tbuckley/cabot-search huggingface dataset:
Airway closure measured by a technegas bolus and SPECT.
Authors: G G King, S Eberl, C M Salome, S R Meikle, A J Woolcock
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Absence of a maximal dose-response plateau and mathematical modeling suggest that asthmatic airways close during bronchoconstriction. Finding segmental areas affected by closure would be important in understanding asthmatic airway function. The aim of this study was to evaluate single-photon emission computed tomography (SPECT) as a method of investigating airway closure. Simultaneous SPECT transmission and emission studies were performed on a thoracic phantom to develop analysis methodology, and on 13 normal subjects after they inhaled a Technegas bolus from residual volume (RV), to measure airway closure. Single-breath nitrogen test values and lung volumes were measured. Airway closure was defined as the percent of Technegas-free lung volume (LVclosed). The mean error +/- 95% CI of the error, as determined by transmission scan, was 1.1 ml +/- 165 ml (0.8% +/- 15% lung volume) in the phantom studies, and 112 ml +/- 419 ml (4% +/- 31% of supine functional residual capacity [FRC]) in the human studies. LVclosed correlated with closing capacity (r = 0.86, p < 0.01 ) and closing volume (r = 0.86, p < 0.01), but not with RV/total lung capacity (TLC). This study indicates that simultaneous SPECT emission and transmission scans, using a Technegas bolus, are a valid method of measuring airway closure in vivo, with the added advantage of providing three-dimensional data that allow the detection of small, discrete areas of airway closure and determination of their volumes and shapes.
Predictors for nocturnal hypoxaemia (mean SaO2 &lt; 90%) in normoxic and mildly hypoxic patients with COPD
Authors: PJ Vos, HT Folgering, CL van Herwaarden
Journal: European Respiratory Journal (1995)

Detection of nocturnal hypoxaemia, defined as a mean arterial oxygen saturation below 90%, in normoxic or mildly hypoxic chronic obstructive pulmonary disease (COPD) patients seems clinically relevant, since this feature may precede pulmonary hypertension. Nocturnal studies are expensive and time-consuming procedures. The current study investigates to what extent it is possible to predict nocturnal hypoxaemia from daytime parameters. Forty two COPD patients with a daytime arterial oxygen tension (PaO2) above 8 kPa participated. Nocturnal oxygenation, daytime blood gas values, and ventilatory responses to hypercapnia were measured. In 10 patients, enough desaturations occurred to qualify as nocturnal hypoxaemia. They had a significantly lower daytime PaO2 value, and a lower steady-state hypercapnic ventilatory response. They also smoked more often, and complained about daytime sleepiness. Multiple linear regression analysis demonstrated that daytime PaO2 (32%) was the best independent predictor. Sleepiness (12%), and number of cigarettes smoked (5%) also contributed independently, but in a minor way. Patients with a high daytime PaO2 (&gt; 11 kPa) did not develop nocturnal hypoxaemia. The hypercapnic ventilatory response was used to distinguish nocturnal hypoxaemic from normoxaemic patients. Only patients with a low response (&lt; 3.5 l.min-1.kPa-1) appeared to run a risk of developing nocturnal hypoxaemia. The sensitivity of this test was 80%, and the specificity 70%. It is concluded that daytime PaO2, hypercapnic ventilatory response and sleepiness are helpful in predicting nocturnal hypoxaemia.
Generation of a monoclonal human single chain antibody fragment to hepatic stellate cells – a potential mechanism for targeting liver anti-fibrotic therapeutics
Authors: Lucy J. Elrick, Val Leel, Morgan G. Blaylock, Linda Duncan, Matthew R. Drever, Gillian Strachan, Keith A. Charlton, Matthew Koruth, Andrew J. Porter, Matthew C. Wright
Journal: Journal of Hepatology (2005)
Insecticidal juvenile hormone analogs stimulate the production of male offspring in the crustacean Daphnia magna.
Authors: Allen W Olmstead, Gerald A LeBlanc
Journal: Environmental Health Perspectives (2003)

Juvenile hormone analogs (JHAs) represent a class of insecticides that were designed specifically to disrupt endocrine-regulated processes relatively unique to insects. Recently we demonstrated that the crustacean juvenoid hormone methyl farnesoate programs oocytes of the crustacean Daphnia magna to develop into males. We hypothesized that insecticidal JHAs might mimic the action of methyl farnesoate, producing altered sex ratios of offspring. Daphnids were exposed chronically (3 weeks) to sublethal concentrations of methyl farnesoate, the JHA pyriproxyfen, and several nonjuvenoid chemicals to discern whether excess male offspring production is a generic response to stress or a specific response to juvenoid hormones. Only methyl farnesoate and pyriproxyfen increased the percentage of males produced by exposed maternal organisms. As previously reported with methyl farnesoate, acute exposure (24 hr) to either pyriproxyfen or the JHA methoprene caused oocytes maturing in the ovary to develop into males. We performed experiments to determine whether combined effects of a JHA and methyl farnesoate conformed better to a model of concentration addition (indicative of same mechanism of action) or independent joint action (indicative of different mechanisms of action). Combined effects conformed better to the concentration-addition model, although some synergy, of unknown etiology, was evident between the insecticides and the hormone. These experiments demonstrate that insecticidal JHAs mimic the action of the crustacean juvenoid hormone methyl farnesoate, resulting in the inappropriate production of male offspring. The occurrence of such an effect in the environment could have dire consequences on susceptible crustacean populations.
Guano in the Renal Pelvis
Authors: Drummond Rennie
Journal: New England Journal of Medicine (1979)

Though preparations purporting to dissolve urinary stones have been advocated for several thousand years, such "litholytics" could be put on a scientific basis only when the composition of all the main forms of stone had been worked out, a task substantially accomplished by 1819.1 "Ammoniaco-magnesian phosphate," described in renal stones in 1797 by Wollaston,2 was given an eponym some 48 years later by mineralogists, following their own strange paths, who had found it on the coast of Africa, in bat guano from the Skipton Caves of Victoria, and in an old church in Hamburg below "quantities of cattle dung." They . . .
THE ASSOCIATION OF HERPES CATARRHALIS WITH ERYTHEMA MULTIFORME (HEBRA)
Authors: L. FORMAN, G. P. B. WHITWELL
Journal: British Journal of Dermatology (1934)

Journal Article THE ASSOCIATION OF HERPES CATARRHALIS WITH ERYTHEMA MULTIFORME (HEBRA) Get access L. FORMAN, M.D., M.R.C.P., L. FORMAN, M.D., M.R.C.P. Assistant Physician, Skin Department, Guy's Hospital; Search for other works by this author on: Oxford Academic Google Scholar G. P. B. WHITWELL, M.D. G. P. B. WHITWELL, M.D. Assistant Medical Officer, Venereal Diseases Department, Guy's Hospital Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 46, Issue 7, 1 July 1934, Page 309, https://doi.org/10.1111/j.1365-2133.1934.tb09788.x Published: 01 July 1934
Research Policy: Glimpses of the National Institutes of Health I: funding and structure
Authors: R. Smith
Journal: BMJ (1988)

The first thing that strikes a visitor to the campus of the National Institutes of Health (NIH) in Bethesda, a suburb of Washington, is its vast size.The institutes, which began a one room laboratory on Staten Island 101 years ago, now cover 300 acres and have their own underground station (fig 1).The campus contains 50 buildings including the National Library ofMedicine, the world's largest reference centre devoted to a single subject, a 540 bed research hospital, and 1420 laboratories.NIH employs 14 000 people at Bethesda and its field stations; 2300 have doctoral degrees and 1000 are physicians.And yet most of the research funded by the institutes is not done on the campus at all: NIH spent only about 11% ofits 1985 budget of $5121m on directed research, that which tends to be done on the campus.'More than 70% was spent on grants to outside research-ers, some of it going to overseas researchers-including British ones.At the end of 1987 I spent a week in Washington talking to people at NIH, the National Science Foundation (a government backed body that also funds scientific research, including some that is medical), and the Institute of Medicine (an organisation with a broad membership that is to medicine roughly what the National Academy of Sciences is to science).I have also talked to American researchers.My aim was to get a feel for the successes and failures of the American way of funding and organising medical research and see what lessons there might be for Britain.Here I look at the structure ofNIH and its annual highly political and public battle for funds; several of the researchers that I spoke to in Britain thought that if Britain had something more like the American system then medical research might do better than at present.
Measuring the Performance of Vaccination Programs Using Cross-Sectional Surveys: A Likelihood Framework and Retrospective Analysis
Authors: Justin Lessler, C. Jessica E. Metcalf, Rebecca F. Grais, Francisco J. Luquero, Derek A. T. Cummings, Bryan T. Grenfell
Journal: PLoS Medicine (2011)

The performance of routine and supplemental immunization activities is usually measured by the administrative method: dividing the number of doses distributed by the size of the target population. This method leads to coverage estimates that are sometimes impossible (e.g., vaccination of 102% of the target population), and are generally inconsistent with the proportion found to be vaccinated in Demographic and Health Surveys (DHS). We describe a method that estimates the fraction of the population accessible to vaccination activities, as well as within-campaign inefficiencies, thus providing a consistent estimate of vaccination coverage.We developed a likelihood framework for estimating the effective coverage of vaccination programs using cross-sectional surveys of vaccine coverage combined with administrative data. We applied our method to measles vaccination in three African countries: Ghana, Madagascar, and Sierra Leone, using data from each country's most recent DHS survey and administrative coverage data reported to the World Health Organization. We estimate that 93% (95% CI: 91, 94) of the population in Ghana was ever covered by any measles vaccination activity, 77% (95% CI: 78, 81) in Madagascar, and 69% (95% CI: 67, 70) in Sierra Leone. "Within-activity" inefficiencies were estimated to be low in Ghana, and higher in Sierra Leone and Madagascar. Our model successfully fits age-specific vaccination coverage levels seen in DHS data, which differ markedly from those predicted by naïve extrapolation from country-reported and World Health Organization-adjusted vaccination coverage.Combining administrative data with survey data substantially improves estimates of vaccination coverage. Estimates of the inefficiency of past vaccination activities and the proportion not covered by any activity allow us to more accurately predict the results of future activities and provide insight into the ways in which vaccination programs are failing to meet their goals. Please see later in the article for the Editors' Summary.
Association of BK Viruria with Hemorrhagic Cystitis in Recipients of Bone Marrow Transplants
Authors: Ray R. Arthur, Keerti V. Shah, Stephen J. Baust, George W. Santos, Rein Saral
Journal: New England Journal of Medicine (1986)

Fifty-three recipients of bone marrow transplants were monitored prospectively for urinary excretion of human polyomaviruses by enzyme-linked immunosorbent assays of urinary supernatants and DNA hybridization assays of urinary cells. Excretion of BK virus was demonstrated in 47 percent of the transplant recipients and was the result of the reactivation of latent virus. Hemorrhagic cystitis of long duration (greater than or equal to 7 days) was associated with BK viruria. The disease occurred four times more frequently in patients who excreted BK virus than in those who did not, and the virus was identified in 55 percent of the urine specimens during episodes of cystitis as compared with 8 to 11 percent of the specimens during cystitis-free periods. BK viruria often preceded or coincided with the onset of the disease. Among 19 patients with BK viruria lasting seven days or longer, hemorrhagic cystitis occurred in 15. Occurrence of the disease was related to the source of marrow. The disease occurred in 50 percent of 38 recipients of allogeneic marrow and in 7 percent of 15 recipients of syngeneic or autologous marrow. Among recipients of allogeneic marrow, the disease was observed in 71 percent of the 21 patients excreting BK virus and in 24 percent of the 17 not excreting the virus. An association of BK virus with hemorrhagic cystitis was demonstrated in 16 of the 18 cases of the disease that were adequately characterized. We conclude that reactivation of BK virus may account for a substantial proportion of late-onset, long-lasting hemorrhagic cystitis in recipients of bone marrow transplants.
Relation Between Diastolic Perfusion Time and Coronary Artery Stenosis During Stress-Induced Myocardial Ischemia
Authors: Giuseppe Ferro, Carlo Duilio, Letizia Spinelli, Giovanni Antonio Liucci, Felice Mazza, Ciro Indolfi
Journal: Circulation (1995)

Background Experimental studies have demonstrated that during stress-induced myocardial ischemia, coronary obstruction and diastolic perfusion time are factors that limit subendocardial perfusion and correlate to degree of myocardial dysfunction. The relation between these two factors has not yet been investigated in humans. The aim of the present study was to assess the relation between diastolic perfusion time and degree of coronary stenosis during different types of stress tests. Methods and Results Nine patients with isolated and proximal stenosis of the left anterior descending coronary artery were selected. Patients underwent three different randomized stress tests (upright, supine bicycle stress test, and transesophageal atrial pacing). Diastolic perfusion time, heart rate (RR interval), and systolic and diastolic pressures were measured during the test and at the ischemic threshold (0.1-mV ST-segment depression). Angiographic measurements of coronary stenosis were evaluated by quantitative coronary angiography. At the ischemic threshold, significant differences among tests were found in heart rate ( P &lt;.05), systolic pressure ( P &lt;.001), and diastolic pressure ( P &lt;.05). In each stress test, diastolic perfusion time at the ischemic threshold was closely correlated with minimal stenosis diameter ( r =.97; P &lt;.001) and percent diameter stenosis ( r =.92; P &lt;.001) with no difference among the tests. In contrast, heart rate, rate-pressure product, and time to ischemic threshold were not significantly correlated with percent diameter stenosis and minimal stenosis diameter. No significant correlation was observed at the ischemic threshold between diastolic perfusion time and corresponding values of heart rate, despite the close correlation at rest ( r =.95; P &lt;.001). Conclusions Despite differences in associated hemodynamic responses to various stress tests, a close relation exists between stenosis severity and diastolic perfusion time at the onset of stress-induced myocardial ischemia. Therefore, diastolic perfusion time at the ischemic threshold may be an indirect estimate of the hemodynamic significance of coronary stenosis.
Case 40-1962
Authors: Marian W. Ropes, Richard B. Cohen
Journal: New England Journal of Medicine (1962)

Presentation of CaseA seventy-three-year-old woman entered the hospital because of headache and weakness.The patient experienced the onset of dull, throbbing occipital headaches two years previously. The headaches were bilateral, occurred at the points of contact of her head with a pillow and were often relieved within a few minutes by sitting up or within an hour by 0.9 gm. of aspirin. At times the headache was avoided by the use of a rolled towel under her neck separating her head from the pillow. Pain also occurred occasionally in the temple when she lay on her side. One year . . .
Plasma glial fibrillary acidic protein levels in children with sickle cell disease
Authors: William J. Savage, Emily Barron‐Casella, Zongming Fu, Pratima Dulloor, Lisa Williams, Barbara J. Crain, Desiree A. White, Jacky M. Jennings, Jennifer E. Van Eyk, Michael R. Debaun, Allen Everett, James F. Casella
Journal: American Journal of Hematology (2011)

To determine if glial fibrillary acidic protein (GFAP) is associated with brain injury in children with sickle cell disease (SCD), we measured plasma GFAP among cross-sectional groups of unselected children with SCD, subsets of children with SCD and normal brain MRI or MRI evidence of cerebral infarct, healthy pediatric controls, and adults with brain injury. Children with SCD had higher plasma GFAP than healthy pediatric controls (mean concentrations 0.14 ± 0.37 vs. 0.07 ± 0.08 ng/mL; P 5 0.003); also, 16.0% (16/100) of children with SCD and cerebral infarct had GFAP elevations above the 95th percentile of healthy pediatric controls (P 5 0.04). Although not statistically significant, children with SCD and cerebral infarct had more elevated GFAP levels than with SCD and no infarct (16/100, 16.0% vs. 14/168, 8.3%; P 5 0.07). Children with SCD and acute brain ischemia had a higher proportion of elevated GFAP than SCD children with normal MRI (3/6, 50% vs.8.3%; P 5 0.01). GFAP was associated with elevated systolic blood pressure in the preceding year and correlated positively with white blood cell count and negatively with age and performance IQ. Plasma GFAP is elevated among children with SCD and may be associated with subclinical brain injury.
Coronary Heart Disease: Doing the “Right Things”
Authors: Jeremiah Stamler
Journal: New England Journal of Medicine (1985)

Since the late 1960s, death rates in the United States from coronary heart disease have fallen steadily and markedly. This decline has involved all sectors of the adult population.1 , 2 For persons aged 35 to 74 years, the rate of mortality from coronary heart disease has fallen by over 30 per cent, resulting in more than 800,000 lives saved since 1968. Death rates from stroke have declined even more precipitously.The decline in mortality from coronary heart disease is all the more remarkable because it occurred after a sustained period of rising death rates from this cause,1 , 2 going back to at . . .
WHO is to change its polio programme in India to try to eradicate the disease
Authors: Claire Frauenfelder
Journal: BMJ (2006)

The World Health Organization is to change its polio eradication programme in India, adding a monovalent oral vaccine to the existing regime, says a study published in Science last week. It is hoped that this addition will finally rid the country of the disease. 

The study's key finding was that poor sanitation and overcrowding produce an ideal environment for the virus in some regions in India ( Science 2006;310:625-6). The poor health of impoverished children also limits the effectiveness of the trivalent vaccine that has been the mainstay of WHO's eradication programme in India, said Bruce Aylward, director of WHO's global polio eradication initiative. 

Data analysed in the report showed that the northeastern Indian states of Uttar Pradesh and Bihar are the problematic areas. The authors pointed out that these same areas were the last in Asia to see smallpox in …
DOPPLER-DERIVED HYPEREMIC MICROVASCULAR RESISTANCE PREDICTS THE OCCURRENCE OF MICROVASCULAR INJURY AND MICROVASCULAR PERFUSION DEFICITS AFTER ANGIOGRAPHICALLY SUCCESSFUL PRIMARY PERCUTANEOUS CORONARY INTERVENTION
Authors: Paul Frederik Arthur Teunissen, Maurits Hollander, Lourens Robbers, Ibrahim Danad, Guus de Waard, Martijn Heymans, Raquel Amier, Stefan Biesbroek, Adriaan Lammertsma, Cornelis Allaart, Jorrit Lemkes, Yolande Appelman, Koen Marques, J. Bronzwaer, Anton Horrevoets, Albert van Rossum, Aernout Beek, Paul Knaapen, Niels Van Royen
Journal: Journal of the American College of Cardiology (2014)
A Further Case of M.C.P.A. Poisoning
Authors: H. R. M. Johnson, O. Koumides
Journal: BMJ (1965)

classified according to their response to the initial dose of the " drug," their general clinical improvement, the duration of intravenous therapy and intragastric suction, and the frequency of complications.Overall results of the trial show that the Trasvlol-treated patients did no better than the controls, and indeed may have fared worse.Although more Trasylol-treated patients had severe pancreatitis there was no difference in out- come at any grade of severity.The poor results with Trasylol could not be attributed to delay in starting therapy or to the age of the patient.We are indebted to Farbenfabriken Bayer A.G., Leverkusen, Germany, who made a gift of Trasylol and the placebo.We would like to acknowledge with gratitude the help of the honorary surgeons of the Royal Prince Albert Hospital who made their patients available for inclusion in the trial.Finally, the study would not have been possible without the co-operation of the nursing and resident staff of the hospital, whose assistance is gratefully acknowledged.
Accelerating Identification and Regulatory Approval of Investigational Cancer Drugs
Authors: Laura J. Esserman, Janet Woodcock
Journal: JAMA (2011)

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