tbuckley/cabot-search huggingface dataset:
On Tying Knots
Authors: Richard M. Ratzan
Journal: JAMA (1980)

I WISH nurses, or whoever's been doing it, would stop tying our patients to bedrails and geri-chairs. Since no physician I've spoken to has ever seen the actual tying-on by hands, and no nurse that I've ever asked has confessed to tying them, the knots, like the shoemaker's new shoes, seem to be the work of elves. There's certainly ample evidence to incriminate physicians themselves as the knot-tying culprits. Pliny the Elder recommends various therapeutic knots in his<i>Natural History</i>, advocating the Hercules knot for "greene wounds." Oribasius, the personal physician of the Emperor Julian, compiled the first textbook on medical knots in the fourth century AD. Entitled<i>Iatrikon Synagogos</i>, it lists nine different knots making up 16 slings for use in surgery and the treatment of fractures. Knots with such colorful names as "The Herdsman Sling," "The Sling Called the Dragon," and "The Genuine Strangling Sling" look, on careful
The History of Certain Medical Instruments
Authors: LOGAN CLENDENING
Journal: Annals of Internal Medicine (1930)

Article1 August 1930The History of Certain Medical InstrumentsLOGAN CLENDENING, M.D.LOGAN CLENDENING, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-4-2-176 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptGalileo Galilei was attending a service at the Cathedral at Pisa (the date was circa 1581). He was not much interested in the sermon or the prayers, but his attention was directed to a chandelier which swung backwards and forwards above his head.The lack of interest Galileo displayed in the blessed mutter of the mass that day in the Cathedral of Pisa has worked entirely to our benefit. Galileo was the scion of a noble Tuscan family and had become a student in medicine at the University of Pisa, much to his father's disgust, because the paternal desire was...Bibliography MITCHELL SW: The Early History of Instrumental Precision in Medicine. The Transactions of the Congress of American Physicians and Surgeons—1891. Vol. II. page 159-198. Google Scholar EBSTEIN E: Dreihundert Jahre Klinischer Thermometrie. Sonderdruck aus klinische Wochenschrift. 13 Mai, 1928. Nor. 20, 5. 950/953. CrossrefGoogle Scholar BRUNTON L: The Lancet, London 1916, T, 317. CrossrefGoogle Scholar WOODHEADVARRIER JONES GSPC: Investigations on Clinical Thermometry. The Lancet, London, 1916 T, 173. CrossrefGoogle Scholar HART : Makers of Science. Oxford Press. Google Scholar MAJOR : Uupublished paper on the history of blood pressure recording. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Kansas Kansas City*Read before the American College of Physicians, February 11, 1930, Minneapolis, Minn. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byExtremes of Body TemperatureHero Worship and the Propagation of Fallacies (Lessons from the Lives of Jean Astruc and John Hunter)*†C. S. BUTLER, M.D., F.A.C.P. 1 August 1930Volume 4, Issue 2Page: 176-189 Issue Published: 1 August 1930 PDF downloadLoading ...
Shift to outpatient procedures has cut inpatient waiting times in England and Wales
Authors: S. Mayor
Journal: BMJ (2003)

Hospital inpatient waiting times have fallen in England and Wales, whereas day case surgery has increased, says a progress report of the health service.

The Chief Executive's Report to the NHS , published this week, outlines activity and performance in the NHS over the past six months and in the three years since the publication of the NHS Plan .

It reports that the number of patients waiting longer than one year for surgery fell by 99% from 16 …
Presence and Bronchomotor Activity of Protease-Activated Receptor-2 in Guinea Pig Airways
Authors: FABIO L. M. RICCIARDOLO, MARTIN STEINHOFF, SILVIA AMADESI, REMO GUERRINI, MICHELE TOGNETTO, MARCELLO TREVISANI, CHRISTOPHE CREMINON, CLAUDE BERTRAND, NIGEL W. BUNNETT, LEONARDO M. FABBRI, SEVERO SALVADORI, PIERANGELO GEPPETTI
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

The protease activated receptor-2 (PAR-2) belongs to a family of G-protein-coupled receptors that are activated by proteolysis. Trypsin cleaves PAR-2, exposing an N-terminal tethered ligand (SLIGRL) that activates the receptor. Messenger RNA (mRNA) for PAR-2 was found in guinea pig airway tissue by reverse transcription-polymerase chain reaction, and PAR-2 was found by immunohistochemistry in airway epithelial and smooth-muscle cells. In anesthetized guinea pigs, trypsin and SLIGRL-NH(2) (given intratracheally or intravenously) caused a bronchoconstriction that was inhibited by the combination of tachykinin-NK(1) and -NK(2) receptor antagonists and was potentiated by inhibition of nitric oxide synthase (NOS). Trypsin and SLIGRL-NH(2) relaxed isolated trachea and main bronchi, and contracted intrapulmonary bronchi. Relaxation of main bronchi was abolished or reversed to contraction by removal of epithelium, administration of indomethacin, and NOS inhibition. PAR-1, PAR-3, and PAR-4 were not involved in the bronchomotor action of either trypsin or SLIGRL-NH(2), because ligands of these receptors were inactive either in vitro or in vivo, and because thrombin (a PAR-1 and PAR-3 agonist) did not show cross-desensitization with PAR-2 agonists in vivo. Thus, we have localized PAR-2 to the guinea-pig airways, and have shown that activation of PAR-2 causes multiple motor effects in these airways, including in vivo bronchoconstriction, which is in part mediated by a neural mechanism.
Anti-lactoferrin antibodies and other types of ANCA in ulcerative colitis, primary sclerosing cholangitis, and Crohn's disease.
Authors: E Peen, S Almer, G Bodemar, B O Ryden, C Sjolin, K Tejle, T Skogh
Journal: Gut (1993)

<h3>Objective</h3> To investigate the pathogenesis of pseudarthrosis in ankylosing spondylitis (AS) based on the pathological analysis of specimens harvested during surgery. <h3>Methods</h3> Radiographic and clinical data for 17 consecutive AS patients with pseudarthrosis were retrospectively analyzed. Meanwhile, the pathological analysis of specimens obtained during surgery was also performed. <h3>Results</h3> In total, 18 extensive Andersson lesions were included. Pseudarthrosis located at the apical region were noted in 12 patients. Complete ossified anterior longitudinal ligaments above or below pseudarthrosis and fracture through posterior elements or facet joints were observed in 7 and 6 lesions, respectively. The most definitive pathological characteristic in all cases was proliferating hypovascular edematous fibrous tissue involving disc, bone-disc border, and vertebral body. Fibrinoid necrosis, necrotic bone fragments, hemosiderin deposits, and active subchondral osteogenesis were found, indicating trauma process. Mild perivascular collections of inflammatory cells were detected in only 2 cases. <h3>Conclusion</h3> AS-related pseudarthrosis is more likely to originate from mechanical trauma than inflammation. The above-mentioned radiological and histological findings showed that multiple mechanisms lead to the formation of pseudarthrosis. These mechanisms include excessive stress, insufficiency fracture, and an acute fracture involving a 3-column structure.
Abstract 661: The K <sub>ATP</sub> -channel Opener, Nicorandil, Attenuates Monocrotaline-induced Endothelial Damage in Pulmonary Vasculature through the Enhanced Expressions of eNOS and Anti-apoptotic Factors via PI3K/Akt and MAPK pathways
Authors: Makoto Sahara, Masataka Sata, Toshihiro Morita, Yasunobu Hirata, Ryozo Nagai
Journal: Circulation (2007)

Background: Recent evidence suggests that nicorandil, a K ATP channel opener, reveals a number of beneficial cardiovascular actions; however, its effects on pulmonary vasculature in the context of pulmonary hypertension (PH) have not yet been elucidated. Methods and Results: Sprague-Dawley rats injected with 60 mg/kg monocrotaline (MCT)-IP were randomized to receive either vehicle, nicorandil (2.5–7.5 mg/kg/day), nicorandil +glibenclamide (a K ATP channel blocker), nicorandil + L- NAME (a NOS inhibitor), or ZVAD-fmk (a caspase inhibitor; 3.3 mg/kg-IV). After 28 days, the increased right ventricular systolic pressure in vehicle-group (51.6 ± 4.4 mmHg) was significantly attenuated by nicorandil in a dose-dependent manner (33.6 ± 4.5 mmHg in Nico 7.5- group; p&lt;0.05) or ZVAD-fmk (32.2 ± 3.1 mmHg; p&lt;0.05). Nicorandil and ZVAD-fmk protected pulmonary endothelium from MCT-induced damage and apoptosis via the enhanced expression of eNOS in lungs, followed by inhibition of both thromboembolic formation in pulmonary microcirculation and medial wall thickening in pulmonary arterioles. These beneficial effects by nicorandil were markedly prevented by coadministration of glibenclamide or L- NAME. Next, HUVECs were incubated in the absence or presence of nicorandil (100 μM) or another K ATP channel opener, diazoxide. TUNEL staining and the MTS assay revealed that HUVECs in serum-free medium displayed apoptosis, which was attenuated by both nicorandil and diazoxide. To study the signaling pathways implicated in the nicorandil-stimulated protective responses, we determined the phosphorylation status of Akt and ERK1/2. Incubation of HUVECs with nicorandil increased both Akt and ERK1/2 phosphorylation in a time-dependent manner. In addition, nicorandil upregulated the protein levels of eNOS and an apoptosis inhibitor, Bcl-2 in HUVECs. These effects by nicorandil on HUVECs were blocked by coadministration of glibenclamide, L- NAME, LY294002 (a PI3K inhibitor), or PD98059 (a MEK inhibitor), respectively. Conclusions: Nicorandil attenuates MCT-induced endothelial damage in pulmonary vasculature through the enhanced expressions of eNOS and anti-apoptotic factors via PI3K/Akt and MAPK pathways. Nicorandil may have a therapeutic potential for PH.
Reduced heart lipid peroxidation precedes cardiac dilatation in turkeys with naturally occurring cardiomyopathy
Authors: D. Lax, S.-L. Zhang, Y. Li, L. Williams, N. A Staley, G. R Noren, S. Einzig
Journal: Cardiovascular Research (1990)

Study objective – The aim of the study was to determine if reduced heart lipid peroxidation in 1–2 month old turkeys with furazolidone induced dilated cardiomyopathy is drug related and model dependent, a non-specific characteristic of the dilated turkey heart, or if alterations of heart lipid peroxidation can occur prior to onset of cardiac dilatation, and therefore may be involved in its pathogenesis. Design – Ventricular lipid peroxidation capacity and superoxide dismutase activity were measured in controls and in turkeys with spontaneous cardiomyopathy at various ages (newly hatched, 7–10 d, and 1–2 months) and stages of the disease. Subjects – 46 turkeys with naturally occurring dilated cardiomyopathy and 29 age matched controls were used at hatch, 7–10 d, and 1–2 months of age. Measurements and main results – Heart lipid peroxidation, measured by thiobarbituric acid reactive substances (malondialdehyde), was found to be reduced not only in the dilated hearts of 1–2 months old cardiomyopathic turkeys [114(SEM 10) v 176(21) nmol·100 mg−1 protein, p = 0.023] but also in the non-dilated hearts of 9–10 day old cardiomyopathic turkeys [135(17) v 274(35) nmol·100 mg−1 protein, p=0.004]. Ventricular superoxide dismutase activity was similar in control and cardiomyopathic turkeys at all stages and there was the expected increase with age. In control turkeys ventricular superoxide dismutase activity in 1–2 month old birds, at 718(52) nitrite units·100 mg–1 protein, was significantly higher than values in 7–10 day old turkeys [398(31) nitrite units·100 mg–1 protein, p = 0.001]. Conclusions – Decreased lipid peroxidation capacity is present in the dilated hearts of spontaneously cardiomyopathic turkeys. However, it is also decreased in cardiomyopathic turkeys at 9–10 d (the time of highest mortality) prior to the onset of cardiac dilatation. Therefore, alterations in heart lipid composition may be involved in the pathogenesis of this cardiomyopathy and not simply a result of the cardiac dilatation/hypertrophy process.
EXPERIMENTAL PSYCHOTIC STATES
Authors: JOHN M. MAC DONALD, JAMES A. V. GALVIN
Journal: American Journal of Psychiatry (1956)

The use of drugs such as mescaline and lysergic acid diethylamide for the experimental production of temporary psychotic states continues to offer unique opportunities for further research. The discovery that a metabolite of adrenaline induces an experimental psychosis suggests the possibility that an error in adrenaline metabolism may be an etiological factor in some naturally occurring psychoses. Experimental psychoses, however, are not identical in form with any naturally occurring ones although there is resemblance to delirium and, to a lesser extent, to schizophrenia. Lysergic acid does not possess therapeutic value sufficient to justify its use in psychiatric practice other than on an experimental basis. As a means of releasing repressed material, it is less effective than intravenous sodium amytal. Self-administration of an hallucinogen by the psychiatrist permits subjective experience of psychotic symptoms.
Vitamin C Nutrition in Haematemesis and Melaena
Authors: S. Lazarus
Journal: BMJ (1937)

Haematemesis and melaena, as a complication of peptic ulcer, occur in a considerable number of cases.Hurst and Ryle (1937) record that approximately 30 per cent. of their cases of peptic ulcer were thus complicated.In some instances haemorrhage is the first indication of the disease.More often, however, it takes place in patients who have had gastric symptoms for a considerable time and have received dietetic treatments.Further haemor- rhages occur in many cases-for example, in 8.4 per cent. of 130 reviewed by de la Viesca (1935).Archer and Graham (1936) demonstrated that six out of a series of nine patients suffering from peptic ulcer were in a subscurvy state.It is well known that wounds in patients with actual clinical scurvy heal poorly, and that healed ulcers, fractures, and scars may actually break down in those suffering from this nutritional defect.It was therefore 'decided to investigate the state of vitamin C nutrition in a group of patients in whom haematemesis and melaena had occurred as a complication of peptic ulcer in order to determine whether these conditions were associated with the presence of the sub- scurvy state.MaterialThe fifteen patients investigated were admitted to the Bispebjerg Hospital, Copenhagen, during the period November, 1936, to February, 1937.Twelve of them were in Department B under the care of Professor Meulengracht.All were given an adequate purde diet and ferrosi tartras from the first day of admission.This method of treatment was introduced by Meulen- gracht in 1931 and reported on in 1935 and 1936.Six of these cases also received alkali from the first day of admission.Three patients were under the care of Dr. Knud Secher in Department C.These were given half- litres of milk and oatmeal soup from the first day, the quantities being rapidly increased to one and a half to two litres in seven to ten days, when additions of semolina, eggs, and potatoes were made.Ferrosi tartras was given from the first day, but no alkali.The clinical diagnosis of haemorrhage from a peptic ulcer was made in thirteen cases and confirmed radiologically in four of these.One case (Q) was complicated by a history of chronic alcoholism, and one showed a general haemorrhagic ten- dency; the notes of this last case are given below in full. ProcedureThe amount of ascorbic acid excreted in the urine of these patients during twenty-four hours was estimated by Harris and Ray's (1933) modification of Tillman's 2: 6-dichlorophenol indophenol method.The estimations were carried out twice during this period.The urine was stored in dark glass bottles in a cool place after the addition of 10 per cent.by volume of glacial acetic acid.Despite these precautions urine kept under these condi- tions was found to lose 10 to 15 per cent. of its estimable ascorbic acid content in eighteen hours.In twelve of the cases estimations were carried out at intervals of three days for a preliminary period of fourteen to twenty days after admission.'The following procedure was then
Early histopathologic changes in familial dilated cardiomyopathy
Authors: C.J. McKenna, H.M. Kwon, G. Sangiorgi, P.J. Carlson, A. Maroo, H.A. McCann, W.D. Edwards, D.R. Holmes, R.S. Schwartz, D.D. Sugruo
Journal: Journal of the American College of Cardiology (1998)
Niche-modulated and niche-modulating genes in bone marrow cells
Authors: Y Cohen, O Garach-Jehoshua, A Bar-Chaim, A Kornberg
Journal: Blood Cancer Journal (2012)

Bone marrow (BM) cells depend on their niche for growth and survival. However, the genes modulated by niche stimuli have not been discriminated yet. For this purpose, we investigated BM aspirations from patients with various hematological malignancies. Each aspirate was fractionated, and the various samples were fixed at different time points and analyzed by microarray. Identification of niche-modulated genes relied on sustained change in expression following loss of niche regulation. Compared with the reference ('authentic') samples, which were fixed immediately following aspiration, the BM samples fixed after longer stay out-of-niche acquired numerous changes in gene-expression profile (GEP). The overall genes modulated included a common subset of functionally diverse genes displaying prompt and sustained 'switch' in expression irrespective of the tumor type. Interestingly, the 'switch' in GEP was reversible and turned 'off-and-on' again in culture conditions, resuming cell-cell-matrix contact versus respread into suspension, respectively. Moreover, the resuming of contact prolonged the survival of tumor cells out-of-niche, and the regression of the 'contactless switch' was followed by induction of a new set of genes, this time mainly encoding extracellular proteins including angiogenic factors and extracellular matrix proteins. Our data set, being unique in authentic expression design, uncovered niche-modulated and niche-modulating genes capable of controlling homing, expansion and angiogenesis.
Assessing Medicare's Prospective Payment System
Authors: Carolyne Davis
Journal: JAMA (1987)

Sager et al<sup>1</sup>raise some interesting and important issues in this issue ofThe Journal. By reviewing hospitalization and mortality data for the Wisconsin-Medicaid elderly population in nursing homes and comparing the data with those for the noninstitutionalized Medicaid population, the authors claim a strong causal relationship between the advent of a prospective payment system (PPS) to hospitals and the rise in admissions to hospitals of the institutionalized elderly Medicaid patients. Likewise, they compare these two population groups for length of stay in the hospitals, noting a significantly greater decrease in length of stay for the institutionalized Medicaid patients than for the noninstitutionalized. Last, they describe a shift in mortality rates, with an increase in nursing home deaths and a corresponding decrease in hospital deaths. This study raises a number of significant issues that I will address, although I may be perceived as somewhat defensive of a system that
The Effect of a Thiazolidinedione Drug, Troglitazone, on Glycemia in Patients with Type 2 Diabetes Mellitus Poorly Controlled with Sulfonylurea and Metformin: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Jean-François Yale, Thomas R. Valiquett, Mahmoud N. Ghazzi, Janet K. Owens-Grillo, Randall W. Whitcomb, Howard L. Foyt
Journal: Annals of Internal Medicine (2001)

Background: The thiazolidinediones are a new class of antidiabetes medication that enhances the actions of insulin in muscle, liver, and adipose tissue. Data have been lacking on their use in combination with both sulfonylurea and metformin among patients for whom insulin is the usual therapeutic alternative for improved glycemic control. Objective: To determine the effects of troglitazone on hemoglobin A1c level in patients treated with maximum tolerated doses of sulfonylurea and metformin who have hemoglobin A1c levels of at least 0.085 (8.5%). This trial was completed before troglitazone was taken off the U.S. market. Design: Randomized, double-blind, placebo-controlled trial, followed by an open-label extension during which all patients received troglitazone. Setting: 16 outpatient clinics in Canada. Patients: 200 patients (mean age, 59 years) with type 2 diabetes mellitus and hemoglobin A1c levels at least 0.085 (8.5%) (mean hemoglobin A1c level, 0.097 [9.7%] and mean fasting plasma glucose level, 12.9 mmol/L [233 mg/dL]) while receiving maximum doses of sulfonylurea and metformin. Measurements: Levels of hemoglobin A1c, fasting plasma glucose, total insulin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Results: Troglitazone, 400 mg/d, when added to sulfonylurea and metformin, significantly decreased hemoglobin A1c level by 0.014 ± 0.002 (95% CI, 0.0167 to 0.0109; P < 0.001) (1.4% ± 0.2% [CI, 1.67% to 1.09%]) and insulin by 19 ± 4 pmol/L (CI, 30 to 10 pmol/L; P < 0.001). At 6 months, 43% of troglitazone-treated patients achieved hemoglobin A1c levels of 0.08 (8%) or lower compared with 6% of placebo recipients. Efficacy was maintained at 12 months. Conclusions: The thiazolidinedione troglitazone, at a dosage of 400 mg/d, is effective when used in combination with sulfonylurea and metformin. Thiazolidinediones may therefore offer an effective alternative to insulin for patients treated with sulfonylurea and metformin who do not achieve adequate glycemic control. *For members of the Troglitazone Triple-Therapy Study Group, see Appendix.
Olive‐pollen profilin. Molecular and immunologic properties
Authors: A. Ledesma, R. Rodríguez, M. Villalba
Journal: Allergy (1998)

Olive‐pollen profilin has been isolated and characterized as a significant allergen. Its molecular properties, such as a molecular mass of 15 kDa; amino‐acid composition; and secondary repetitive structure percentages of 15%α‐helix, 33%β‐strand, 20%β‐turn, and 32% random coil, have been determined. Its allergenic capability, a recognition frequency estimated at 24% of olive‐hypersensitive patients, and high cross‐reactivity with all the pollen used have been found. The presence of conformational epitopes in the olive profilin, as well as a high structural and immunologic similarity to other pollen sources such as birch and ash, can be established from these studies.