tbuckley/cabot-search huggingface dataset:
Aids to prevent pressure sores.
Authors: J B Young
Journal: BMJ (1990)

Everyday Aids and AppliancesAids to prevent pressure sores John B Young Pressure sores are a potentially preventable complica- tion of immobilising illnesses.They can be painful and distressing to the patient and may necessitate long periods in hospital.They are expensive: treatment of pressure sores costs the NHS an estimated £150 million a year.'Although treatment of the established sore is important, methods of prevention should be our main concern.Vulnerable patients must be identified and appropriate nursing methods and equipment selected.I have concentrated mainly on beds and mattresses, but all surfaces on which patients sit or lie, including easy chairs, wheelchairs, casualty trolleys, and operat- ing tables, need attention. Mechanisms of pressure sore formationPressure sores originate deep within subcutaneous tissues.The body can withstand high pressures if uniformly applied (such as for deep sea divers) but local (point) pressure and shearing forces produce tissue distortion and so impair or occlude capillary flow producing ischaemia (fig 1).The standard NHS hospital mattress can produce point pressures of up to 150 mm Hg.Ischaemia is likely to develop if the normal capillary pres,sure of 12-33 mm Hg is exceeded for long enough.Critical capillary pressures may be lower in debilitated or elderly patients.Friction, a component of shear, may contribute separately to pressure sores by stripping superficial skin layers, leading to ulceration.FIG 1-Unstressed subcutaneous tissue (left); deforming effects ofpoint pressure (centre); and shear (right)
Bone and bone substitutes
Authors: Hisham F. Nasr, Mary Elizabeth Aichelmann‐Reidy, Raymond A. Yukna
Journal: Periodontology 2000 (1999)

Bone replacement grafts will play a continuing role in periodontal and other regenerative therapy. Several choices are available to the clinician including autogenous, allogeneic, xenogeneic and a variety of alloplastic materials. Except for fresh autogenous bone, bone replacement graft(s) do not provide the cellular elements necessary for osteogenesis nor can they reliably be considered truly osteoinductive, but instead are mostly osteoconductive, providing a scaffold for bone deposition. Currently, significant decrease in clinical probing depth and gain of clinical attachment have been reported following use of bone replacement grafts when compared to flap debridement surgery alone for periodontal osseous defects. Reported differences among bone replacement grafts (autogenous, allogeneic, xenogeneic, and alloplastic) occur with respect to histological outcomes. Overall, probing depth reduction, attachment level gain and degree of defect fill are similar for all bone replacement grafts.
Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study
Authors: Michael Ryan, Anthony Wong, David Rabago, Kenneth Lee, Jack Taunton
Journal: British Journal of Sports Medicine (2011)

Purpose To evaluate whether ultrasound-guided injection of hyperosmolar dextrose for treatment of patellar tendinopathy decreases pain scores and normalises the appearance of the patellar tendon on ultrasound. Methods Subjects were referred from primary care clinics and failed conservative treatment. Subjects received a diagnostic ultrasound examination, then ultrasound-guided injection of 25% dextrose with lidocaine into the area of tendinopathy until they were satisfied with treatment. The primary outcome measure was a three-part visual analogue scale (VAS; baseline and mean of 45 weeks after start of treatment) for pain at rest, activities of daily living (ADL) and during sport. Secondary outcomes included segmental ultrasound examinations assessing tendon hypoechogenicity (area and severity score), neovascularity (severity score) and the presence or absence of intratendinous tearing and calcification, irregularities of cortical bone and thickness. Results 47 consecutive referrals were included. Subjects received a mean of four (±3) injection sessions. At mean 45 weeks post-enrollment, subjects reported a reduction in pain across the three VAS items (rest 38.4±25–18.7±18.4; ADL 51.1±22.9–25.8±20.1; sport 78.1±15.7–38.8±26.1; p&lt;0.01). There was improvement in neovascularity following the dextrose injection. A significant correlation between hypoechogenicity severity scores and pain at follow-up is reported. Conclusion There was a reduction in pain and an improvement in ultrasound appearance following ultrasound-guided dextrose injections for refractory patellar tendinopathy. An improved hypoechoic appearance of the tendon was associated with decreased pain scores, suggesting that dextrose injections may modify patellar tendinopathy at the tissue level and that fibrillar changes may play a role in tendon nociception.
The Role of Empirical Research in Bioethics
Authors: Alexander A. Kon
Journal: The American Journal of Bioethics (2009)

There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics.
Using information from asthma patients: a trial of information feedback in primary care
Authors: P. White, A. Atherton, G. Hewett, K. Howells
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To test the effects of feedback of information about patients9 asthma to primary care teams. <b>Design</b>: Patients9 reports of morbidity, use of health services, and drug use on questionnaire was given to primary care teams. Randomised controlled trial with general practices as the subject of the intervention was used to test effectiveness of supplying information. <b>Setting</b>: Primary care in district health authority, London. <b>Subjects</b>: 23 general practices, each of which notified at least 20 asthmatic patients aged 15-60 years for each principal. Practices were randomly allocated to an intervention group (receiving feedback of information on control of asthma) or a control group (no feedback). <b>Intervention</b>: Information on cards inserted in patients9 medical records; booklet copies of information for team members; formal presentation to primary care teams; poster displays of data on patients in each practice. <b>Main outcome measures</b>: Type and frequency of asthma symptoms, use of health services, use of asthma drugs. <b>Results</b>: Reported morbidity at entry to the study was substantial: 45% (818) patients reported breathlessness at least once a week. Less than half these patients were using inhaled steroids regularly. Intervention and control groups did not differ in practice or patient characteristics on entry to the study. In spite of the potential for improvement no differences were observed between the two practice groups at the end of the study—for example, breathlessness at least once a week in last six months was experienced by 36% in intervention group v 35% in control group (t=−0.27, P&lt;0.79); surgery attendance in last six months by 48% v 48% (t=−0.05, P&lt;0.96); regular use of inhaled steroids by 60% v 58% (t=0.51, P&lt;0.62). <b>Conclusion</b>: Feedback to general practitioners of information about patients9 asthma does not on its own lead to change in the outcome of clinical care.
Population growth of human Y chromosomes: a study of Y chromosome microsatellites
Authors: J. K. Pritchard, M. T. Seielstad, A. Perez-Lezaun, M. W. Feldman
Journal: Molecular Biology and Evolution (1999)

We use variation at a set of eight human Y chromosome microsatellite loci to investigate the demographic history of the Y chromosome. Instead of assuming a population of constant size, as in most of the previous work on the Y chromosome, we consider a model which permits a period of recent population growth. We show that for most of the populations in our sample this model fits the data far better than a model with no growth. We estimate the demographic parameters of this model for each population and also the time to the most recent common ancestor. Since there is some uncertainty about the details of the microsatellite mutation process, we consider several plausible mutation schemes and estimate the variance in mutation size simultaneously with the demographic parameters of interest. Our finding of a recent common ancestor (probably in the last 120,000 years), coupled with a strong signal of demographic expansion in all populations, suggests either a recent human expansion from a small ancestral population, or natural selection acting on the Y chromosome.
No time to train the surgeons:The rot is deep
Authors: Aman S Coonar
Journal: BMJ (2004)

EDITOR—Chikwe et al highlight the crisis in surgical training in the United Kingdom.1 Many of the advantages of the “apprentice” model have been destroyed without a comfortable and successful new structure being in place. Some elements can be rectified with ease—comprehensive academic courses, wet labs, a refashioned senior registrar phase, …
Relationship of aggregated intramembranous particles to water permeability in vasopressin-treated toad urinary bladder.
Authors: W A Kachadorian, S D Levine, J B Wade, V A Di Scala, R M Hays
Journal: Journal of Clinical Investigation (1977)

It has been previously demonstrated with freeze-fracture electron microscopy that vasopressin induces specific structural alterations of the luminal membrane of granular cells from toad urinary bladder in a dose-dependent fashion. These alterations consist of aggregated intramembranous particles and are observed both in the presence and absence of an osmotic gradient. We examined the effect of methohexital, a selective inhibitor of vasopressin-stimulated water flow, and the effect of phloretin, a selective inhibitor of urea permeability, on the structure of the granular cell luminal membrane. Methohexital treatment of the vasopressin-stimulated toad bladder reduced both the osmotic water flow and vasopressin-induced alterations of membrane structure to the same extent. Phloretin reduced urea permeability but not water flow or particle aggregation. Since neither agent affects vasopressin-stimulated sodium movement, these findings indicate that the phenomenon of particle aggregation is specifically related to vasopressin-induced water permeability and not to changes in urea or sodium permeability.
Calorie Labeling on Menus and Menu Boards
Authors: Danja Sarink, Anna Peeters, Kathryn Backholer
Journal: JAMA (2014)

The Viewpoint by Drs Block and Roberto on calorie labeling on menus and menu boards summarized the possible benefits of this health promotion policy. We would like to emphasize the importance of expanding current evaluations to understand the effect of calorie labeling across socioeconomic backgrounds.
Abstract 5450: H-RASG12V transformation modulates antioxidant activities and enhances genotoxicity to arsenite in human urothelial cells
Authors: Yi-Chun Liao, Kuo-chu Lai, Te-Chang Lee
Journal: Cancer Research (2012)

Abstract Inorganic arsenite (iAs) is a human carcinogen. Epidemiological evidence has revealed the strong association of chronic exposure to arsenic with increased incidences of cancers, including skin, lung, liver, bladder, etc. However, the exact carcinogenic mechanisms of iAs are not completely understood. Numerous studies have shown that mutation-activated H-Ras is frequently observed (about 30 ∼ 50%) in human urothelial carcinoma. In this study, we explored the gentoxic effects of iAs in human urothelial cells ectopically expressing H-RasG12V, an activated H-Ras oncogene. Our results showed that H-RasG12V-transformed human uroepithelial cells (HUC-RAS) were more susceptible to arsenite-induced cell death, DNA damage, micronuclei formation, and anchorage independent growth than control cells (HUC-neo). Furthermore, we found that iAs treatment induced higher intracellular levels of reactive oxygen species (ROS) in HUC-RAS cells than HUC-neo. In addition, iAs-induced genetic damages could be effectively suppressed by N-acetyl-L-cysteine (NAC). We therefore further determined the effects of iAs on antioxidant activities in these 2 cell lines. Our results showed that glutathione (GSH) and superoxide dismutase (SOD) activity were significantly elevated by treatment of HUC-neo cells with iAs, but not in HUC-RAS cells.Alternatively, catalase activity, 2-fold increase in HUC-RAS cells as compared to HUC-neo cells, was significantly suppressed by iAs. Taken together, we may infer that H-RasG12V expression disturbs redox homeostasis by increasing catalase activity. Since catalase activity is sensitive to iAs, it may account for the susceptibility of H-RAS transformed cells to iAs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5450. doi:1538-7445.AM2012-5450
Futility: Another Way?
Authors: Steven M. Radwany
Journal: Annals of Internal Medicine (2014)

Letters17 June 2014Futility: Another Way?Steven M. Radwany, MDSteven M. Radwany, MDFrom Summa Health System and Northeast Ohio Medical University, Akron, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5012-5 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I was touched by Shah's essay (1). It points to how unprepared we are as physicians to address what is essentially an emotional crisis in response to an irreversible medical situation. My read of this story is that a daughter's grief and sense of isolation were treated with repeated invasive surgical procedures. Please believe that I do not say this to criticize Shah. He was put in an untenable position as a surgical resident to try to address someone in severe emotional distress on first acquaintance, probably without the training or tools needed to help begin to ...Reference1. Shah SK. Futility. Ann Intern Med. 2014;160:138-9. [PMID: 24592501] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Steven M. Radwany, MDAffiliations: From Summa Health System and Northeast Ohio Medical University, Akron, Ohio.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0191. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFutility Samir K. Shah Futility Samir K. Shah Futility: Another Way? Joanne Lynn Futility: Another Way? Simon Kassabian Futility: Another Way? Keyvan Ravakhah Futility: Another Way? Samir K. Shah Futility: Another Way? Keyvan Ravakhah Futility: Another Way? Samir K. Shah Futility: Another Way? Joanne Lynn Futility: Another Way? Simon Kassabian Metrics 17 June 2014Volume 160, Issue 12Page: 878KeywordsConflicts of interestDisclosureEmotionsHealth careMedical educationPalliative carePsychology ePublished: 17 June 2014 Issue Published: 17 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
In-vivocharacterization of plaque morphology by optical coherence tomography predicts coronary artery remodeling
Authors: Briain D. Mac Neill, Harry C. Lowe, Eugene Pomeranstev, Denise DeJoseph, Hiroshi Yabushita, Guillermo J. Tearney, Brett E. Bouma, Ik-Kyung Jang
Journal: Journal of the American College of Cardiology (2003)
Abstract 1110: MicroRNA-1 Regulates Cardiomyocyte Differentiation And Proliferation In Human-derived Cardiomyocyte Progenitor Cells.
Authors: Joost P Sluijter, Alain van Mil, Tom H Korfage, Corina H Metz, Pieter A Doevendans, Marie-Jose Goumans
Journal: Circulation (2007)

Myocardial regeneration can occur in humans, albeit with very low efficiency. To improve regeneration of the injured myocardium, one can enhance the intrinsic capacity of the heart to regenerate itself and/or replace the damaged tissue by cell transplantation. Recently, we have isolated cardiomyocyte progenitor cells (CMPCs) from human fetal hearts and from adult human biopsies that can be expanded in culture and efficiently differentiated into beating cardiomyocytes. In addition, these CMPCs also efficiently differentiate into tubular structures on matrigel, forming aligned endothelial cells surrounded by smooth muscle cells. Recently, several studies have demonstrated that microRNAs (miRNAs) are important for transcriptional regulation during angiogenesis, heart development, and maintenance of stem cell populations by translational repression. We hypothesize that, since miRNAs regulate stem cell maintenance, miRNAs are involved in proliferation/differentiation of the human cardiomyocytes progenitor cells  in vitro .   Methods and results:  Human fetal CMPCs were isolated, cultured and efficiently differentiated into beating cardiomyocytes. We observed that the muscle-specific miRNA-1 was highly upregulated (qRT-PCR, >7000 fold) in differentiated cardiomyocytes and hardly present in proliferating CMPCs. Transient transfection of miRNA-1 in undifferentiated CMPCs reduced their proliferation rate by 25% (MTT assay and FACS analysis) and enhanced differentiation into cardiomyocytes. When undifferentiated CMPCs were transiently transfected with miRNA-1 and seeded onto matrigel, angiogenic morphology was changed. The mean length and size of the tubules was significantly increased (2.5 and 4.5 fold, respectively), whereas the number of junctions was reduced by 50%. This suggests that more CMPCs were directed into the smooth muscle-like phenotype and not into branching endothelial cells, leading to larger tubules with less side junctions.   Conclusion:  Our results demonstrate a strong regulatory role of miRNAs in human CMPC proliferation and differentiation into cardiomyocytes. miRNA-1 functions as a key regulator, and is involved in the onset of human CMPC differentiation into cardiomyocytes and smooth muscle like cells.
Clinical Observations with an Orthogonal Lead System
Authors: ROBERT S. WILKINSON, ROBERT RABINOWITZ, STANLEY MELTZER, J. A. ABILDSKOV
Journal: Circulation (1962)

Orthogonal electrocardiographic leads of 85 normal and 104 abnormal subjects obtained with a new lead system were examined for the counterparts of clinically significant findings in conventional 12-lead electrocardiograms. Most of the findings judged significant in conventional leads had easily recognizable counterparts in orthogonal leads. Excluding findings suggestive of ventricular enlargement, the conventional tracings of 40 subjects showed QRS abnormalities, and counterparts of these were identified in the orthogonal leads of all but one subject. Counterparts of findings suggesting ventricular enlargement could not be evaluated, since the range of normal variation of orthogonal leads obtained with the system used has not been established in quantitative terms. Conventional records of 99 subjects showed abnormalities of the S-T segments or T waves or both, and recognizable abnormalities of these portions of the curves were present in the orthogonal leads of 97 of the subjects.
Profound Inhibition of Myogenic Tone in Rat Cardiac Allografts Is Due to eNOS- and iNOS-Based Nitric Oxide and an Intrinsic Defect in Vascular Smooth Muscle Contraction
Authors: Peter L. Skarsgard, Xiaodong Wang, Paul McDonald, Amy H. Lui, Eugene K. Lam, Bruce M. McManus, Cornelis van Breemen, Ismail Laher
Journal: Circulation (2000)

Background —The physiological consequences of inducible NO synthase (iNOS) expression were studied in allograft coronary arteries by pressure myography. Methods and Results —Septal coronary arteries (diameter, 200.6±3.3 μm) were harvested from allograft and isograft hearts, and their myogenic properties were measured before and after iNOS and nonselective NOS inhibition with aminoguanidine (AG, 100 μmol/L) and N G -nitro- l -arginine methyl ester (L-NAME) (200 μmol/L). Fura 2 fluorescence microscopy was used to measure [Ca 2+ ] i in isolated endothelial cells. Monoclonal anti-iNOS immunostains demonstrated iNOS protein in day 2, 7, 14, and 28 allograft vessels, but only in day 2 isograft vessels. Myogenic tone was profoundly inhibited in allograft vessels from day 4 onward. In day 4 allograft vessels, these differences were abolished by L-NAME but not AG, suggesting greater basal release of eNOS-based NO from allograft endothelium. Fluorescence measurements confirmed elevation of [Ca 2+ ] i in day 4 allograft endothelium, providing a mechanism for enhanced eNOS activity. For days 7 to 28, AG potentiated myogenic tone in allograft but not isograft vessels, indicating that vasoactive iNOS-based NO was present. In mature vessels, constriction via agonist- and depolarization-mediated mechanisms showed parallel inhibition, suggesting an intrinsic defect in vascular smooth muscle cell contraction. Conclusions —Our data indicate that the profound inhibition of myogenic tone in allograft arteries involves direct vasodilation by eNOS- and iNOS-based NO, as well as an intrinsic defect in vascular smooth muscle contraction. The hemodynamic profile resulting from these changes in allograft resistance vessel function would favor movement of extracellular fluid from the intravascular space into the myocardial interstitium, resulting in edema, increased ventricular stiffness, and poor ventricular performance.
The partial smoking ban in licensed establishments and health inequalities in England: modelling study
Authors: Alan A Woodall, Emma J Sandbach, Catherine M Woodward, Paul Aveyard, Graham Merrington
Journal: BMJ (2005)

Implications for policy makers and future researchNurse led hospital at home or early discharge schemes for patients with COPD should be prioritised over the type of nurse led models of chronic disease management that have been studied to date.There is little evidence available at present to support the models that have been evaluated.Existing services providing this sort of care should be robustly evaluated against the aims of the particular service.The evidence around long term or intensive case management and hospital readmission is currently equivocal and requires further study.The potential benefits of schemes for chronic disease management in patients with COPD receiving long term oxygen therapy should also be explored further.Several potentially important outcomes have not been evaluated, including patients' satisfaction, self management, patients' coping and adherence, smoking cessation, and the effects on carers.