tbuckley/cabot-search huggingface dataset:
Nutrition and fluid balance must be taken seriously
Authors: R. M. Leach, A. Brotherton, M. Stroud, R. Thompson
Journal: BMJ (2013)

Richard Leach and colleagues explain why ensuring adequate nutrition and hydration makes both clinical and financial sense and requires the attention of everyone involved in healthcare

Provision of appropriate nutrition and hydration is a hallmark of compassionate care but is often neglected in all types of healthcare.1 2 3 4 5 These problems are not new and have been reported in the medical literature for nearly four decades.6 7 The consequences are clinically and financially costly. The estimated excess UK health related costs of malnutrition are at least £13bn (€15bn; $20bn) annually.1

Patients with malnutrition have a deficit of energy, protein, vitamins, or minerals, and this has measurable adverse effects on the body.2 Those at risk include patients with poor intake or appetite, dysphagia, chronic disease, or poor functional and social or cognitive ability. Defining adequate hydration is complex. It is estimated by the synthesis of clinical indicators (such as confusion, tachycardia, blood pressure, and thirst), serum biochemistry (such as urea and creatinine), tissue perfusion markers (such as urine output, lactate levels), and urine specific gravity. We examine the scale of malnutrition and poor hydration in our hospitals and communities, explain why it matters, and put forward proposals for change.

The UK national nutrition surveys estimate that over three million people are either malnourished or at risk of malnutrition, of whom more than 90%, or 2.7 million, are cared for in the community (box 1).1 2 3 5 8 One in three patients admitted to hospital or a care home, and one in five of those admitted to mental health facilities were malnourished or at risk of malnutrition, according to four national surveys (31 646 people admitted to hospital, 3404 to care homes, and 1206 to mental health facilities).8 Nutritional status often declines further after …
IMMUNOLOGICAL STUDIES IN ULCERATIVE COLITIS
Authors: R. Lagercrantz, S. Hammarström, P. Perlmann, B. E. Gustafsson
Journal: The Journal of Experimental Medicine (1968)

The incidence and height of antibody titers to colon, assayed by indirect hemagglutination with a heat stable colon extract from germ free rats, is significantly higher in sera from patients with ulcerative colitis than in those from healthy controls or from patients with amebic liver abscess or dysentery. While sera from ulcerative colitis patients and controls are indistinguishable in regard to incidence and height of antibody titers to Forsman antigen, Staphylococcus aureus S 209, Clostridium difficile, and several common strains of E. coli, they have elevated titers and increased incidence of antibodies to a heat stable antigen of E. coli O14. Patients with amebic dysentery have normal titers of such antibodies. Absorption of patients' sera with E. coli O14 antigen inhibits the colon directed hemagglutination reaction in approximately 30% of the cases tested. Likewise, the anti-E. coli O14 reaction can sometimes be inhibited with the colon extract. Other E. coli strains and other bacteria are inactive or have only weak inhibitory activity. Hemagglutination inhibition experiments show that germ free rat colon and E. coli O14 contain common structures, depicted by antibodies in the patients' sera. This pattern of reactivity closely resembles that seen in rats made autoimmune to colon by injection of newborn rabbit colon. E. coli O14 is known to carry a heterogenetic antigen present in lower concentration (or activity) in most Enterobacteriaceae. Hemagglutination inhibition experiments with rabbit antisera to E. coli O14 suggest that the antigen common for E. coli O14 and colon is related to this heterogenetic antigen. The findings imply that this antigen, which is constantly present in low concentrations in the human colon, may give rise to anticolon antibody formation in ulcerative colitis through breakage of tolerance. Since this antigen is present in healthy individuals as well, additional factors are required to explain the induction of anti-colon autoimmunity in ulcerative colitis.
The Graduate Education of Physicians
Authors: John S. Millis
Journal: New England Journal of Medicine (1967)

I AM deeply honored by the invitation to deliver the Shattuck Lecture for 1967 to the Annual Meeting of the Massachusetts Medical Society. I am mindful of the long list of distinguished physicians who have preceded me as the Shattuck Lecturer, and I devoutly hope that I may make a contribution that in a small way will be worthy of so illustrious a tradition. The chairman of the Committee on Publications, Dr. James M. Faulkner, has suggested that I speak on the Graduate Education of Physicians, the title of the Report of the Citizens Commission on Graduate Medical Education, . . .
Inhibition of adenylate kinase by P<sup>1</sup>,P<sup>5</sup>‐Di(adenosine 5′) pentaphosphate in assays of erythrocyte enzyme activities requiring adenine nucleotides
Authors: William N. Valentine, Donald E. Paglia, Misae Nakatani, Richard A. Brockway
Journal: American Journal of Hematology (1989)

Abstract P 1 ,P 5 ‐di(adenosine 5′)pentaphosphate (Ap 5 A) is an excellent inhibitor of human hemofysate adenylate kinase at concentrations near 2 μM and above. At ten times this concentration and in hemolysate enzyme assays under conditions described in this paper it appears not to alter reaction data in the case of hexokinase, phosphofructokinase, and phosphoglycerokinase. In the pyruvate kinase assay, very modest reductions in activity are noted, and kinetics with phosphoenolpyruvate, adenosine diphosphate (ADP), and uridine diphosphate (UDP) are unaltered.
The bile acid synthetic gene 3β-hydroxy-Δ5-C27-steroid oxidoreductase is mutated in progressive intrahepatic cholestasis
Authors: Margrit Schwarz, Angelique C. Wright, Daphne L. Davis, Hisham Nazer, Ingemar Björkhem, David W. Russell
Journal: Journal of Clinical Investigation (2000)

We used expression cloning to isolate cDNAs encoding a microsomal 3β-hydroxy-Δ5-C27-steroid oxidoreductase (C27 3β-HSD) that is expressed predominantly in the liver. The predicted product shares 34% sequence identity with the C19 and C21 3β-HSD enzymes, which participate in steroid hormone metabolism. When transfected into cultured cells, the cloned C27 3β-HSD cDNA encodes an enzyme that is active against four 7α-hydroxylated sterols, indicating that a single C27 3β-HSD enzyme can participate in all known pathways of bile acid synthesis. The expressed enzyme did not metabolize several different C19/21 steroids as substrates. The levels of hepatic C27 3β-HSD mRNA in the mouse are not sexually dimorphic and do not change in response to dietary cholesterol or to changes in bile acid pool size. The corresponding human gene on chromosome 16p11.2-12 contains six exons and spans 3 kb of DNA, and we identified a 2-bp deletion in the C27 3β-HSD gene of a patient with neonatal progressive intrahepatic cholestasis. This mutation eliminates the activity of the enzyme in transfected cells. These findings establish the central role of C27 3β-HSD in the biosynthesis of bile acids and provide molecular tools for the diagnosis of a third type of neonatal progressive intrahepatic cholestasis associated with impaired bile acid synthesis.
Polyarteritis Nodosa Complicated by Bilateral Optic Neuropathy
Authors: O. C. Kimbrell, J. A. Wheliss
Journal: JAMA (1967)

EVEN THOUGH considerable material has been published about the syndrome of polyarteritis nodosa since its original description in 1886 by Kussmaul and Maier,<sup>1</sup>very little has been added to significantly modify their account. The continuing confusion as to the etiology and accurate classification of polyarteritis nodosa has resulted in varying reports as to its frequency. According to postmortem surveys the incidence varies from one to eight cases per 1,000 random unselected autopsies.<sup>2</sup> The manifestations of this entity are extremely variable since it results from segmental inflammation primarily of the small- and medium-sized blood vessels. A single body system or a combination of systems may be affected in varying degrees with divergent symptoms. Among these, ocular complaints are unusual. This communication describes a case of polyarteritis nodosa with the significant symptom being sudden loss of vision in the left eye. <h3>Report of a Case</h3> A 74-year-old white man was
Surgery of the Adolescent
Authors: Robert J. Touloukian
Journal: JAMA (1987)

<i>Surgery of the Adolescent</i>is a new book, encompassing 354 pages and 17 chapters, that attempts to fill the void between pediatric surgical texts and the many excellent general surgical texts concerned with the adults. Unfortunately, the authors' goal of "providing a single source of information for dealing with the numerous and varied surgical disorders of the adolescent, identifying the unique character of these problems in the teenager, and distinguishing such disorders in this age group from older patients" has been only partly accomplished. The chapters on head trauma, injuries to the adolescent athlete, and orthopedic disorders are notable for their thorough presentation and illustration. I found the algorithm for the early treatment of head trauma to be useful. In contrast, a chapter on acute appendicitis covers only four pages and includes a differential diagnosis of abdominal pain when the reader anticipates an elaboration on the assessment for functional abdominal-pain
Characterization of Ileal Vitamin B12 Binding Using Homogeneous Human and Hog Intrinsic Factors
Authors: David C. Hooper, David H. Alpers, Robert L. Burger, Carol S. Mehlman, Robert H. Allen
Journal: Journal of Clinical Investigation (1973)

Elucidation of the mechanism of intrinsic factor (IF)-mediated vitamin B12 (B12) binding to ileal binding sites has been hampered by the use of crude or only partially purified preparations of IF in previous studies. We have used homogeneous human IF and hog IF isolated by affinity chromatography to study [57Co]B12 binding to ileal mucosal homogenates. The following observations were made: (a) Human IF-B12 and hog IF-B12 were bound to human, monkey, hog, dog, rabbit, mouse, hamster, and guinea pig ileal, but not jejunal, homogenates in amounts significantly greater than free B12 or B12 bound to five other homogeneous B12-binding proteins; (b) only IF-mediated B12 binding was localized to ileal homogenates and was inhibited by EDTA; (c) values for the association constant (Ka) for the various ileal homogenates mentioned above and human IF-B12 and hog IF-B12 ranged from 0.3 × 109 M-1 to 13.0 × 109 M-1. Apparent differences in the Ka for human IF-B12 and hog IF-B12 existed in most species; (d) the number of ileal IF-B12 binding sites per gram (wet weight) of ileal mucosa ranged from 0.3 × 1012 to 4.9 × 1012. The same value was always obtained with human IF-B12 and hog IF-B12 for any given homogenate preparation; (c) 100-fold excesses of free B12 or human IF and hog IF devoid of B12 did not significantly inhibit human IF-B12 and hog IF-B12 binding to human and hog ileal homogenates.
Thyroid 99mTc-Pertechnetate Uptake: Simple and Accurate
Authors: SANFORD V. BERENS, ROBERT F. LONG, GERALD E. CAPLAN, JAMES GOODGAME
Journal: Clinical Nuclear Medicine (1976)

A total of 981 consecutive thyroid uptake studies with 99mTc-Pertechnetate are reviewed. Of these, 258 patients underwent measurement of both 99mTc and 131I uptake. An accuracy rate of greater than 90% based on correlation with the 131 I values as well as clinical and laboratory information clearly establishes the simplified 99mTc uptake study as a reliable index of thyroid function.
A Pain Rating Scale and a Pain Behavior Checklist for Clinical Use: Development, Norms, and the Consistency Score
Authors: Jerald F. Dirk, Jeffrey Wunder, Robert Kinsman, Joseph McElhinny, Nelson F. Jones
Journal: Psychotherapy and Psychosomatics (1993)

A Pain Rating Scale [PRS] and a Pain Behavior Checklist [PBC] were developed for use during a clinical pain interview. Norms were based on 395 chronic pain patients referred for pain management. The PRS obtained ratings of present pain, and worst and least pain during the previous 30 days. The PBC recorded 16 pain behaviors during the 45- to 60-min interview. Normative data were given for seven measures: (1) worst pain rating, past month; (2) least pain rating, past month; (3) present pain rating; (4) difference between worst and least pain ratings; (5) pain behavior score; (6) total pain score (based on Nos. 1, 2, 3, and 5), and (7) consistency score. The consistency score reflects the agreement (or discrepancy) between the pain behavior and present pain ratings. A moderate overall relationship was found between pain behavior and present pain ratings (r = 0.46, p < 0.001). The frequency of good agreement between pain behavior and present pain ratings was unaffected by sex, race, age, pain site, type of injury, duration of pain, legal representation, and evaluating psychologist; but it varied markedly with conscious symptom magnification. Patients seen as consciously exaggerating pain (n = 127) gave higher pain ratings (all p values < 0.001); and had frequent (64.6%) discrepancies between their pain report and pain behavior compared to others (14.2%). The report of present pain was unrelated to pain behavior for conscious exaggerators (r = 0.04, NS); in contrast there was a moderately high relationship for other patients (r = 0.68, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Cellular mechanisms of impaired adrenergic responsiveness in neonatal dogs.
Authors: S G Rockson, C J Homcy, P Quinn, W T Manders, E Haber, S F Vatner
Journal: Journal of Clinical Investigation (1981)

The myocardial responsiveness of conscious, instrumental dogs to exogenously administered isoproterenol and norepinephrine was investigated in neonatal, 6-wk-old, and adult animals. Comparable base-line values for peak left ventricular derivative of pressure with respect to time were observed in all age categories. However, when compared with adult responses, the sympathomimetic amine-induced increases in neonatal left ventricular dP/dt were significantly blunted at each concentration of adrenergic agonist examined, whereas the 6-wk-old puppies displayed an intermediate inotropic response. To investigate the cellular mechanisms of this blunted neonatal response, we correlated physiologic and biochemical measurements of the myocardial responses to catecholamines in each age category. When compared with adult myocardial membrane preparations, neonatal cardiac membranes were characterized in vitro by an increased density of beta-adrenergic binding sites, comparable affinity for adrenergic agonists and antagonists, and an enhanced coupling of adenylate cyclase activation to receptor occupancy. Simultaneous changes in either the serum catecholamine concentration or the membrane content of other intrinsic proteins failed to account for the observed neonatal increase in beta-adrenergic receptor density. These findings are most consistent with a compensatory mechanism of the cardiac cell membrane, whereby an inherent depression in the adrenergic responsiveness of the immature myocardium appears to induce the increase in receptor density and activation of adenylate cyclase.
Invasive versus conservative strategy after thrombolytic therapy for acute myocardial infarction in patients with antecedent angina a report from thrombolysis in myocardial infarction phase II (TIMI II)
Authors: Nicholas A. Ruocco, Bruce A. Bergelson, Alice K. Jacobs, Margaret M. Frederick, David P. Faxon, Thomas J. Ryan
Journal: Journal of the American College of Cardiology (1992)
Low-dose lenalidomide plus cytarabine induce complete remission that can be predicted by genetic profiling in elderly acute myeloid leukemia patients
Authors: G Visani, F Ferrara, F Di Raimondo, F Loscocco, G Sparaventi, S Paolini, F Fuligni, A Gazzola, M Rossi, M A Laginestra, M R Caraci, C Riccardi, M Rocchi, A Visani, S A Pileri, P P Piccaluga, A Isidori
Journal: Leukemia (2014)

Low-dose lenalidomide plus cytarabine induce complete remission that can be predicted by genetic profiling in elderly acute myeloid leukemia patients
Claims of clone pregnancy could threaten US stem cell research
Authors: R. Dobson
Journal: BMJ (2002)

Leading scientists are concerned that reports of a woman being pregnant with a cloned baby could lead to a halt in stem cell research in the United States.

They fear that controversy over reports of what would be the world's first cloned human could tip the US Senate in favour of banning the cloning of embryos for stem cell research. Such a ban would seriously undermine work that offers the possibility of cures for many diseases.

“My worry is that it is going to do very severe damage to the legitimate application of cloning,” said Dr Robert Lanza, head of …
The new general practitioners' contract
Authors: R. C Fraser
Journal: BMJ (1989)

group of fit 29 year old men.The slight reductions in protein synthesis in the patients with myalgic encephalomyelitis might well be explained by the differences in age, sex, and body build between the control and study groups.In addition, since there was no evidence of muscle wasting in the patients it follows that protein degradation was reduced to the same degree as protein synthesis.We have studied patients with muscle pain and weakness, many of whom dated the onset of their
What should be done about mephedrone?
Authors: A. R Winstock, J. Marsden, L. Mitcheson
Journal: BMJ (2010)

Background: An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004.Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care.The review took place in 2008 and we report here on the principal findings of that review.Methods: This study utilised a mixed methods approach.An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS.Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care.Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available.Results: There was wide variation in the standard of medical facilities and infrastructure provided across the IPS.The range of medical equipment available was generally below that of the equivalent general practice scheme in the community.There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population.There is limited administrative support, with the majority of prisons not having a medical secretary.There are few psychiatric or counselling sessions available.Conclusions: People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.
Development of a Quality-of-Life Instrument for Autoimmune Bullous Disease
Authors: Deshan F. Sebaratnam, Anna Marie Hanna, Shien-ning Chee, John W. Frew, Supriya S. Venugopal, Benjamin S. Daniel, Linda K. Martin, Lesley M. Rhodes, Jeremy Choon Kai Tan, Charles Qian Wang, Belinda Welsh, Tamar Nijsten, Dédée F. Murrell
Journal: JAMA Dermatology (2013)

Quality-of-life (QOL) evaluation is an increasingly important outcome measure in dermatology, with disease-specific QOL instruments being the most sensitive to changes in disease status.To develop a QOL instrument specific to autoimmune bullous disease (AIBD).A comprehensive item generation process was used to build a 45-item pilot Autoimmune Bullous Disease Quality of Life (ABQOL) questionnaire, distributed to 70 patients with AIBD. Experts in bullous disease refined the pilot ABQOL before factor analysis was performed to yield the final ABQOL questionnaire of 17 questions. We evaluated validity and reliability across a range of indices.Australian dermatology outpatient clinics and private dermatology practices. PATIENTS AND EXPOSURE: Patients with a histological diagnosis of AIBD.The development of an AIBD-specific QOL instrument.Face and content validity were established through the comprehensive patient interview process and expert review. In terms of convergent validity, the ABQOL was found to have a moderate correlation with scores on the Dermatology Life Quality Index (R = 0.63) and the General Health subscale of the 36-Item Short Form Health Survey (R = 0.69; P = .009) and low correlation with the Pemphigus Disease Area Index (R = 0.42) and Autoimmune Bullous Disease Skin Disorder Intensity Score (R = 0.48). In terms of discriminant validity, the ABQOL was found to be more sensitive than the Dermatology Life Quality Index (P = .02). The ABQOL was also found to be a reliable instrument evaluated by internal consistency (Cronbach α coefficient, 0.84) and test-retest reliability (mean percentage variation, 0.92).The ABQOL has been shown to be a valid and reliable instrument that may serve as an end point in clinical trials. Future work should include incorporating patient weighting on questions to further increase content validity and translation of the measure to other languages.anzctr.org.au Identifier: ACTRN12612000750886.
O12 * GENETIC CHARACTERISATION OF PI3K-RELATED PATHWAYS IN PAEDIATRIC GBM IN VITRO
Authors: P. Channathodiyil, H. Kardooni, N. Potter, J. Darling, M. Morris, T. Warr
Journal: Neuro-Oncology (2014)

INTRODUCTION: A major obstacle to the development and validation of new therapeutic strategies (including small-molecule inhibitors of PI3K signalling) in paediatric GBM is the relative scarcity of well-characterised cell culture models. We investigated genomic copy number aberrations (CNAs),promoter methylation, mRNA and micro RNA expression in 18 paediatric GBM short-term cell cultures, including 3 diffuse intrinsic pontine gliomas (DIPGs). METHOD: Agilent 244K microarrays, Illumina methylation 450K bead chip arrays, Affymetrix U133A and 3D Toray microarrays were used to detect copy number changes, promoter methylation,mRNA expression and miRNA expression respectively. Data was analysed using Partek genomics suite v6.6. Potential target genes were validated by semi-quantitative RT-PCR and combined bisulphite restriction analyses (COBRA). All samples were tested for BRAFV600E and H3F3A mutations. RESULTS: Genomic gain of TARP was seen in 10/18 (56%) and PDLIM7 in 5/18(28%) cases (including 2 DIPGs). Loss of ADAM3A in 9/18(50%) samples (including 1 DIPG) was associated with under expression in all cases. Promoter methylation induced down regulation of both KRT8 and DAB1 in at least 9/18 (50%) cases. H3F3A mutation was found in 2/18 (11%) samples (including 1 DIPG). Concurrent loss of CDKN2A/CDKN2B and BRAFV600E mutation was observed in 1/18 (6%) samples. Integrated analyses revealed frequent down regulation of miR-4505 (negative regulator of CTSK) and up-regulation of miR-144 (negative regulator of CXCL12) in the panel. CONCLUSION: Our data report frequent aberrations in PI3K signalling in paediatric GBM, raising the possibility of therapeutic intervention of this pathway and increasing confidence in the validity of preclinical testing.
Alcoholics' Expectancies and Recall of Experiences During Intoxication
Authors: JOHN S. TAMERIN, SHELDON WEINER, JACK H. MENDELSON
Journal: American Journal of Psychiatry (1970)

Using a modified Q-sort test administered to 13 male alcoholics, the authors attempted to assess alcoholics' expectancies prior to drinking and to compare these with their subsequent self-reports of feeling states and behavior during experimentally induced intoxication. They found that during intoxication subjects observed significantly more aggression, sexuality, and dysphoria in themselves than they had anticipated. A marked increase in irresponsible behavior, however, was successfully predicted.