tbuckley/cabot-search huggingface dataset:
GMC recommends scrapping medical majority on its council
Authors: Clare Dyer
Journal: BMJ (2006)

<h3>Abstract</h3> <h3>Introduction</h3> Tuberculosis (TB) is caused by Mycobacterium tuberculosis. In humans, a number of genes have been identified as susceptible to pulmonary tuberculosis. The relationship between NRAMP1 polymorphisms and pulmonary tuberculosis has been studied in different populations and has reported contradictory results. The aim of this study was to investigate the relationship between the common polymorphisms of NRAMP1 gene and the susceptibility to pulmonary tuberculosis in the LUR Population of Lorestan province of Iran. <h3>Materials and Methods</h3> In this case control study, three common polymorphisms of NRAMP1 gene (3’UTR, INT4 and D543N) were genotyped using PCR-RFLP technique in the LUR population of Lorestan province. In this study, 100 patients with pulmonary tuberculosis (PTB) were studied as case group and 100 healthy controls that matched for age and sex with the patient group, studied as control group. Statistical analysis was performed using SPSS 18 software. <h3>Results</h3> In the present study we observed that the GG genotype of D543N polymorphism was statistically significantly associated with increased susceptibility to TB (84% in the case group vs. 72% in the control group, %95CI=1.024-4.071, OR=2.042, P=0.0405). Also, G allele of D543N polymorphism was statistically significantly associated with increased susceptibility to pulmonary tuberculosis (90% in the case group vs. 81.5% in the control group, %95CI=1.140-3.663, OR=2.043, P=0.015). On the other hand, the frequency of allele A of D543N polymorphism was significantly lower in patients than in the control group (10% in the case group vs. 18.5% in the control group, %95CI=0.273-0.878, OR=0.489, P=0.015). Although genotypic and allelic frequency of 3’UTR and INT4 polymorphisms between patients and controls showed no significant differences in the study population. <h3>Discussion and conclusion</h3> Our observations showed that GG genotype and G allele of D543N polymorphism have a significant role in increasing the susceptibility to pulmonary tuberculosis in the LUR Population of Lorestan province. Also, allele A of D543N polymorphism has a significant effect on resistance to pulmonary tuberculosis in this population. Although there was no significant correlation between genotypes and alleles of 3’UTR and INT4 polymorphisms with susceptibility to or resistance to pulmonary TB in this population. It is suggested that a larger sample size be used in future studies. It is also recommended to conduct this type of study on other ethnicities.
Postoperative Hyponatremia in Menstruant Women
Authors: J. Carlos Ayus
Journal: Annals of Internal Medicine (1993)

Letters15 June 1993Postoperative Hyponatremia in Menstruant WomenJ. Carlos Ayus, MD and Allen I. Areiff, MDJ. Carlos Ayus, MDSearch for more papers by this author and Allen I. Areiff, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-12-199306150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Taylor requests therapeutic details of our patients with hyponatremic encephalopathy [1]. Among 16 treated male patients, the change in serum sodium was 19 mmol after 24 hours and 21 mmol after 48 hours. All seven surviving women were treated with hypertonic NaCl within 1 hour of the diagnosis: Changes in serum sodium were 15 mmol after 24 hours and 18 mmol after 48 hours. Only 7 of the 33 women were treated for their hyponatremia, and therapy was delayed for 5 hours. The serum sodium was then increased by 13 mmol after 24 hours. The only male ...References1. Fraser CL, Arieff AI. Fatal central diabetes mellitus and insipidus resulting from untreated hyponatremia: a new syndrome. Ann Intern Med. 1990; 112:113-9. Google Scholar2. Tien R, Arieff AI, Kucharczyk W, Wasik A, Kucharczyk J. Hyponatremic encephalopathy: is central pontine myelinolysis a component? Am J Med. 1992; 92:513-22. Google Scholar3. Sterns RH. Treatment of hyponatremia: unsafe at any speed? Am Kidney Found Nephrol Lett. 1989; 6:1-10. Google Scholar4. Newman TB, Browner WS, Cummings SR, Hulley SB. Designing a new study. II. Cross-sectional and case–control studies. In: Hulley SB, Cummings SR, eds. Designing Clinical Research. Baltimore: Williams & Wilkins, 1988:75-86. Google Scholar5. Ayus JC, Wheeler JM, Arieff AI. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med. 1992; 117: 891-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1993Volume 118, Issue 12Page: 984-985KeywordsBrain diseasesDeath ratesHyponatremiaMorbidityMortalityResearch designShockSodiumSodium chlorideToxic shock syndrome ePublished: 15 August 2000 Issue Published: 15 June 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Trial tests new combination of drugs to treat tuberculosis
Authors: B. Roehr
Journal: BMJ (2012)

The Global Alliance for TB Drug Development (TB Alliance) has launched a first of its kind clinical trial of a new drug combination that is enrolling patients with drug sensitive or multidrug resistant tuberculosis. 

The trial is a milestone in the process of revitalising all phases of tuberculosis research—from basic pathology to diagnostics, new drugs, and vaccines—that began a decade ago, said Mel Spigelman, president of the TB Alliance, at a forum in Washington, DC, in advance of world TB day on 24 March. The alliance is a collaboration of drug companies, government agencies, and charities.

To elicit a response in people with drug resistant tuberculosis, doctors have often added a …
Oregon reaffirms assisted suicide
Authors: J. Roberts
Journal: BMJ (1997)

Voters in the western state of Oregon have upheld the United States's first law that allows assisted suicide for terminally ill patients.

In 1994 Oregon, known for attempts at various types of medical reform, narrowly passed a law that permitted doctor assisted suicide. The law was challenged in the courts, which declared that states have the right to pursue such approaches. Opponents of suicide, most notably the Roman Catholic church, spent over $4m (£2.5m) to bring the issue back.

In one of the …
Global burden of alcoholic liver diseases
Authors: Jürgen Rehm, Andriy V. Samokhvalov, Kevin D. Shield
Journal: Journal of Hepatology (2013)

Liver diseases contribute markedly to the global burden of mortality and disease. This paper provides an overview from a global perspective of the contribution of alcohol to liver diseases. The Global Burden of Disease study methodology was used to estimate the burden of alcohol-attributable liver cirrhosis and alcohol-attributable liver cancer in 2010 as measured by deaths and disability adjusted life years (DALYs). This methodology estimates attributable fractions based on alcohol exposure distribution and relative risks associated with different levels of drinking. Globally, in 2010, alcohol-attributable liver cirrhosis was responsible for 493,300 deaths (156,900 female deaths and 336,400 male deaths) and 14,544,000 DALYs (4,112,000 DALYs for women and 10,432,000 DALYs for men), representing 0.9% (0.7% for women and 1.2% for men) of all global deaths and 0.6% (0.4% for women and 0.8% for men) of all global DALYs, and 47.9% of all liver cirrhosis deaths (46.5% for women and 48.5% for men) and 46.9% of all liver cirrhosis DALYs (44.5% for women and 47.9% for men). Alcohol-attributable liver cancer was responsible for 80,600 deaths (14,800 female deaths and 65,900 male deaths) and 2,142,000 DALYs (335,000 DALYs for women and 1,807,000 DALYs for men). The burden of alcohol-attributable liver cirrhosis and liver cancer is high and entirely preventable. Interventions to reduce alcohol consumption are recommended as a population health priority and may range from taxation increases for alcoholic beverages to increases in screening and treatment rates for alcohol use disorders.
Early Predictors of Career Achievement in Academic Medicine
Authors: Frederick L. Brancati, Lucy A. Mead, David M. Levine, David Martin, Simeon Margolis, Michael J. Klag
Journal: JAMA (1992)

To identify early personal and scholastic factors that predict academic career choice and long-term career achievement among academic physicians.A longitudinal cohort study.Nine hundred forty-four male physicians who graduated from The Johns Hopkins University School of Medicine, Baltimore, MD, from 1948 through 1964.Career achievement outcomes included attained faculty rank in 1990 and the number of citations (20 to 24 years after graduation) to published work.Of the 944 physicians, 424 (45%) had chosen academic careers. Scholastic performance and research experience in medical school were independently associated with having chosen an academic career (P less than .001). Among academicians, higher attained rank in 1990 was independently associated with the following: (1) membership in Alpha Omega Alpha (relative risk [RR] = 4.94, P = .0001); (2) rank in the top third of the graduating class (RR = 2.68, P = .01); and (3) research experience in medical school (RR = 3.11, P = .0001). These three factors were also independently associated with more citations to participants' published work (P less than .05).These data suggest that scholastic performance and research experience during medical school predict career achievement in academic medicine over 20 years in the future.
Adeno-associated Virus Type 5 Reduces Learning Deficits and Restores Glutamate Receptor Subunit Levels in MPS VII Mice CNS
Authors: Gumei Liu, Yong Hong Chen, Xiaohua He, Inês Martins, Jason A Heth, John A Chiorini, Beverly L Davidson
Journal: Molecular Therapy (2007)

A major challenge in treating lysosomal storage diseases with enzyme therapy is correcting symptoms in the central nervous system (CNS). This study used a murine model of mucopolysaccharidosis type VII (MPS VII) to test whether pathological and functional CNS defects could be corrected by expressing beta-glucuronidase via bilateral intrastriatal injection of adeno-associated virus type 5 (AAV5betagluc) vectors. After injecting AAV5betagluc, different brain regions expressed active beta-glucuronidase, which corrected lysosomal storage defects. Compared to age-matched littermates, adult MPS VII mice were impaired in spatial learning and memory, as measured by the repeated acquisition and performance chamber (RAPC) assay. AAV5betagluc-treated MPS VII mice improved significantly in the RAPC assay, relative to saline-injected littermates. Moreover, our studies reveal that cognitive changes in MPS VII mice correlate with decreased N-methyl-d-aspartate and alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid receptor expression. Importantly, AAV5betagluc delivery restored glutamate receptor levels. Together, these data demonstrate that AAV5 vectors deliver a therapeutically effective beta-glucuronidase gene to the CNS and further suggest a possible mechanism underlying spatial learning defects in MPS VII mice.
Is Poor Glycemic Control Associated With Reduced Red Blood Cell Lifespan?
Authors: Robert M. Cohen, Robert S. Franco, Clinton H. Joiner
Journal: Diabetes Care (2004)

A major assumption in the interpretation of HbA1c as a measure of glycemic control is that the duration of Hb exposure to glucose does not vary among patients who are hematologically normal. In this issue of Diabetes Care , Virtue et al. (1) use an appealingly simple method to quantitate erythrocyte lifespan (2,3) and report an inverse correlation with glycohemoglobin concentration in patients with diabetes. They interpret this as a reduced erythrocyte lifespan at higher blood glucose concentrations. The calculation of erythrocyte lifespan depends on Hb concentration and the amount of carbon monoxide (CO) in exhaled air and in atmospheric air collected at the subject’s home just after awakening. The principles behind the method are that heme catabolism is the only endogenous source of CO and that erythrocytes removed from the circulation are the major source of heme. However, there are multiple assumptions behind the methodology, which may not be met, in the complicated scenario of diabetes. These all come together in Eq. 1 of Virtue et al. (see [1] for the definition of terms) \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \[\mathrm{Erythrocyte lifespan}{=}\frac{{[}\mathrm{Hb}{]}(22,400)(\mathrm{blood volume})}{0.7(\mathrm{endogenous} P\mathrm{\mbox{\textsc{co}}}(64,400)(1,440)(\mathrm{alveolar ventilation})}\] \end{document} which determines erythrocyte lifespan as the inverse of the CO excretion rate, estimating from CO the amount of heme metabolized, and then the amounts of Hb and, finally, red blood cells removed. Heme is a component not only of Hb but also of cytochromes and muscle myoglobin, with cytochromes being ubiquitous but particularly enriched in liver. The Hb concentration depends not only on erythrocyte mass but also on plasma volume; hence, it is sensitive to variations in …
A Randomized Evaluation of Two Health Care Quality Improvement Program (HCQIP) Interventions to Improve the Adequacy of Hemodialysis Care of ESRD Patients
Authors: William M. McClellan, Emily Hodgin, Stephen Pastan, Lisa McAdams, Michael Soucie
Journal: Journal of the American Society of Nephrology (2004)

ABSTRACT. End-stage renal disease (ESRD) Networks are quality improvement organizations that collect, analyze, and report information to clinicians and allied health providers about discrepancies between observed patterns of care of ESRD patients and what has been recommended by clinical practice guidelines. The Networks facilitate response to this information by assisting ESRD treatment centers to develop quality improvement programs to redress inadequate care. The authors evaluated this process of quality improvement by selecting 42 treatment centers in a single ESRD Network with the lowest facility-specific mean urea reduction ratio (URR). The treatment centers were randomly assigned to two intervention strategies: (1) feedback alone; (2) an intensive intervention that included feedback, workshops, distribution of educational materials and clinical practice guidelines, technical assistance with the development of quality improvement plans, and continued monitoring. The intensive intervention had greater improvement in the increased proportions of patients dialyzed with prescribed blood flow (P = 0.02) and documented review of prescription (P = 0.01). Furthermore, the mean center URR increased nearly 3% among intensive intervention centers (from 68.1 to 70.9) but only 0.09% among the feedback centers (68.2 to 69.1) (P = 0.002). Similarly, time on dialysis increased 7.5 min on average among patients in intervention centers but decreased 2 min for patients in comparison centers (P = 0.03). These results demonstrate that Network feedback, coupled with the intensive intervention, resulted in improvement in care that would otherwise not have occurred.
DERMATITIS DUE TO NUPERCAINE
Authors: S. J. Fanburg
Journal: JAMA (1933)

Within the past few years a new local anesthetic known as nupercaine has been introduced into this country. In Europe the same substance is known as percaine. It is recommended as producing anesthesia of prolonged duration. It is much more toxic than procaine, but, owing to the high dilutions in which it is possible to use nupercaine, the relative toxicity is about equalized.1Chemically, nupercaine is known as the hydrochloride of the diethylethylenediamide of butyloxycinchoninic acid, and its structural formula is as follows: It is not related to procaine, which is the monohydrochloride of para-aminobenzoyl-diethylaminoethanol. It is colorless, odorless, easily soluble in water or saline solution and is precipitated by alkali. Nupercaine is also recommended by the manufacturers for the relief of pruritus and is put up for that purpose in the form of an ointment of hydrous wool fat and petrolatum, containing a 1 per cent nupercaine base.
Effects of Helicobacter pylori vacuolating cytotoxin on primary cultures of human gastric epithelial cells.
Authors: D T Smoot, J H Resau, M H Earlington, M Simpson, T L Cover
Journal: Gut (1996)

BACKGROUND: Many Helicobacter pylori strains produce a cytotoxin that induces cytoplasmic vacuolation in various types of eukaryotic cells. In contrast with the marked cell vacuolation that occurs in vitro in response to this cytotoxin, comparatively little epithelial vacuolation has been observed in the gastric mucosa of H pylori infected persons. AIMS: Experiments were performed to determine the susceptibility of human gastric epithelial cells in vitro to H pylori vacuolating cytotoxin activity. METHODS: Human gastric epithelial cells, harvested from upper gastrointestinal endoscopic biopsy specimens, were incubated overnight with broth culture supernatants from either a wild type cytotoxin producing (tox+) H pylori strain or an isogenic mutant strain that lacks cytotoxin activity. RESULTS: Prominent cytoplasmic vacuolation occurred in response to tox+ supernatant, but not supernatant from the isogenic mutant strain. Primary human gastric epithelial cells were significantly more sensitive to H pylori vacuolating cytotoxin activity than were either HeLa or AGS cells. Exposure of human gastric epithelial cells to high concentrations of tox+ supernatant for 48 hours caused lethal cell injury. CONCLUSIONS: These studies indicate that primary human gastric epithelial cells are highly sensitive to H pylori vacuolating cytotoxin activity.
Peroxisome proliferator-activated receptor-β/δ protects against chemically induced liver toxicity in mice
Authors: Weiwei Shan, Christopher J. Nicol, Shinji Ito, Moses T. Bility, Mary J. Kennett, Jerrold M. Ward, Frank J. Gonzalez, Jeffrey M. Peters
Journal: Hepatology (2007)

Potential functional roles for the peroxisome proliferator-activated receptor-β/δ (PPARβ/δ) in skeletal muscle fatty acid catabolism and epithelial carcinogenesis have recently been described. Whereas PPARβ/δ is expressed in liver, its function in this tissue is less clear. To determine the role of PPARβ/δ in chemically induced liver toxicity, wild-type and PPARβ/δ-null mice were treated with azoxymethane (AOM) and markers of liver toxicity examined. Bile duct hyperplasia, regenerative hyperplasia, and increased serum alanine aminotransferase (ALT) were found in AOM-treated PPARβ/δ-null mice, and these effects were not observed in similarly treated wild-type mice. Exacerbated carbon tetrachloride (CCl4) hepatoxicity was also observed in PPARβ/δ-null as compared with wild-type mice. No differences in messenger RNAs (mRNAs) encoding cytochrome2E1 required for the metabolic activation of AOM and CCl4 were observed between wild-type or PPARβ/δ-null mice in response to CCl4. Significant differences in the expression of genes reflecting enhanced nuclear factor kappa B (NF-κB) activity were noted in PPARβ/δ-null mice. Conclusion: Results from these studies show that PPARβ/δ is protective against liver toxicity induced by AOM and CCl4, suggesting that this receptor is hepatoprotective against environmental chemicals that are metabolized in this tissue. (Hepatology 2007.)
Hepatitis C virus infection among teenagers in an endemic township in Taiwan: epidemiological and clinical follow-up studies
Authors: Jee-Fu Huang, Sheng-Nan Lu, Pye-Yu Chue, Chuan-Mo Lee, Ming-Lung Yu, Wan-Long Chuang, Jing-Houng Wang, Chia-Yen Dai, I-Long Chen, Chin-Hua Shih, Wen-Yu Chang
Journal: Journal of Hepatology (2002)
Solitary Plasmacytoma of Bone: An Unusual Cause of Severe Sacral Pain in a Young Man
Authors: Choong L. Wong, Robert Mansberg
Journal: Clinical Nuclear Medicine (2005)

A 35-year-old man presented with insidious onset of severe sacral pain. Plain radiography, computed tomography, and magnetic resonance imaging revealed a large, locally invasive mass within the sacrum. Skeletal scintigraphy showed marked hyperemia and minimal peripheral osteoblastic activity of the sacral mass. An F-18 FDG PET study was performed for further assessment and clinical staging. The mass demonstrated high glucose avidity consistent with a high-grade tumor. Histologic examination confirmed the lesion to be a plasmacytoma. Solitary plasmacytoma of bone occurs predominantly in older patients involving the axial skeleton. This case is interesting in view of the large dimension, sacral involvement, the young age of the patient, and the appearance of this lesion across multiple imaging modalities.
Total skin electron beam therapy may be associated with improvement of peripheral blood disease in Sézary syndrome
Authors: Camille E. Introcaso, Bizhan Micaily, Stephen K. Richardson, Jacqueline M. Junkins-Hopkins, Jessica S. Yoon, Ellen J. Kim, Carmela C. Vittorio, Alain H. Rook
Journal: Journal of the American Academy of Dermatology (2008)
Rare, Nonsynonymous Variant in the Smooth Muscle-Specific Isoform of Myosin Heavy Chain, <i>MYH11</i> , R247C, Alters Force Generation in the Aorta and Phenotype of Smooth Muscle Cells
Authors: Shao-Qing Kuang, Callie S. Kwartler, Katerina L. Byanova, John Pham, Limin Gong, Siddharth K. Prakash, Jian Huang, Kristine E. Kamm, James T. Stull, H. Lee Sweeney, Dianna M. Milewicz
Journal: Circulation Research (2012)

Mutations in myosin heavy chain (MYH11) cause autosomal dominant inheritance of thoracic aortic aneurysms and dissections. At the same time, rare, nonsynonymous variants in MYH11 that are predicted to disrupt protein function but do not cause inherited aortic disease are common in the general population and the vascular disease risk associated with these variants is unknown.To determine the consequences of the recurrent MYH11 rare variant, R247C, through functional studies in vitro and analysis of a knock-in mouse model with this specific variant, including assessment of aortic contraction, response to vascular injury, and phenotype of primary aortic smooth muscle cells (SMCs).The steady state ATPase activity (actin-activated) and the rates of phosphate and ADP release were lower for the R247C mutant myosin than for the wild-type, as was the rate of actin filament sliding in an in vitro motility assay. Myh11(R247C/R247C) mice exhibited normal growth, reproduction, and aortic histology but decreased aortic contraction. In response to vascular injury, Myh11(R247C/R247C) mice showed significantly increased neointimal formation due to increased SMC proliferation when compared with the wild-type mice. Primary aortic SMCs explanted from the Myh11(R247C/R247C) mice were dedifferentiated compared with wild-type SMCs based on increased proliferation and reduced expression of SMC contractile proteins. The mutant SMCs also displayed altered focal adhesions and decreased Rho activation, associated with decreased nuclear localization of myocardin-related transcription factor-A. Exposure of the Myh11(R247C/R247C) SMCs to a Rho activator rescued the dedifferentiated phenotype of the SMCs.These results indicate that a rare variant in MYH11, R247C, alters myosin contractile function and SMC phenotype, leading to increased proliferation in vitro and in response to vascular injury.
New therapy for postintubation laryngeal edema and tracheitis in children
Authors: W. S. Jordan
Journal: JAMA (1970)

In the postanesthetic period, laryngeal edema and tracheitis with obstructive croup-like symptoms occur in a certain percentage of children who undergo intubation for surgery. In a small portion of these children, despite the usual therapy with cool mist occasionally combined with corticosteroids, progression of the obstruction requires more active means of restoring the airway. With positive pressure assistance to ventilation while nebulizing racemic epinephrine, we have been able to relieve the obstruction in all children with this complication without recourse to reintubation or tracheotomy.