tbuckley/cabot-search huggingface dataset:
Exercise induced neurally mediated syncope in an elite rower: a treatment dilemma
Authors: G Whyte, N Stephens, R Budgett, S Sharma, R E Shave, W J McKenna
Journal: British Journal of Sports Medicine (2004)

In March 2002, a 25 year old white woman presented to the British Olympic Medical Centre after bouts of syncope and pre-syncope. The athlete was an international rower, competing in the single sculls event, and was training an average of 10 sessions/week. Training sessions included rowing and weight training, with training across the full range of intensities. The presenting symptoms included two episodes of syncope after 2000 m maximal tests on a rowing ergometer, together with episodes of pre-syncope on water that had not resulted in syncope. All episodes of pre-syncope/syncope occurred immediately after exercise in a seated position. The duration of syncope was not formally documented but was described as lasting one or two minutes, with periods of malaise lasting for considerable periods (more than one hour) after syncope. There had been no previous examination of heart rate and/or blood pressure response during these episodes. Separately the patient noted a tendency for pre-syncope and syncope during medical procedures. There was no family history of heart disease including sudden “unexplained” death.

On examination, the athlete was in sinus rhythm with bradycardia (about 40 beats/min) and sinus arrhythmia. All other measures, including PR and QT interval, were within normal limits. Resting blood pressure was 110/70 mm Hg. Echocardiography showed normal intracardiac dimensions (maximum left ventricular wall thickness; 10 mm) with normal systolic function of both left and right ventricles. Origins of left and right coronary arteries were normal. Mild pulmonary valve regurgitation was noted (inaudible clinically).

During integrated cardiopulmonary exercise stress testing, the athlete completed level 5 of a BRUCE protocol stopping because of maximal exercise capacity. …
Integrated metabolic spatial‐temporal model for the prediction of ammonia detoxification during liver damage and regeneration
Authors: Freimut Schliess, Stefan Hoehme, Sebastian G. Henkel, Ahmed Ghallab, Dominik Driesch, Jan Böttger, Reinhard Guthke, Michael Pfaff, Jan G. Hengstler, Rolf Gebhardt, Dieter Häussinger, Dirk Drasdo, Sebastian Zellmer
Journal: Hepatology (2014)

The impairment of hepatic metabolism due to liver injury has high systemic relevance. However, it is difficult to calculate the impairment of metabolic capacity from a specific pattern of liver damage with conventional techniques. We established an integrated metabolic spatial-temporal model (IM) using hepatic ammonia detoxification as a paradigm. First, a metabolic model (MM) based on mass balancing and mouse liver perfusion data was established to describe ammonia detoxification and its zonation. Next, the MM was combined with a spatial-temporal model simulating liver tissue damage and regeneration after CCl4 intoxication. The resulting IM simulated and visualized whether, where, and to what extent liver damage compromised ammonia detoxification. It allowed us to enter the extent and spatial patterns of liver damage and then calculate the outflow concentrations of ammonia, glutamine, and urea in the hepatic vein. The model was validated through comparisons with (1) published data for isolated, perfused livers with and without CCl4 intoxication and (2) a set of in vivo experiments. Using the experimentally determined portal concentrations of ammonia, the model adequately predicted metabolite concentrations over time in the hepatic vein during toxin-induced liver damage and regeneration in rodents. Further simulations, especially in combination with a simplified model of blood circulation with three ammonia-detoxifying compartments, indicated a yet unidentified process of ammonia consumption during liver regeneration and revealed unexpected concomitant changes in amino acid metabolism in the liver and at extrahepatic sites.The IM of hepatic ammonia detoxification considerably improves our understanding of the metabolic impact of liver disease and highlights the importance of integrated modeling approaches on the way toward virtual organisms.
Doctors need not give blood transfusion to mentally ill Jehovah's Witness, judge rules
Authors: C. Dyer
Journal: BMJ (2014)

Doctors need not give a blood transfusion to a 23 year old Jehovah’s Witness detained under the Mental Health Act who slashed his arm with a razor blade and who keeps trying to reopen the wound, a High Court judge has ruled.

In the Court of Protection in London Mr Justice Mostyn decided that the man, a convicted sex offender named only as J, has the mental …
Isoproterenol antagonizes prolongation of refractory period by the class III antiarrhythmic agent E-4031 in guinea pig myocytes. Mechanism of action.
Authors: M C Sanguinetti, N K Jurkiewicz, A Scott, P K Siegl
Journal: Circulation Research (1991)

The mechanism by which isoproterenol (ISO) prevents the prolongation of action potential duration (APD) and refractory period (RP) by the class III antiarrhythmic agent E-4031 was studied. E-4031 (1 microM) increased RP by 50% with no effect on contractile force in papillary muscles isolated from guinea pig heart. ISO (1 microM) increased force of contraction more than fivefold and decreased RP by 25%. The prolongation of RP by E-4031 was prevented by pretreatment of muscles with ISO. The prolongation of APD in isolated guinea pig ventricular myocytes by 5 microM E-4031 also was antagonized by prior exposure of the cells to 1 microM ISO. Instantaneous currents and delayed rectifier K+ currents, IK, were measured in isolated myocytes using the suction microelectrode voltage-clamp technique. Currents were measured in response to 225-msec depolarizing pulses from a holding potential of -40 mV. Previous studies have demonstrated that IK in these cells results from activation of two distinct outward K+ currents, IKs and IKr (specifically blocked by E-4031). ISO doubled the magnitude of IKs without significant effect on IKr. The instantaneous current, putatively identified as a Cl- current, also was doubled by ISO but was unaffected by E-4031. The augmented conductance of IKs and instantaneous current by ISO results in a decrease in RP. The small effect of E-4031 on APD and RP in the presence of ISO results from the smaller contribution of IKr relative to the augmented repolarizing currents.
SEXUAL ADJUSTMENT IN MARRIAGE
Authors: K. Walker
Journal: BMJ (1954)

<i>Objective</i>—To describe the long term effectiveness of a community based program targeting prevention of burns in young children. <i>Design</i>—Quasiexperimental. <i>Setting</i>—The Norwegian city of Harstad (main intervention), six surrounding municipalities (intervention diffusion), and Trondheim (reference). <i>Participants</i>—Children under age 5 years in the three study populations. <i>Methods</i>—Outpatient and inpatient hospital data were coded according to the Nordic system, and collected as part of a national injury surveillance system. Burn data collection started in May 1985. The first 19.5 months of the study provided baseline data, while the last 10 years involved community based intervention, using a mix of passive and active interventions. <i>Results</i>—The mean burn injury rate decreased by 51.5% after the implementation of the intervention in Harstad (p&lt;0.05) and by 40.1% in the six municipalities (not significant). Rates in the reference city, Trondheim, increased 18.1% (not significant). In Harstad and the six surrounding municipalities there was a considerable reduction in hospital admissions, operations, and bed days. Interventions with passive strategies were more effective, stove and tap water burns being eliminated in the last four years, while active strategies were less effective. <i>Conclusions</i>—A program targeting burns in children can be effective and sustainable. Local injury data provided the stimulus for community action.
Sexual activity and risk of myocardial infarction
Authors: D. K. Hellerstein
Journal: JAMA (1996)

To the Editor.  —Dr Muller and colleagues 1 have presented a fine service for patients rehabilitating from myocardial infarction (MI). Their conclusion affirms that of Hellerstein and Friedman 2 26 years ago, which was based on 18 years of prior clinical experience and observation and correlation with results obtained from their benchmark study. Their study included a control group of patients at high risk for MI (those who have a family history of heart disease, overweight, and smokers) with normal vital signs, and their methods of observation included extensive history, physical examinations, and laboratory characterizations (ie, somatotype determinations, cholesterol and triglyceride measurements), and electrocardiograms (ECGs) at rest, during usual activity, and during sexual activity. Estimations of myocardial oxygen consumption were based on same-subject provocative testing in the laboratory. Psychological evaluations were conducted, including the Minnesota Multiphasic Personality Inventory and social indexing. Furthermore, the results contradicted laboratory observations of sexual activity
Iontophoresis-driven penetration of nanovesicles through microneedle-induced skin microchannels for enhancing transdermal delivery of insulin
Authors: Huabing Chen, Hongda Zhu, Jingnan Zheng, Dongsheng Mou, Jiangling Wan, Junyong Zhang, Tielin Shi, Yingjun Zhao, Huibi Xu, Xiangliang Yang
Journal: Journal of Controlled Release (2009)
EFFECT OF THE FEEDING OF EGG YOLK POWDER ON BODY WEIGHT
Authors: Alfred Steiner
Journal: JAMA (1941)

During the course of a study on the serum cholesterol in a series of patients<sup>1</sup>who were being fed on egg powder, it was observed that a gain in body weight occurred. This observation was of interest in view of the fact that previous efforts to improve the nutrition of the subjects under consideration by means of high caloric diets with vitamin supplements had failed. The results of the feeding of egg yolk powder on the body weight of 10 patients are presented here. A group of 10 patients, 8 with rheumatoid arthritis<sup>2</sup>and 2 with chronic nephritis without edema, who had been previously hospitalized from two to six months, were observed during a control period of five weeks. A well balanced diet containing from 2,600 to 3,000 calories was fed to the patients during this period. Subsequently the patients were given diets containing from 1,900 to 2,500
Transthoracic Defibrillation of Swine With Monophasic and Biphasic Waveforms
Authors: Bradford E. Gliner, Thomas E. Lyster, Stephen M. Dillion, Gust H. Bardy
Journal: Circulation (1995)

Biphasic waveforms have had a favorable impact on internal defibrillation but have seen minimal use in transthoracic defibrillation systems. The purpose of this study was to compare monophasic and biphasic waveforms for transthoracic defibrillation in swine.Three interrelated studies were performed in 19 swine to establish the relative transthoracic defibrillation efficacy of biphasic shock waveforms. In study 1, we measured voltage (V50) and energy (E50) strength-duration curves for monophasic and biphasic truncated exponential waveforms. We then independently examined the effects of phase duration and tilt on biphasic waveform defibrillation with a total waveform duration from study 1 that provided the minimum V50 (study 2) and the minimum E50 (study 3). At each pulse duration tested in study 1, biphasic waveforms defibrillated with significantly less voltage and energy than monophasic waveforms. At a duration of 12 ms, there was a voltage minimum for biphasic waveform defibrillation. At this duration, V50 was 1378 +/- 505 V for the biphasic waveform compared with 2185 +/- 361 V for the monophasic waveform, P = .01. For both monophasic and biphasic waveforms, E50 increased with pulse duration. With a total pulse duration of 12 ms, E50 was 169 +/- 101 J for the biphasic waveform compared with 414 +/- 114 J for the monophasic waveform, P = .003. In study 2, optimization of phase duration and total tilt reduced the defibrillation requirements of the 12-ms "minimum voltage" biphasic waveform to 1284 +/- 187 V and 129 +/- 36 J. In study 3, the 8-ms "minimum energy" biphasic waveform had an E50 of 115 +/- 35 J that was 11% less than the 12-ms biphasic waveform, P = .11; however, voltage requirements of 1476 +/- 239 V were 15% higher, P = .005.This study demonstrates the superiority of truncated biphasic waveforms over truncated monophasic waveforms for transthoracic defibrillation of swine. Biphasic waveforms should prove as advantageous at reducing voltage and energy requirements for transthoracic defibrillation as they have for internal defibrillation.
Spending on neglected diseases has increased, says report
Authors: Fiona Fleck
Journal: BMJ (2004)

A substantial increase in global spending on health research over the last decade has boosted funds available for neglected diseases that mainly affect poor, developing countries, the Global Fund for Health Research said in its annual report.

The report, published this month, found that spending on health research worldwide has increased by about 50% since 1998, helped by large donations from governments and charitable foundations for diseases that affect poor people, such as malaria, tuberculosis, and dengue fever.

Stephen Matlin, head of the Geneva based organisation, …
AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATT
Authors: H. B. MULHOLLAND
Journal: Annals of Internal Medicine (1937)

Article1 October 1937AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATTINTRAVENOUS LIVER EXTRACT IN THE THERAPY OF PERNICIOUS ANEMIA; REPORT OF A CASE*H. B. MULHOLLAND, M.D., F.A.C.P.H. B. MULHOLLAND, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-4-671 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is a common observation that patients with pernicious anemia may fail to respond to the oral administration of liver, liver extract and ventriculin, and that these same patients will respond promptly to an extract given intramuscularly. Satisfactory and more rapid improvement in the patient's blood has been frequently noted after intravenous injection of specially prepared liver extract.1, 2, 3, 4, 5 However, this intravenous therapy is not in general use because of the side reactions noted in many cases.The case of pernicious anemia reported in this paper is of interest because on the first admission the patient responded...Bibliography1. CASTLETAYLOR WBFH: Intravenous use of liver extract, Jr. Am. Med. Assoc., 1931, xcvi, 1199. Google Scholar2. FOUTSZERFAS PJLG: Use of liver extract intravenously, Arch. Int. Med., 1932, l, 27. CrossrefGoogle Scholar3. SRAUSSCASTLE MBWB: Parenteral liver therapy in the treatment of pernicious anemia, Jr. Am. Med. Assoc., 1932, xcviii, 1620. CrossrefGoogle Scholar4. MURPHY WP: Parenteral use of liver extract in pernicious anemia, Jr. Am. Med. Assoc., 1932, xcviii, 1051. CrossrefGoogle Scholar5. ISAACSSTURGISGOLDHAMMERBETHEL RCCSMFH: The use of liver extract intravenously in the treatment of pernicious anemia, Jr. Am. Med. Assoc., 1933, c, 629. CrossrefGoogle Scholar6. RHOADSMILLER CPDK: Intensive liver extract therapy of sprue, Jr. Am. Med. Assoc., 1934, ciii, 389. Google Scholar7. CASTLERHOADSLAWSONPAYNE WBCPHAGC: Etiology and treatment of sprue, Arch. Int. Med., 1935, lvi, 627. CrossrefGoogle Scholar8. MINOT GR: The importance of the treatment of pernicious anemia on a quantitative basis, Jr. Am. Med. Assoc., 1932, xcix, 1906. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: H. B. MULHOLLAND, M.D., F.A.C.P.Affiliations: University, Virginia*Received for publication August 4, 1937.From the Department of Internal Medicine, University of Virginia Hospital. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Diagnosis and Treatment of AnemiaDie Erkrankungen des erythrocytären SystemsAbstractsErkennung und Behandlung der Anämien 1 October 1937Volume 11, Issue 4Page: 671-674KeywordsBloodHospital medicineIntravenous injectionsLiverOral administrationPernicious anemia ePublished: 1 December 2008 Issue Published: 1 October 1937 PDF downloadLoading ...
Racial Differences In The Relationship Of Total and Food-Specific IgE To Atopic Dermatitis In Childhood
Authors: Gillian Bassirpour, Edward M. Zoratti, Ganesa Wegienka, Suzanne Havstad, Alexandra Sitarik, Haejin Kim, Dennis Ownby, Christine Cole Johnson
Journal: Journal of Allergy and Clinical Immunology (2014)
988-2 Thrombin Activity, but not Generation, is Inhibited by Intravenous Heparin Following Thrombolysis: Results from the GUSTO Hemostasis Substudy
Authors: Brian S. Crenshaw, Richard C. Becker, Christopher B. Granger, Russell P. Tracy, Costas T. Lambrew, Allan M. Ross, Robert M. Califf, Eric J. Topol, Edwin G. Bovill
Journal: Journal of the American College of Cardiology (1995)
Cancer of the Nasopharynx: Its Natural History and Treatment
Authors: Lyle M. Sellers
Journal: JAMA (1961)

This small monograph, on an important subject, is concise and is characterized by a total lack of discursiveness. It is a careful and honest report of a personal experience with a deadly clinical class of neoplasms. Its limitations on this basis are admitted frankly. Its advantages are only suggested. The racial distributions of this class of lesions reveals the astonishing fact that the Asiatic Chinese and the Mediterranean Maltese, with no geographic, ethnic, or environmental connections, have the highest frequency incidence of this disease. Lederman holds the treatment of these lesions to be primarily and almost totally radiotherapeutic. The necessity for cooperation between the otolaryngologist, the ophthalmologist, the neurologist, the internist, and the radiologist is stressed so that all phases of the disease may be controlled, that nutrition may be maintained, and that prophylaxis against infection and radiogenic destruction of teeth and other vital structures may be carried forward.
The Location of the Gate in the Acetylcholine Receptor Channel
Authors: Gary G. Wilson, Arthur Karlin
Journal: Neuron (1998)

The cation-conducting channel of the nicotinic acetylcholine (ACh) receptor is lined by the first (M1) and second (M2) membrane-spanning segments of each of its five subunits. Six consecutive residues, αS239 to αT244, in the α subunit M1–M2 loop and at the intracellular end of M2 were mutated to cysteine. The accessibility of the substituted cysteines were probed with small, cationic, sulfhydryl-specific reagents added extracellularly and intracellularly. In the closed state of the channel, there is a barrier to these reagents added from either side between αG240 and αT244. ACh induces the removal of this barrier, which acts as an activation gate. The residues αG240, αE241, αK242, and αT244 line a narrow part of the channel, in which this gate is located.
MK-1775, a Potent Wee1 Inhibitor, Synergizes with Gemcitabine to Achieve Tumor Regressions, Selectively in p53-Deficient Pancreatic Cancer Xenografts
Authors: N.V. Rajeshkumar, Elizabeth De Oliveira, Niki Ottenhof, James Watters, David Brooks, Tim Demuth, Stuart D. Shumway, Shinji Mizuarai, Hiroshi Hirai, Anirban Maitra, Manuel Hidalgo
Journal: Clinical Cancer Research (2011)

Investigate the efficacy and pharmacodynamic effects of MK-1775, a potent Wee1 inhibitor, in both monotherapy and in combination with gemcitabine (GEM) using a panel of p53-deficient and p53 wild-type human pancreatic cancer xenografts.Nine individual patient-derived pancreatic cancer xenografts (6 with p53-deficient and 3 with p53 wild-type status) from the PancXenoBank collection at Johns Hopkins were treated with MK-1775, GEM, or GEM followed 24 hour later by MK-1775, for 4 weeks. Tumor growth rate/regressions were calculated on day 28. Target modulation was assessed by Western blotting and immunohistochemistry.MK-1775 treatment led to the inhibition of Wee1 kinase and reduced inhibitory phosphorylation of its substrate Cdc2. MK-1775, when dosed with GEM, abrogated the checkpoint arrest to promote mitotic entry and facilitated tumor cell death as compared to control and GEM-treated tumors. MK-1775 monotherapy did not induce tumor regressions. However, the combination of GEM with MK-1775 produced robust antitumor activity and remarkably enhanced tumor regression response (4.01-fold) compared to GEM treatment in p53-deficient tumors. Tumor regrowth curves plotted after the drug treatment period suggest that the effect of the combination therapy is longer-lasting than that of GEM. None of the agents produced tumor regressions in p53 wild-type xenografts.These results indicate that MK-1775 selectively synergizes with GEM to achieve tumor regressions, selectively in p53-deficient pancreatic cancer xenografts.
U.N.I.C.E.F.-W.H.O. course for senior teachers of child health: can a small international group create change.
Authors: G J Ebrahim, D Morley, J K Lloyd, O H Wolff
Journal: BMJ (1974)

of initiating them into this field. On the other hand, if such forecasts prove over-optimistic general practitioners who adopt the scheme will have a simple, practical method of collecting information in their practice.12 The availability of information gives the doctor feedback about his practice and encourages him to ask questions. It draws attention to issues such as the high percentage of patients treated with antibiotics and sedatives. Information is being collected on a continuing basis and we think that the system could be readily adapted in other practices.
Protecting Patients from Discrimination — The Americans with Disabilities Act and HIV Infection
Authors: G J Annas
Journal: New England Journal of Medicine (1998)

The Americans with Disabilities Act (ADA) was passed in 1990 to expand the reach of the Rehabilitation Act of 1973 and make discrimination on the basis of disability unlawful.1 The wheelchair symbol has become a universal sign of disability, but there are, of course, many types of disability that have been the basis of discrimination over the years, including blindness, deafness, epilepsy, cancer, heart disease, and mental retardation. AIDS is a disability under the ADA, and most commentators have assumed that infection with the human immunodeficiency virus (HIV) also qualifies as a disability under this act. It was not, however, . . .
WORKMEN'S COMPENSATION ACTS AND PHYSICIANS' FEES
Authors: Leslie W. Beebe
Journal: JAMA (1934)

<h3>To the Editor:—</h3> On July 3, 1934, there ended in the Circuit Court of [Cook County] Illinois a case which will be instructive to all doctors who take care of the occasional case of an employee injured while at his work. In 1930 one of my regular patients came to me with a hand infection produced by an injury occurring during his work. I treated him. The last time was about forty days after the injury. A week after he first consulted me the Continental Casualty Company sent me a blank form asking for a report on his injury, which I filled out and returned to them. The same was done with one or two later report blanks. After the patient was well I sent him a bill for services, making my regular charges to him as to any of my other patients. A few days later I received a