardiovascular effects (systolic and diastolic blood pressure increased by about 40-50/25-30 mm Hg), neither agonist altered lung function, as assessed by measurements of specific airway compliance (sGaw), peak expiratory flow (PEF), or end expiratory flow rate, in either group. It is concluded that circulating alpha agonists, whether alpha 1 selective (phenylephrine) or non-selective (noradrenaline), fail to alter basal bronchial tone in patients with exercise induced asthma or in healthy subjects.
Mechanism of efficacy of 2-amino oleic acid for inhibition of calcification of glutaraldehyde-pretreated porcine bioprosthetic heart valves.
Authors: W Chen, F J Schoen, R J Levy
Journal: Circulation (1994)

BACKGROUND Calcification is a frequent cause of the clinical failures of glutaraldehyde-pretreated bioprosthetic heart valves (BPHV) fabricated from glutaraldehyde-cross-linked porcine aortic valves. 2-Amino oleic acid (AOA) has been shown in previous in vivo studies to be a promising anticalcification agent. Our objective was to investigate the mechanism of calcification inhibition mediated by AOA pretreatment of porcine aortic valve bioprostheses. METHODS AND RESULTS BPHV tissues were treated with an AOA solution for 72 hours before experimentation. The diffusion of AOA across both cusp and aortic wall was evaluated. The lag time for AOA to diffuse across the aortic wall was prolonged compared with that of the cusp. An extraction study was performed to determine the stability of AOA binding; the results indicated that the binding was relatively stable regardless of solvent extraction conditions. The interaction between ionic calcium and AOA on treated tissue also was investigated by evaluating the patterns of calcium diffusion across both treated and untreated tissues. The results showed that AOA significantly reduced the diffusion of calcium. AOA inhibition of aortic valve calcification (calcium level, 5.5 +/- 3.0 mg/g of tissue compared with control; calcium level, 91.2 +/- 19.5 mg/g of tissue) but not aortic wall (calcium level, 158.7 +/- 10.3 mg/g of tissue compared with control; calcium level, 157.5 +/- 7.9 mg/g of tissue) was demonstrated on representative specimens from valves implanted in left ventricular apicoaortic shunts explanted after 150 days. CONCLUSIONS AOA covalently binds to glutaraldehyde-pretreated bioprosthetic heart valve tissue, presumably as the result of an aldehyde-amino reaction. Covalently bound AOA diminishes Ca2+ diffusion compared with non-AOA-pretreated bioprosthetic tissues. This may explain in part the anticalcification mechanism of AOA. Furthermore, AOA inhibits calcification of porcine BPHV cusps in the circulation.
Arterial Blood Gas Reference Values for Sea Level and an Altitude of 1,400 Meters
Authors: ROBERT O. CRAPO, ROBERT L. JENSEN, MATHEW HEGEWALD, DONALD P. TASHKIN
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Blood gas measurements were collected on healthy lifetime nonsmokers at sea level (n = 96) and at an altitude of 1,400 meters (n = 243) to establish reference equations. At each study site, arterial blood samples were analyzed in duplicate on two separate blood gas analyzers and CO-oximeters. Arterial blood gas variables included Pa(O(2)), Pa(CO(2)), pH, and calculated alveolar-arterial PO(2) difference (AaPO(2)). CO-oximeter variables were Hb, COHb, MetHb, and Sa(O(2)). Subjects were 18 to 81 yr of age with 166 male and 173 female. Outlier data were excluded from multiple regression analysis, and reference equations were fitted to the data in two ways: (1) best fit using linear, squared, and cross-product terms; (2) simple equations, including only the variables that explained at least 3% of the variance. Two sets of equations were created: (1) using only the sea level data and (2) using the combined data with barometric pressure as an independent variable. Comparisons with earlier studies revealed small but significant differences; the decline in Pa(O(2)) with age at each altitude was consistent with most previous studies. At sea level, the equation that included barometric pressure predicted Pa(O(2)) slightly better than the sea level specific equation. The inclusion of barometric pressure in the equations allows better prediction of blood gas reference values at sea level and at altitudes as high as 1,400 meters.
Paying for research related injuries in the US
Authors: Mark Hochhauser
Journal: BMJ (2006)

EDITOR—That the United Kingdom considers clinical trial patients to be covered by consumer contract law puts it at odds with the United States.1 2 Because the US Food and Drug Administration (FDA) does not consider the informed consent process to be a contract between researchers and subjects, US subjects are not protected by consumer laws.

Standard consent form language tells US subjects that “By signing this consent form you do not waive any of your legal rights” but does not describe those rights. In 11 years on …
A phase 1 trial of the Fc-engineered CD19 antibody XmAb5574 (MOR00208) demonstrates safety and preliminary efficacy in relapsed CLL
Authors: Jennifer A. Woyach, Farrukh Awan, Ian W. Flinn, Jesus G. Berdeja, Elizabeth Wiley, Sharmeen Mansoor, Ying Huang, Gerard Lozanski, Paul A. Foster, John C. Byrd
Journal: Blood (2014)
MONSTROSITY OR DOUBLE FETUS.
Authors: J. E. BENTON
Journal: JAMA (1899)

Myself and father, Dr. E. A. Benton, were called in consultation by Dr. W. N. Hunt of this city at 1 p.m., June 15, 1899, in the case of Mrs. D., a multipara in her fourth confinement. She had been in labor for about twelve hours with a vertex presentation in the first position, and strong labor pains for several hours after complete dilation of the os had failed to advance the head beyond the lower third of the pelvis. From external examination and the history of the ease, twin pregnancy was diagnosed, and under chloroform, forceps were applied and the head brought down with considerable difficulty through the external parts; but no more progress could be made toward delivery. We then concluded we had to deal with some kind of monstrosity. We amputated the head and tried to turn or bring it in position to deliver, but failed. We
Critique of Studies of Lithium Salts in the Treatment of Mania
Authors: WILLIE KAI SHULL, JOSEPH D. SAPIRA
Journal: American Journal of Psychiatry (1970)

The authors review all available studies of lithium therapy of mania (comprising 805 patients) to determine whether lithium's pharmacologic efficacy has been demonstrated in the customary manner. All studies reviewed except for one were found to have serious methodological deficiencies. The authors conclude that the available data demonstrate neither efficacy nor inefficacy, primarily because of inadequate experimental design.
Clinical and psychosocial predictors of illness duration from randomised controlled trial of prescribing strategies for sore throat
Authors: P Little, C Gould, I Williamson, G Warner, M Gantley, A L Kinmonth
Journal: BMJ (1999)

Sore throat is one of the commonest reasons for visiting general practitioners yet little is known about what factors are important in its natural course.This is important since people with prolonged illness after the consultation-the 36% with illness lasting more than five days after seeing the doctor (the median)-are much more likely to reattend. 1 Providing patients with information about duration of illness can reduce expectation and reattendance. 2 We studied factors that affect duration of sore throat and assessed whether satisfaction with the consultation independently predicts duration of illness. 3
Involve specialists in commissioning, urges Royal College of Physicians
Authors: C. White
Journal: BMJ (2011)

Hospital specialists and public health doctors must be appointed to commissioning consortium boards and have a key role in decisions made about patient care and service planning at both national and local level, the Royal College of Physicians has said.

The college has set out its priorities for change in its response to the government’s listening exercise on the Health and Social Care Bill.

It argues that the involvement of specialists and other relevant healthcare professionals in commissioning, rather than just in an advisory capacity, is crucial if patients are to receive optimal quality, integrated care.

Representation and involvement of secondary care clinicians should be key criteria for the authorisation …
Early Clinical Experience with Bleomycin in the United Kingdom in Series of 105 Patients
Authors: K. E. Halnan, N. M. Bleehen, T. B. Brewin, T. J. Deeley, D. F. N. Harrison, C. Howland, P. B. Kunkler, G. L. Ritchie, E. Wiltshaw, I. D. H. Todd
Journal: BMJ (1972)

The results of treating a series of 105 patients (79 with advanced squamous cell carcinoma, 21 with advanced lymphoma, and 5 with miscellaneous tumours) with bleomycin are described. The drug was usually given as a single agent. Four patients with squamous cell carcinoma showed complete regression and there was partial regression in 25. Side effects were frequent, particularly skin changes and stomatitis; death from pneumonitis occurred in one patient.
Pediatricians Participating in Medicaid
Authors: Michael H. Fox
Journal: JAMA (1992)

<h3>To the Editor.</h3> —In their article on factors associated with pediatricians' participation in Medicaid in North Carolina, Margolis et al<sup>1</sup>concluded that higher reimbursement rates exert only modest effects on participation. They believe that a strategy aimed at improving pediatricians' knowledge of the program and at enlisting the support of community physicians would be more effective since participation appears to be strongly influenced by a pediatrician's familiarity with and attitude toward Medicaid. They also conclude that pediatricians who practice in smaller communities or areas with lower physician-to-patient ratios are more likely to accept Medicaid patients. In an effort to retain obstetricians' participation, the Maryland Medicaid program increased payments for deliveries from $265 to $550 in March and then to $795 in July 1986. The rationale was to eliminate the disparity in payment between Medicaid and private insurers and thereby to reduce financial disincentives toward participation. Recently, we evaluated the
Is there an edge effect with the sirolimus-eluting stent?
Authors: Jose Eduardo E. Sousa, K. Tanabe, M. Degertekin, J. Fajadet, M. Perin, E.Ban Hayashi, A. Colombo, M.C. Morice, P.W. Serruys, C. Demeyere
Journal: Journal of the American College of Cardiology (2002)
Antibiotic treatment of Lyme borreliosis: what is the evidence?
Authors: R Dinser
Journal: Annals of the Rheumatic Diseases (2005)

Antibiotic treatment of all disease manifestations after infection with <i>Borrelia</i> sensu lato spp aims at resolving the presenting disease manifestation and preventing late stage disease. The goals are resolution of the preventing manifestation and prevention of the spread of bacteria to prevent late disease like arthritis. Different borrelial species prevail in Europe. The natural disease course of European borreliosis is not well defined and the effect of antibiotic treatment is unclear.
Prospective study of genetic counselling.
Authors: A E Emery, J A Raeburn, R Skinner, S Holloway, P Lewis
Journal: BMJ (1979)

A prospective study was carried out on 200 consecutive subjects seen for counselling (consultands) for serious genetic disorders. Educational and social background of consultands and their knowledge and understanding of their particular problem were assessed before counselling, and their response was determined immediately afterwards and three months and two years later by an independent observer not concerned in the genetic counselling. The husband's educational background was particularly important in influencing a couple's comprehension of counselling. X-linked recessive and chromosomal disorders presented the most difficulties in comprehension. The counsellors' assessment of comprehension was a good guide to the consultands' comprehension as assessed at subsequent follow-up. The proportion deterred from having children increased with time and over a third had been sterilised within two years of counselling. It is suggested that follow-up after counselling should be routine, especially when the counsellor suspects that comprehension has not been good, in X-linked recessive and chromosomal disorders, and when the risks of having an affected child are considered to be high.
Clinical and laboratory studies of arthritis in leprosy.
Authors: S. L. Atkin, A. el-Ghobarey, M. Kamel, J. P. Owen, W. C. Dick
Journal: BMJ (1989)

Arthritis associated with leprosy is underreported. In Egypt 66 patients from a leprosy colony were studied, 20 of whom had arthropathy. This was characterised by an inflammatory symmetrical peripheral polyarthritis. The wrist, metacarpal and proximal interphalangeal joints of the hands, the knees, and the metatarsophalangeal joints of the feet were affected with associated morning stiffness. The arthritis was erosive in 11 out of 20 patients, had no features of the arthritis associated with erythema nodosum leprosum reactions, but symptomatically responded to antileprosy treatment. This arthritis would seem to be a previously unrecognised feature of leprosy.
Alterations of right ventricular systolic time intervals by chronic pressure and volume overloading.
Authors: E I Curtiss, P S Reddy, J D O'Toole, J A Shaver
Journal: Circulation (1976)

Right ventricular (RV) systolic time intervals and hemodynamic parameters were determined by micromanometric techniques in 13 subjects with normal right ventricles (NRV). These data were compared to those of 16 patients with pulmonary hypertension (PH) or predominant pressure overloading and 13 individuals with uncomplicated secundum atrial septal defects (ASD) or predominant volume overloading. In PH, the QP2 interval tends to remain within the normal range due to reciprocal changes in isovolumic contraction (ICT) and ejection (RVET) times. Elevations of pulmonary artery diastolic pressure are associated with increases in the mean rate of isovolumic pressure rise (MRIPR) (r = 0.84), but the latter change does not fully compensate for the widened ventriculoarterial diastolic pressure difference and ICT becomes prolonged (P less than 0.001). Factors other than stroke index depression which may contribute to the decreased duration of RVET (P less than 0.001) include tricuspid regurgitation and elevation of pulmonary vascular impedance. In ASD, QP2 is significantly prolonged (P less than 0.025) due to a significant increase in RVET (P less than 0.005). In contrast to NRV, a linear correlation of RVET and stroke index was not present, which suggested an alteration of ejection dynamics in this group. Despite a high incidence of complete or incomplete right bundle branch block the interval from QRS onset to rapid RV pressure upstroke was not prolonged. This is most probably the result of peripheral bundle branch block of genesis of the QRS pattern by right ventricular hypertrophy.
Richner-Hanhart syndrome (tyrosinaemia-II) (report of four cases without ocular involvement)
Authors: A. REHAK, M.M. SELIM, G. YADAV
Journal: British Journal of Dermatology (1981)

Four cases of tyrosinaemia with cutaneous manifestations, but without ocular involvement, are reported in a family with consanguineous parents. The tyrosine levels in the serum and in the urine were normal in both parents, while in the offsprings the tyrosine levels were elevated 7½–13 times in the serum and3–13 times in the urine. Although the serum tyrosine levels in our cases were higher than in most of the cases reported in the literature the eyes of all our patients were normal. The skin manifestations were very impressive, and varying degrees of mental retardation were present in all patients. The patients put on a low-protein diet improved considerably and have been kept symptom-free for 1½ years. The possible implication of the discrepancy between the high serum levels and lack of ocular changes is discussed. Our results suggest that the Richner-Hanhart syndrome may include more than one distinct biochemical entity.
Psychiatric training: the consultants' view.
Authors: P Brook
Journal: BMJ (1977)

All consultants in general psychiatry appointed between 1 October 1972 and 30 September 1975 were sent a questionnaire asking about their training experience in various aspects of psychiatric practice. The results showed that the standards of training in 13 areas of psychiatry were generally poor, although psychiatrists who had trained at the Maudsley Hospital had generally had better training than those who had worked in psychiatric hospitals. Perhaps the most alarming feature was the general lack of improvement over the past nine years. It will be several years before the effects of the visist of approval made by the Royal College of Psychiatrists can be seen and assessed. Meanwhile, the demands for a fairer share of experience for all trainees can perhaps be met by introducing rotational programmes that include both teaching and psychiatric hospitals.
Social and Economic Factors in Patients With Coronary Disease-Reply
Authors: Redford B. Williams
Journal: JAMA (1992)

<h3>In Reply.</h3> —Dr Burke raises several issues. Our "close confidant" variable was a single question asking the patient whether they had someone they felt close to and could confide in (see Table 2 in our article). In our studies to date, we found social support to be distinct from depression, although there may be a relationship between the two constructs. We did not specifically evaluate "living alone." We are glad to see that Dr Lux is faithfully attending the continuing medical education lectures at his hospital, and we agree with his suggestion that much clinical research (especially clinical trials) requires a more careful interpretation than is available from reading the conclusions of papers in the medical literature. There is a growing consensus that social support needs to be tested in randomized trials, and Frasure-Smith and Prince<sup>1</sup>have recently reported favorable effects on mortality after MI with such an intervention
ECHOCARDIOGRAPHIC PREDICTORS FOR PROGRESSION TO PERSISTENT OR PERMANENT ATRIAL FIRBRILLATION IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION: E6P STUDY
Authors: Yeonyee Elizabeth Yoon, Sung-Ai Kim, Kyoung-Ha Park, Seong Hwan Kim, Jae-Hyeong Park, Seung-Pyo Lee, Hyung-Kwan Kim, Yong-Jin Kim, Dae-Won Sohn, Goo-Yeong Cho
Journal: Journal of the American College of Cardiology (2013)
Hospital Utilization and Characteristics of Patients Experiencing Recurrent Readmissions Within Children's Hospitals
Authors: Jay G. Berry, David E. Hall, Dennis Z. Kuo, Eyal Cohen, Rishi Agrawal, Chris Feudtner, Matt Hall, Jacqueline Kueser, William Kaplan, John Neff
Journal: JAMA (2011)

<h3>Context</h3>Early hospital readmission is emerging as an indicator of care quality. Some children with chronic illnesses may be readmitted on a recurrent basis, but there are limited data describing their rehospitalization patterns and impact.<h3>Objectives</h3>To describe the inpatient resource utilization, clinical characteristics, and admission reasons of patients recurrently readmitted to children's hospitals.<h3>Design, Setting, and Patients</h3>Retrospective cohort analysis of 317 643 patients (n = 579 504 admissions) admitted to 37 US children's hospitals in 2003 with follow-up through 2008.<h3>Main Outcome Measure</h3>Maximum number of readmissions experienced by each child within any 365-day interval during the 5-year follow-up period.<h3>Results</h3>In the sample, 69 294 patients (21.8%) experienced at least 1 readmission within 365 days of a prior admission. Within a 365-day interval, 9237 patients (2.9%) experienced 4 or more readmissions; time between admissions was a median 37 days (interquartile range [IQR], 21-63). These patients accounted for 18.8% (109 155 admissions) of all admissions and 23.2% ($3.4 billion) of total inpatient charges for the study cohort during the entire follow-up period. Tests for trend indicated that as the number of readmissions increased from 0 to 4 or more, the prevalences increased for a complex chronic condition (from 22.3% [n = 55 382/248 349] to 89.0% [n = 8225/9237]; P &lt; .001), technology assistance (from 5.3% [n = 13 163] to 52.6% [n = 4859]; P &lt; .001), public insurance use (from 40.9% [n = 101 575] to 56.3% [n = 5202]; P &lt; .001), and non-Hispanic black race (from 21.8% [n = 54 140] to 34.4% [n = 3181]; P &lt; .001); and the prevalence decreased for readmissions associated with an ambulatory care–sensitive condition (from 23.1% [62 847/272 065] to 14.0% [15 282/109 155], P &lt; .001). Of patients readmitted 4 or more times in a 365-day interval, 2633 (28.5%) were rehospitalized for a problem in the same organ system across all admissions during the interval.<h3>Conclusions</h3>Among a group of pediatric hospitals, 18.8% of admissions and 23.2% of inpatient charges were accounted for by the 2.9% of patients with frequent recurrent admissions. Many of these patients were rehospitalized recurrently for a problem in the same organ system.
SERUM PROTEASES AND THE MECHANISM OF THE ABDERHALDEN REACTION
Authors: James W. Jobling, A. A. Eggstein, William Petersen
Journal: The Journal of Experimental Medicine (1915)

1. Normal serum protease is not specific; it is active in both dilute acid as well as alkaline media. It is destroyed by heating to 70° C. for thirty minutes. It is markedly impaired when heated at 56° C. for thirty minutes. It is inhibited by the unsaturated soaps and lipoids. 2. Guinea pig and rabbit serum contain relatively much protease; the leucocytes are without proteolytic ferments. 3. Normal human and dog serum contain little or no protease; the leucocytes are strongly proteolytic. 4. Serum complement and protease are not identical. 5. During various pathological conditions the non-specific protease is increased in both human and dog serum. 6. An increase in antiferment is in many instances coincident. 7. During the Abderhalden reaction the placental tissue becomes more resistant to enzyme action, because of the adsorption of the antiferment from the serum. 8. The dialyzed serum loses antiferment because of adsorption by the placental tissue or other adsorbing substances, including probably the dialyzing membrane. 9. The digestive substrate is the serum protein made available for protease action by the adsorption of the antiferment. 10. The proteases in pathological conditions investigated by us (pregnancy, tuberculosis, and pneumonia) are non-specific.