tbuckley/cabot-search huggingface dataset:
Misoprostol: Discovery, development, and clinical applications
Authors: Paul W. Collins
Journal: Medicinal Research Reviews (1990)

Misoprostol is a synthetic 15-deoxy-16-hydroxy-16-methyl analog of PGE1, and the first prostaglandin to be registered for the treatment of peptic ulcer disease. Misoprostol is a safe and well-tolerated drug that exerts potent gastric antisecretory effects and mucosal protective actions on the gastric and duodenal mucosa. In a dosage of 800 micrograms daily in two or four divided doses, misoprostol produced rates of complete ulcer healing in both gastric and duodenal ulcer patients significantly superior to placebo and comparable to H2 receptor antagonists. The major adverse effect is diarrhea in about 10% of patients, but this is usually mild and self-limiting. Misoprostol possesses uterotonic activity and should not be used in pregnant women or those who wish to become pregnant. Misoprostol effectively heals and prevents NSAID-induced gastropathy, a therapeutic need previously unserved. Due to its mucosal protective properties, misoprostol may have advantages over antisecretory drugs in the compromised patient who is a chronic smoker or alcohol user, in refractory duodenal ulcer patients, in recurrent ulcer, and in emergency use for acute upper GI bleeding. Misoprostol's tissue-protective effects may also extend to other therapeutic areas.
Inhibition of lactation with combined oestrogen and progestogen.
Authors: P. N. Gillibrand, P. J. Huntingford
Journal: BMJ (1968)

Bwnm 769 degrees, will be what matters, but they will be quite essential for ensuring proper growth and distribution of scientific resources in the regions.It is not inconceivable that some may have started their scientific careers as pathologists.You make the point that the pathologist has no need of a new career structure, but the report does not propose that the careers structure of medical-graduate laboratory workers should be altered nor their numbers reduced.It does make it clear that an important aim is to attract more first-class scientists, medically qualified or otherwise.The proposed National Hospital Scientific Council, responsible for keeping an eye on the needs of the whole hospital scientific service, pathologists included, should do much to ensure that clinical and laboratory priorities, as regards buildings, staff, and equipment, no longer have to compete at local level.This, it seems to me, can do nothing but good.As an admittedly " academic," medically qualified biochemist, who is none the less fully involved in everyday hospital work, I personally welcome the report as a timely and courageous attempt to solve a number of complex and difficult problems before they get out of hand.I can but hope that the unimaginative, not to say prejudiced, tone of your leading
Regional myocardial and organ blood flow after myocardial infarction: application of the microsphere principle in man.
Authors: A P Selwyn, M J Shea, R Foale, J E Deanfield, R Wilson, C M de Landsheere, D L Turton, F Brady, V W Pike, D I Brookes
Journal: Circulation (1986)

A physiologic means of measuring the distribution of cardiac output and regional myocardial blood flow has been developed that uses human albumin microspheres labeled with carbon-11 (11C) and external detection with positron emission tomography. Ten patients with previous myocardial infarction were studied to investigate the level of blood flow in normal and infarcted segments of the heart. After diagnostic catheterization, 4 to 6 mCi of 11C on 2 to 3 million sterile microspheres (15 to 20 micron) were mixed and injected into the apex of the left ventricle during timed withdrawal of arterial blood to obtain reference flow values. Regional activity in brain, heart, lungs, liver, spleen, and kidneys was measured tomographically. Blood flow was calculated based on the relationship between total activity in a reference flow and tissue activity in tomograms of each organ (ml/min/100 g). No adverse effects were noted after injection of the microspheres. Successive myocardial tomograms showed no loss of activity. There were no significant differences in flow values in matched regions of paired organs. Mean cerebral flow was 52.4 +/- 10.0 ml/min/100 g in the frontal lobes, 54.4 +/- 8.8 in the temporal lobes, 67.6 +/- 8.2 in the occipital lobes, and 53.0 +/- 9.4 in the basal ganglia. Flow was 16.0 +/- 8.4 ml/min/100 g (range 0 to 40.0) in the center of infarcted myocardium and 82.0 +/- 32.0 in the remote segments. This method meets most of the demands for use of microspheres to measure tissue blood flow. The wide range of flow values in infarcted myocardium may be a function of infarct size, spatial resolution, or pathologic evidence of islands of viable tissue. Patients with angina had high flow values in the infarcted segment, whereas those with heart failure had significantly lower values. Surviving myocardium in the region of the infarct may need to be considered if patients complain of angina, particularly when treatment is aimed at preserving ventricular function.
Tracing the molecular pathogenesis of antiphospholipid syndrome
Authors: Hartmut Weiler
Journal: Journal of Clinical Investigation (2008)

Fetal loss induced by antiphospholipid antibodies (aPLs) in mice is a complement-driven inflammatory condition. Engagement of the complement receptor C5aR on neutrophils induces expression of the principal initiator of the blood clotting mechanism, tissue factor (TF), and blocking this downstream event of complement activation prevents antibody-induced fetal loss. In this issue of the JCI, the study by Redecha et al. clarifies that in mice, the contribution of TF to this pathogenic mechanism is independent of its role in coagulation and thrombosis, but involves inflammatory signaling through the receptor PAR2 (see the related article beginning on page 3453). The study not only sheds light on a critical effector mechanism of aPL-induced fetal loss, but also suggests that treatment with statins, which decrease TF and PAR2 expression, may hold promise as a therapeutic approach to antiphospholipid syndrome–associated pregnancy complications.
A Case of Severe Withdrawal Syndrome due to Dextropropoxyphene
Authors: Karin Hedenmalm
Journal: Annals of Internal Medicine (1995)

Letters15 September 1995A Case of Severe Withdrawal Syndrome due to DextropropoxypheneKarin Hedenmalm, MDKarin Hedenmalm, MDNorrland University Hospital; S-901 85 Umea; SwedenSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-6-199509150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Withdrawal reactions due to dextropropoxyphene have previously been reported in the medical literature [1-5]. Common symptoms are nausea, tremor, agitation, insomnia, diaphoresis, fever, and headache; however, confusion, psychotic reactions, and seizures have also been reported. I report a case of severe withdrawal syndrome due to dextropropoxyphene.A 69-year-old woman had been receiving dextropropoxyphene (100 mg, 1 to 2 tablets as required) for a chronic pain syndrome. After surgery for a hip fracture, ketobemidone was administered for analgesia during the first 2 days after surgery. On the third day, the patient became increasingly confused, hallucinated, and sweated severely. ...References1. Maletzky BM. Addiction to propoxyphene (Darvon): a second look. Int J Addict. 1974; 9:775-84. Google Scholar2. Strode SW. Propoxyphene dependence and withdrawal. Am Fam Physician. 1985; 32:105-8. Google Scholar3. Bikadoroff S, Cusimano M. Atypical withdrawal syndrome due to propoxyphene. Isr J Psychiatry Relat Sci. 1986; 23:157-9. Google Scholar4. Johnson DA, Bohan ME. Propoxyphene withdrawal with clonidine. Am J Psychiatry. 1983; 140:1217-8. Google Scholar5. Giannini AJ, Gregg LO, Andriano JP. P's and blues: potentiation of propoxyphene withdrawal by a variety of antihistamines. Clin Toxicol. 1984; 22:397-402. Google Scholar Author, Article, and Disclosure InformationAuthors: Karin Hedenmalm, MDAffiliations: Norrland University Hospital; S-901 85 Umea; Sweden PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDextropropoxyphene withdrawal 15 September 1995Volume 123, Issue 6Page: 473KeywordsHeart rateHip fracturesInsomniaIntensive care unitsMorphineNauseaOpiatesSurgeryTemperatureVentilators ePublished: 15 August 2000 Issue Published: 15 September 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Danish government turns to doctors to tackle rising absenteeism from work
Authors: Ned Stafford
Journal: BMJ (2008)

The Danish government is concerned about an increase in the number of employees who are missing work because of illness. It has enlisted the help of the Danish Medical Association to devise a plan to help keep people working and to cut disability payments.

A recent study coordinated by the Danish Ministry of Employment calculated that the national cost of missed work because of illness in wages and sick benefits in 2006 was 37bn Danish kroner (£4bn; €5bn; $8bn), or about 2.3% of gross domestic product. Particularly worrisome is the finding …
Exacerbation of reperfusion arrhythmias by sudden oxidant stress.
Authors: Y Kusama, M Bernier, D J Hearse
Journal: Circulation Research (1990)

A burst of free oxygen radical production has been demonstrated during the early moments of reperfusion, coincident with the onset of reperfusion arrhythmias, which can be attenuated by antioxidants. We have investigated whether a sudden burst of oxidant stress, superimposed on that occurring during reperfusion, can exacerbate reperfusion arrhythmias. Rat hearts (n = 12/group) were subjected to 12 minutes of aerobic perfusion; during the last 2 minutes, rose bengal (1 mumol/l) was added to the perfusion fluid. Then, regional ischemia was induced, and rose bengal-free perfusion was restored. After 5 minutes of ischemia, reperfusion was initiated for 5 minutes, and during the first 30 seconds of reperfusion, hearts were uniformly illuminated (8,500 lux) with green light (530-590 nm). The photoactivation of rose bengal trapped in the tissue, producing singlet oxygen and superoxide, resulted in an exacerbation of reperfusion arrhythmias. Thus, 92% of hearts developed ventricular premature beats, 83% ventricular tachycardia, and 33% ventricular fibrillation. In contrast, hearts with regional ischemia and reperfusion in the absence of rose bengal and/or illumination did not develop ventricular fibrillation; only one heart exhibited ventricular tachycardia, and the incidence of ventricular premature beats was lower (42-50%). Furthermore, the burst of oxidant stress shortened the time to onset of ventricular premature beats from 21.7 +/- 5.6 to 9.9 +/- 2.1 seconds. Additional studies revealed that rose bengal photoactivation without reperfusion was less arrhythmogenic compared with the combination of reperfusion plus photoactivation. These results demonstrate that a sudden burst of oxidant stress during the early moments of reperfusion can exacerbate the vulnerability to reperfusion arrhythmias.
Antiviral therapy of chronic hepatitis B: Opportunities and challenges in Asia
Authors: Yun-Fan Liaw
Journal: Journal of Hepatology (2009)

Asia comprises more than 40 countries encompassing a wide geographic area with a very large population. Many of these countries have low-income economies together with high endemicity of chronic hepatitis B virus (HBV) infection, which is usually acquired perinatally or during early childhood. The well elucidated natural history of chronic HBV infection, together with the extensive research and the longest experience in the use of therapeutic agents in Asia have provided a great opportunity for Asian patients to benefit from recent advancements. However, treatment of chronic HBV infection is a complex task that requires individualized assessment, thus representing a great challenge for general physicians. The inherent problems of the drugs currently available, together with a lack of awareness of the disease among patients, government, and healthcare practitioners are obstacles to proper management of HBV. The most critical challenge and obstacle is the high cost of medical care and antiviral drugs. Lack of adequate reimbursement for treatment and diagnostic testing makes adherence to treatment guidelines impossible. Hence lamivudine is still widely used in Asia. To address these challenges, the ongoing awareness campaigns, active screening programs, educational activities are needed but must be enhanced. Cost-cutting measures and international support are essential to improve the difficult situation in this part of the world.
Exhaled breath condensate: methodological recommendations and unresolved questions
Authors: I. Horváth, J. Hunt, P. J. Barnes
Journal: European Respiratory Journal (2005)

Collection of exhaled breath condensate (EBC) is a noninvasive method for obtaining samples from the lungs. EBC contains large number of mediators including adenosine, ammonia, hydrogen peroxide, isoprostanes, leukotrienes, nitrogen oxides, peptides and cytokines. Concentrations of these mediators are influenced by lung diseases and modulated by therapeutic interventions. Similarly EBC pH also changes in respiratory diseases. The aim of the American Thoracic Society/European Respiratory Society Task Force on EBC was to identify the important methodological issues surrounding EBC collection and assay, to provide recommendations for the measurements and to highlight areas where further research is required. Based on the currently available evidence and the consensus of the expert panel for EBC collection, the following general recommendations were put together for oral sample collection: collect during tidal breathing using a noseclip and a saliva trap; define cooling temperature and collection time (10 min is generally sufficient to obtain 1-2 mL of sample and well tolerated by patients); use inert material for condenser; do not use resistor and do not use filter between the subject and the condenser. These are only general recommendations and certain circumstances may dictate variation from them. Important areas for future research involve: ascertaining mechanisms and site of exhaled breath condensate particle formation; determination of dilution markers; improving reproducibility; employment of EBC in longitudinal studies; and determining the utility of exhaled breath condensate measures for the management of individual patients. These studies are required before recommending this technique for use in clinical practice.
Abstract 2356: Biomarkers of progressive squamous lung dyplasia.
Authors: Micah Friedman, Meredith Tennis, Lori Dwyer-Nield, Robert Keith, Raphael Nemenoff, Wilbur Franklin, Mark Geraci, Michael Edwards, Sugita Michio, Dan Merrick
Journal: Cancer Research (2013)

Abstract Lung cancer is the leading cause of cancer death in the United States. Squamous cell lung cancers (SCC) comprise approximately 30% of lung cancer cases, and 48,000 people are projected to die this year in the U.S. from SCC. Bronchial dysplasia (BD) is a precursor of SCC, however not all BDs progress to carcinoma. Persistent or progressive BD is associated with a higher risk for the development of invasive lung cancer. We hypothesize that characterization of the difference between persistent and regressive BD will identify high risk patients and suggest novel therapeutic targets for prevention of progression to lung SCC. Gene expression analysis was used to identify differences between persistent and regressive BD. Subjects recruited to Colorado SPORE in Lung Cancer screening studies that met sputum atypia criteria and underwent multiple bronchoscopies were evaluated. Sixty-three frozen baseline biopsies showing BD by histology were classified as persistent/progressive (group 1) or regressive (group 2) according the presence or absence of BD on follow-up biopsies at the same sites. H&amp;E staining was performed on frozen sections to confirm histology, and RNA was harvested and used to create gene expression arrays. PLK1 was selected as a gene of interest based on significantly increased levels of expression and pathway analyses implicating increased activity of cellular pathways associated with PLK-1 expression. Additionally, bronchial epithelial cells were cultured from fresh biopsies taken immediately adjacent to persistent or regressive bronchial sites, and RNA, DNA, and protein were harvested. qRT-PCR was performed on RNA extracted from these persistent and regressive biopsy epithelial cultures. PLK1 expression in epithelial cultures was shown to be increased in persistent as compared to regressive cell lines suggesting that this cell cycle control enzyme may represent a possible chemoprevention target in persistent/progressive dysplasias. RNA was also extracted from a variety of immortalized cancer cell lines of both squamous and adenocarcinoma subtypes, and qRT-PCR was used to establish baseline expression of these genes in cancer cells. Eleven of 20 lung cancer cell lines showed at least 20 fold higher PKL-1 expression compared to non-tumorigenic cell lines while 4 out of 4 lines of SCC origin showed 75 fold or higher expression further supporting a role for this enzyme in SCC progression. Citation Format: Micah Friedman, Meredith Tennis, Lori Dwyer-Nield, Robert Keith, Raphael Nemenoff, Wilbur Franklin, Mark Geraci, Michael Edwards, Sugita Michio, Dan Merrick. Biomarkers of progressive squamous lung dyplasia. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2356. doi:10.1158/1538-7445.AM2013-2356
Nonaggressive Obstetric Management
Authors: Frank A. Chervenak
Journal: JAMA (1989)

Nonaggressive obstetric management was used in 13 cases of anomalous fetuses during the third trimester. Criteria that define these anomalies are (1) a very high probability of a correct diagnosis and (2) either (<i>a</i>) a very high probability of death as an outcome of the anomaly diagnosed or (<i>b</i>) a very high probability of severe and irreversible deficit of cognitive developmental capacity as a result of the anomaly diagnosed. On the basis of two approaches to obstetric ethics, we defend the legitimacy of nonaggressive management of third-trimester pregnancies complicated by fetal anomalies that meet these criteria. (<i>JAMA</i>. 1989;261:3439-3440)
An Inflammatory Pseudotumor of the Lung in Q Fever Pneumonia
Authors: David Thomas Janigan, Thomas James Marrie
Journal: New England Journal of Medicine (1983)

INFLAMMATORY pseudotumor" is a generic term for a lung mass, usually solitary, composed of mixtures of histiocytes or macrophages (sometimes lipid-filled — i.e., "foam cells"), plasma cells, lymphocytes, fibroblasts, and collagen.1 Because these components are present in highly variable ratios and spatial interrelations,2 3 4 5 these lesions have been designated variously as "plasma-cell granuloma," "fibrohistiocytoma," "xanthoma," "xanthofibroma," "xanthogranuloma," "xanthomatous pseudotumor," and "post-inflammatory pseudotumor." Their clinical features, including evidence of a preceding or concurrent respiratory infection, are also quite varied.2 3 4 , 6 , 7 However, the most consistent and clinically important feature is their radiologic mimicry of malignant neoplasms, so that nearly all reported examples have been . . .
Traumatic Mitral Insufficiency
Authors: Albert N. Brest
Journal: JAMA (1961)

Experiences with 1,021 patients operated on for isolated mitral stenosis were reviewed. It was found that mitral-valve incompetence was created in 380 of the 1,021 patients; however, the extent of the anatomic defect was limited in most instances. In most cases, permanent clinical improvement ensued despite the creation of minor mitral insufficiency, but in the more severe forms improvement was absent or only temporary, and clinical decline followed. The diagnosis could be clarified by auscultation, x-ray, electrocardiography, and cardiac catheterization. The regurgitant flow of blood was best measured by ventriculography. Surgical correction of the traumatic defect was attempted in 4 subjects. Crosspolar plication alone or in combination with an Ivalon repair of a torn leaflet or chorda tendinea was accompanied by a satisfactory clinical result in 3 instances.
Junctional blisters in acquired bullous disorders of the dermal-epidermal junction zone: role of the lamina lucida as the mechanical locus minoris resistentiae*
Authors: G. F. KLEIN, H. HINTNER, G. SCHULER, P. FRITSCH
Journal: British Journal of Dermatology (1983)

Journal Article Junctional blisters in acquired bullous disorders of the dermal‐epidermal junction zone: role of the lamina lucida as the mechanical locus minoris resistentiae Get access G. F. KLEIN, G. F. KLEIN Department of Dermatology, University of Innsbruck, Austria Georg F. Klein, M. D., Dept of Dermatology, University of Innsbruck, Anichstr. 35, A‐6020 Innsbruck, Austria. Search for other works by this author on: Oxford Academic Google Scholar H. HINTNER, H. HINTNER Department of Dermatology, University of Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar G. SCHULER, G. SCHULER Department of Dermatology, University of Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar P. FRITSCH P. FRITSCH Department of Dermatology, University of Innsbruck, Austria Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 109, Issue 5, 1 November 1983, Pages 499–508, https://doi.org/10.1111/j.1365-2133.1983.tb07671.x Published: 01 November 1983 Article history Accepted: 06 April 1983 Published: 01 November 1983
DIAGNOSIS AND TREATMENT OF ACUTE INTESTINAL OBSTRUCTION
Authors: Robert E. L. Berry
Journal: JAMA (1952)

There has been some progress in our knowledge of the pathological physiology and treatment of acute intestinal obstruction in the past two decades. Despite this advance, the mortality rate in the treatment of such obstructions remains discouragingly high. There are differences of opinion among persons with considerable experience as to certain aspects of management, but this does not seem to be importantly related to the continued high mortality rate. The commonest causes of death in small-bowel obstructions<sup>1</sup>are peritonitis and infection. Because they are, for the most part, late manifestations of the disease process, their prevention and early, effective treatment should be the logical method of significantly lowering mortality rates. Failure of early diagnosis and delayed application of proved sound therapeutic procedure undoubtedly are the most important factors in maintenance of the lethal results of acute obstruction. <h3>DIAGNOSIS</h3><h3>Acute Mechanical Small-Bowel Obstruction.—</h3> Early diagnosis of intestinal obstruction is possible
Usefulness of Lymphoscintigraphy in Demonstrating Lymphedema in Patients With Noonan Syndrome
Authors: Mei-Fang Cheng, Yen-Wen Wu, Kai-Yuan Tzen, Ruoh-Fang Yen
Journal: Clinical Nuclear Medicine (2008)

Lymphatic dysplasia/hypoplasia is found in 15% to 20% of patients with Noonan syndrome. We report a 16-year-old boy with a classic phenotype of Noonan syndrome but a normal karyotype in chromosomal study. During the last 5 years, he had progressive bilateral lower limb edema. The microfilaria study, duplex sonography, and MRI of the lower extremities were all unremarkable. But lymphoscintigraphy showed stocking-like dermal backflow in both legs, delayed lymphatic flow to the inguinal nodes, and dilated lymphatic channels in the abdomen and thorax. These findings suggest that lymphoscintigraphy may be useful in providing vital information on the lymphatic drainage for patients with Noonan syndrome.