tbuckley/cabot-search huggingface dataset:
Changing prescription patterns for lithium and valproic acid in old age: shifting practice without evidence
Authors: K. I Shulman
Journal: BMJ (2003)

Over the past decade, valproic acid (prescribed as divalproex in North America) has been marketed as an alternative to lithium for treating bipolar disorders. For elderly patients, however, there is no clear evidence that valproic acid is more beneficial than lithium. Moreover, the evidence for the superiority of valproic acid in treating bipolar disorders—mixed episodes and rapid cycling—has been challenged in a recent Cochrane review.1 Valproic acid has not benefited patients with manic and psychiatric symptoms in dementia, despite the growing use of the drug in the management of these conditions.2 Recently, the relatively rapid shift in prescription patterns has been questioned.3 We describe trends in the use of lithium and valproic acid in a large population of people over 65.

We obtained information on drug use from the Ontario Drug Benefit Program, which provides comprehensive drug benefits to all residents aged 65 or older in Ontario, Canada. …
Decreased Anion Gap Associated With Hypoalbuminemia and Polyclonal Gammopathy
Authors: Amin A. Nanji
Journal: JAMA (1981)

Anion gaps were determined in 82 patients with hypoalbuminemia; 24 of these patients had a polyclonal increase in γ-globulin levels (designated group 5). The 58 patients without the polyclonal increase in γ-globulin levels were subdivided according to the origin of their serum albumin loss as follows: group 1, renal; group 2, gastrointestinal; group 3, skin; and group 4, malignant neoplasms. All groups had a statistically significant reduction in their mean anion gaps when compared with normal control subjects. The greatest decrease was when hypoalbuminemia was accompanied by a polyclonal increase in γ-globulin levels. Hypoalbuminemia with or without a polyclonal gammopathy is a cause of a low anion gap. No statistically significant correlation was found between the anion gaps and individual serum albumin concentrations. (<i>JAMA</i>1981;246:859-860)
Vascular NADPH oxidases: molecular mechanisms of activation
Authors: R BRANDES, J KREUZER
Journal: Cardiovascular Research (2004)

Oxygen-derived free radicals are thought to contribute to the initiation and progression of cardiovascular disease via several different mechanisms, such as consumption of nitric oxide, oxidation of proteins and lipids, and activation of redox-sensitive signalling cascades. Vascular NADPH oxidases are important sources of vascular radical formation. The activities of these enzymes, which in some aspects are similar to the leukocyte NADPH oxidase, are controlled on the expression level and complex activation mechanisms. As a plethora of vascular stimuli, such as growth factors, cytokines, physical stimuli, and lipids elicits radical formation by these enzymes, a careful analysis is required for the understanding of the activation of the NADPH oxidases. This article reviews the components of the NADPH oxidases in leukocytes and vascular tissue. Emphasis is put on the activation of the oxidases, including upstream signalling events and molecular modes of interaction between the subunits.
Antibiotic Therapy in Lyme Disease
Authors: ALLEN C. STEERE
Journal: Annals of Internal Medicine (1980)

We studied antibiotic efficacy in 113 patients with erythema chronicum migrans, the first manifestation of Lyme disease. Erythema chronicum migrans and its associated symptoms resolved faster in patients given penicillin or tetracycline (median duration, 4 and 2 days, respectively) than in untreated patients (10 days; P < 0.001 and P = 0.005, respectively). Erythromycin had no significant effect. Although the frequency of subsequent neurologic and cardiac abnormalities was similar in all four groups, significantly fewer patients given penicillin developed arthritis than did untreated patients (P = 0.001). Among 15 patients with arthritis who were followed for at least 29 months, the total duration of joint involvement was shorter in penicillin-treated patients (median, 4 weeks) than in untreated patients (17 weeks; P = 0.019). Although the clinical manifestations of the disease may fluctuate in frequency from year to year and influence apparent antibiotic effect, we conclude that penicillin therapy shortens the duration of erythema chronicum migrans and may prevent or attenuate subsequent arthritis.
Faecal bile acid excretion in children with inflammatory bowel disease.
Authors: J Ejderhamn, J J Rafter, B Strandvik
Journal: Gut (1991)

Faecal bile acid excretion and intestinal transit time were studied in 18 children with inflammatory bowel disease in clinical remission and with normal stools: 16 with ulcerative colitis, two with Crohn9s colitis, mean age 14 years (range 10-17 years). Five healthy children, mean age 12.4 years (range 10-17 years), were studied as control subjects. Most patients were taking sulphasalazine, but none were taking steroids. Transit time was determined by carmine and did not differ between groups. Faeces were collected for 72 hours, and faecal water was prepared by centrifugation of faeces at 15,000 x g for two hours. Bile acids in total faeces and faecal water were studied using capillary gas-liquid chromatography-mass spectrometry. Faecal excretion of total bile acids, unconjugated bile acids, and glycine and taurine conjugates were significantly increased in patients as was faecal water excretion of total bile acids, particularly the taurine conjugates and cholic and chenodeoxycholic acids. Total concentrations of bile acids in faeces and faecal water were two to five times higher in patients. The children with inflammatory bowel disease in clinical remission had high excretion and concentration rates of bile acids, especially taurine conjugates, in both total faeces and faecal water, a finding of considerable interest in the pathogenesis of malignancy in these diseases.
International medical graduates
Authors: S. J Farrow
Journal: Journal of the Royal Society of Medicine (2006)

Ezzati et al. (May 2006 JRSM 1 ) misplace their confidence by a wide margin in claiming to have reached the first 'unbiased' estimates of state and national levels and trends of obesity in the USA.To do so, they claim to have calculated rates of self-reporting biases using data from the NHANES (National Health and Nutrition Examination Survey) and Behavioral Risk Factor Surveillance System (BRFSS) surveys of the US Center for Disease Control and Prevention, which were assumed to be representative of the USA population on the basis of the original sampling design.In reality the assumption is questionable, the response rates being about 80% for NHANES and 45% for BRFSS.If nothing else, such a discrepancy sets a distance between what the two surveys may represent, also considering that the surveys represent different samples.In a crucial decision, Ezzati et al. excluded subjects who did not participate in both surveys-an exclusion that inevitably invalidates any claim that the bias estimates reached could be representative of the USA population or of individual state populations.Such elementary flaws lead to ask how scarce resources could be approved for such a wanting study design.
Early use of glycoprotein 2b3a inhibitors and outcomes in non-ST elevation MI: observations from the NRMI-4
Authors: Eric D. Peterson, John G. Canto, Charles V. Pollack, Lori Parsons, Matt T. Roe, Kathee Littrell, Nathan R. Every, Hal V. Barron
Journal: Journal of the American College of Cardiology (2002)
Disappearance of vesicoureteric reflux during long-term prophylaxis of urinary tract infection in children.
Authors: D Edwards, I C Normand, N Prescod, J M Smellie
Journal: BMJ (1977)

Seventy-five children aged 3 weeks to 12 years and found on investigation of symptomatic urinary infection to have vesicoureteric reflux were managed conservatively with continuous low-dose prophylaxis. Serial cystographic and renal growth studies were performed during seven to 15 years' follow-up. Reflux disappeared spontaneously in 53 children (71%) and from 79% of the affected ureters. This occurred at any age and not only in infancy or at puberty. The initial severity or reflux was the most important factor affecting the outcome. Reflux disappeared from 85% of ureters of normal calibre but from only 41% of dilated ureters. Gross reflux associated with existing severe renal scarring was least likely to disappear. Nevertheless, reflux stopped in 12 of the 19 initially scarred renal units (63%). Reflux was as likely to disappear in children who had a recurrence of urinary infection as in those who had no further infection. Renal growth appeared to be normal in 93% of kidneys and fresh or extending scarring was seen in only two children. Management programmes for children with vesicoureteric reflux should take into account the self-limiting nature of three-quarters of the reflux found on investigating uncomplicated urinary tract infection.
Inspiratory muscle load and capacity in chronic heart failure
Authors: N Hart, Mark Kearney, N B Pride, M Green, F Lofaso, Ajay Shah, John Moxham, M I Polkey
Journal: Thorax (2004)

Although breathlessness is common in chronic heart failure (CHF), the role of inspiratory muscle dysfunction remains unclear. We hypothesised that inspiratory muscle endurance, expressed as a function of endurance time (Tlim) adjusted for inspiratory muscle load and inspiratory muscle capacity, would be reduced in CHF.Endurance was measured in 10 healthy controls and 10 patients with CHF using threshold loading at 40% maximal oesophageal pressure (Poes(max)). Oesophageal pressure-time product (PTPoes per cycle) and Poes(max) were used as indices of inspiratory muscle load and capacity, respectively.Although Poes(max) was slightly less in the CHF group (-117.7 (23.6) v -100.0 (18.3) cm H(2)O; 95% CI -37.5 to 2.2 cm H(2)O, p = 0.1), Tlim was greatly reduced (1800 v 306 (190) s; 95% CI 1368 to 1620 s, p<0.0001) and the observed PTPoes per cycle/Poes(max) was increased (0.13 (0.05) v 0.21 (0.04); 95% CI -0.11 to -0.03, p = 0.001). Most of this increased inspiratory muscle load was due to a maladaptive breathing pattern, with a reduction in expiratory time (3.0 (5.8) v 1.1 (0.3) s; 95% CI 0.3 to 3.5 s, p = 0.03) accompanied by an increased inspiratory time relative to total respiratory cycle (Ti/Ttot) (0.43 (0.14) v 0.62 (0.07); 95% CI -0.3 to -0.1, p = 0.001). However, log Tlim, which incorporates the higher inspiratory muscle load to capacity ratio caused by this altered breathing pattern, was >/=85% predicted in seven of 10 patients.Although a marked reduction in endurance time was observed in CHF, much of this reduction was explained by the increased inspiratory muscle load to capacity ratio, suggesting that the major contributor to task failure was a maladaptive breathing pattern rather than impaired inspiratory muscle endurance.
Pseudodiphtheritic Membranous Pharyngitis Caused by Corynebacterium hemolyticum
Authors: Stephen L. Green
Journal: JAMA (1981)

DIPHTHERIA is the most serious pharyngeal infection in terms of morbidity and mortality, both to the patient and the community. Although fewer than 60 to 70 cases are recorded annually,1the possibility of this illness must always be considered in patients with membranous tonsillitis and pharyngitis. We report a case of membranous pharyngitis caused byCorynebacterium hemolyticumthat strongly mimicked diphtheria. Review of the literature suggests that this organism, though infrequently recognized, may in fact be responsible for many severe and prolonged throat infections.  Report of a Case  A 16-year-old girl was admitted to Hampton General Hospital, Hampton, Va, on May 22,1980, with a three-week history of high fever and sore throat. Although she had experienced a documented case of mononucleosis (heterophil antibody test reaction for mononucleosis was positive) the previous year, the admitting diagnosis was again mononucleosis, since a test for heterophil antibody performed at her physician's office
Advances in Male Contraception
Authors: Stephanie T. Page, John K. Amory, William J. Bremner
Journal: Endocrine Reviews (2008)

Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90-95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade.
Synaptic targeting of rabphilin-3A, a synaptic vesicle Ca2+/phospholipid-binding protein, depends on rab3A/3C
Authors: Cai Li, Kohji Takei, Martin Geppert, Laurie Daniell, Katinka Stenius, Edwin R. Chapman, Reinhard Jahn, Pietro De Camilli, Thomas C. Südhof
Journal: Neuron (1994)
Patients and doctors are asked to report antivirals' side effects as swine flu spreads
Authors: Z. Kmietowicz
Journal: BMJ (2009)

The number of people in the United Kingdom confirmed as having died after contracting the A/H1N1 virus rose to seven this week after the deaths of three more people, including two children, were announced. All were said to have had serious underlying health problems.

A nine year old girl from south London died at the weekend. The girl is the second person in the capital to die after contracting the virus. NHS London said that no further details of the case would be released.

The two others came from Dewsbury in West Yorkshire. One, a 9 year old girl, died on 2 July. She had epilepsy and attended a special school. The other …
Clinical and Laboratory Experiences with Encephalitis due to Herpes Virus Hominis.
Authors: Barry D. Wenglin
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Clinical and Laboratory Experiences with Encephalitis due to Herpes Virus Hominis.Barry D. Wenglin, M.D., Douglas W. Voth, M.D., Murli Manohar, Ph.D., Chien Liu, M.D.Barry D. Wenglin, M.D.Search for more papers by this author, Douglas W. Voth, M.D.Search for more papers by this author, Murli Manohar, Ph.D.Search for more papers by this author, Chien Liu, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-829_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEncephalitis caused by herpes virus hominis is generally a serious disease. Although most patients may present with a short course of fever, headache, convulsions and obtundness, there are no pathognomonic signs and symptoms to permit definitive diagnosis. Routine laboratory studies including cerebrospinal fluid (CSF) examinations are usually not helpful. Herpes virus, as a rule, cannot be isolated from CSF specimens.Within 5 years, 10 patients had encephalitis caused by herpes virus as confirmed by positive immunofluorescent staining of viral antigen and virus isolation in the brain, and high serum antibody titers against herpes virus hominis. The etiologic diagnosis for the... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Kansas City, Kan. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 829-829KeywordsCerebrospinal fluidClinical laboratoriesColony stimulating factorConvulsionsEncephalitisFeversHeadachesImmunofluorescence stainingResearch laboratoriesSigns and symptoms Issue Published: 1 May 1971 PDF DownloadLoading ...
Coexistent Variegate Porphyria and Porphyria Cutanea Tarda
Authors: Robert S. Day, Lennox Eales, Doreen Meissner
Journal: New England Journal of Medicine (1982)

VARIEGATE porphyria is inherited as an autosomal dominant disorder with the clinical characteristics of cutaneous involvement and acute attacks, although these features do not always accompany one another and many who carry the gene are asymptomatic throughout their lives.1 2 3 Porphyria cutanea tarda (also known as symptomatic porphyria) is thought to have two forms4: One is clearly inherited in an autosomal dominant manner, and the other is a sporadic disorder whose hereditary characteristics, if any, remain unclear. The major clinical characteristics of both forms are cutaneous lesions identical to those described for variegate porphyria,1 but an acute attack never occurs. . . .
The Cell Surface
Authors: R. D. Berlin, J. M. Oliver, T. E. Ukena, H. H. Yin
Journal: New England Journal of Medicine (1975)

THERE is little doubt that there are important differences in the biologic behavior of tumor cells and normal cells that can be correlated with altered surface properties. Thus, the uncontrolled growth and invasiveness of cancers is accompanied in vivo by loss of contact inhibition of cell movement and cell division, decreased surface adhesiveness and altered membrane transport of various nutrients. This correspondence between in vivo and in vitro observations has stimulated considerable interest in the underlying molecular events that control cell surface properties. Two major themes, which are probably not mutually exclusive, have been developed to explain how membrane function . . .
Points: Premenstrual tension syndrome
Authors: J J Segall
Journal: BMJ (1979)

This would perhaps bring home to the DHSS the extent to which the consultants are financ- ing the Health Service by running their own cars.I personally as a consultant manage to run one mini.My wife wonders why I spend all this money running a car for the sake of the NHS when she never has the use of it.I feel that the time has come now for my wife to have the use of our car and to insist that the hospital provides transport when it is needed.
Balancing Family and Career: Advice from the Trenches
Authors: Molly Carnes
Journal: Annals of Internal Medicine (1996)

On Being a Doctor1 October 1996Balancing Family and Career: Advice from the TrenchesMolly Carnes, MDMolly Carnes, MDUniversity of Wisconsin and Geriatric Research Education and Clinical Center, Madison, WI 53705Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-7-199610010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I was recently asked to address a group of residents on the subject of balancing family and career. Although I had never considered myself an expert on this topic, I provided these young physicians—almost half of whom were women—with practical advice from my own experience over the past 14 years. Although many of my suggestions seemed self-evident to me, the residents' enthusiastic responses encouraged me to offer my suggestions to a wider audience.Women currently make up a greater percentage of medical students, residents, fellows, and physicians in the United States than ever before. As a result, balancing family and ... Author, Article, and Disclosure InformationAffiliations: University of Wisconsin and Geriatric Research Education and Clinical Center, Madison, WI 53705Corresponding Author: Molly Carnes, MD, Geriatric Research Education and Clinical Center, Middleton Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByWomen in Urology Residency, 1978-2013: A Critical Look at Gender Representation in Our SpecialtyTen Steps to Finding the Right Balance Between Career and FamilyDeveloping a Reproductive Life PlanSearching for Excellence & Diversity: Increasing the Hiring of Women Faculty at One Academic Medical CenterViewpoint: A Challenge to Academic Health Centers and the National Institutes of Health to Prevent Unintended Gender Bias in the Selection of Clinical and Translational Science Award LeadersWho Are Physician???Scientists??? Role Models? Gender Makes a DifferenceUsing Women's Health Research to Develop Women Leaders in Academic Health Sciences: The National Centers of Excellence in Women's HealthWomen in the Workplace 1 October 1996Volume 125, Issue 7Page: 618-620KeywordsAcademic medicineChildrenEmotionsFallsSportsTemperatureTicksUrban areasVeinsX chromosomes Issue Published: 1 October 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Tear or dissection after coronary angioplasty. Morphologic correlates of an ischemic complication.
Authors: A J Black, D L Namay, A L Niederman, N J Lembo, G S Roubin, J S Douglas, S B King
Journal: Circulation (1989)

Intimal tear or dissection is an important descriptor of ischemic complications after coronary angioplasty, but only the minority of patients will develop an acute ischemic event. To identify additional factors that may predict the development of an ischemic event when arterial disruption occurs during otherwise uncomplicated angioplasty, the records of 1,346 patients prospectively identified as having tear or dissection without immediate vessel closure were examined. Ischemic complications, defined as ischemic chest pain, myocardial infarction, the need for coronary bypass surgery, or death, occurred in 120 patients (9%). Significant multivariate correlates of an ischemic complication were the presence of unstable angina or a totally occluded vessel before angioplasty and diameter stenosis of greater than 30% after angioplasty. Detailed geometric and videodensitometric analysis of the postdilatation angiograms of a subset of 96 consecutive patients was carried out. Ischemic complications occurred in 11 patients (11%). Multivariate analysis revealed that the independent correlates of complications, in decreasing order of importance, were the length of the tear or dissection (p = 0.001), diameter stenosis after angioplasty (p = 0.001), cross-sectional area after dilatation measured by videodensitometric methods (p = 0.013), and the presence of extraluminal contrast (p = 0.044). When tear or dissection occurs during otherwise uncomplicated coronary angioplasty, patients at risk of developing delayed ischemic complications can be identified and may benefit from measures designed to minimize this risk. By controlling for the geometric or mechanical factors that result in tear or dissection, it has been possible to identify factors not previously thought associated with ischemic complications.(ABSTRACT TRUNCATED AT 250 WORDS)