tbuckley/cabot-search huggingface dataset:
Use of colonic eicosanoid concentrations as predictors of relapse in ulcerative colitis: double blind placebo controlled study on sulphasalazine maintenance treatment.
Authors: K Lauritsen, L S Laursen, K Bukhave, J Rask-Madsen
Journal: Gut (1988)

To establish whether concentrations of eicosanoids determined by equilibrium in vivo dialysis of faeces and equilibrium in vivo dialysis of rectum might predict a relapse in ulcerative colitis, 23 patients with completely inactive disease, maintained on sulphasalazine, stopped treatment and entered a prospective study. Concentrations of prostaglandin E2 were determined by radioimmunoassay on purified faecal and rectal dialysates at entry, at two weeks, and at two, six, and 12 months. If the above concentrations exceeded control concentrations (0.5 ng/ml and 1.0 ng/ml in faecal and rectal fluid, respectively) at any study day, the patient was allocated at random to double blind treatment with sulphasalazine 2 g/day, or placebo for six months. A relapse, defined as recurrence of symptoms accompanied by endoscopic inflammation occurred in none of six and in four of five patients allocated to sulphasalazine and placebo, respectively (p less than 0.05). In no case a normal rectal prostaglandin E2 concentration was associated with a relapse in the short term, but only two of 12 patients observed passively remained in remission. In retrospect, leukotriene B4 was a less sensitive predictor of relapse than prostaglandin E2. We conclude that raised concentrations of prostaglandin E2 in rectal dialysis fluid identify patients with a substantial risk of relapse.
India decides to train non-medical rural healthcare providers
Authors: G. Mudur
Journal: BMJ (2010)

After a decade of debate the Indian government has signalled its intention to introduce a new medical education programme to train rural healthcare providers for village health centres where doctors are unavailable.

The Medical Council of India, in consultation with the country’s health ministry, last week released an outline of an alternative model of medical education that would be open only to students who have completed all their school education in villages. Graduates from the programme would be allowed to practise medicine only in rural areas and would be prohibited from offering services in urban areas.

The proposed four year bachelor of rural health care course will involve lessons in clinical examination, medicine, obstetrics and gynaecology, orthopaedics, paediatrics, surgery, epidemiology, and public health. It would be of shorter …
Serum Leucine Aminopeptidase in Carcinoma of Pancreas and Other Diseases
Authors: A. L. Miller, L. Worsley
Journal: BMJ (1960)

an enzyme which acts preferentially on peptides in which the free amino group is that of an L-leucine residue.Its presence has been demonstrated in all human tissues assayed, with high activity in the duodenum, liver, and kidney (Green, Tsou, Bressler, and Seligman, 1955; Nachlas,
Salvage of Extremities with Ischemic Necrosis in Diabetic Patients by Infrapopliteal Arterial Bypass
Authors: Frederick A Reichle, Kevin P Rankin, Charles R Shuman
Journal: Diabetes Care (1979)

Initial and long-term limb salvage can be achieved by infrapopliteal bypass in diabetic patients with ischemic necrosis of the distal extremity. Mortality is low in all groups, and mortality of subsequent amputation apparently is not affected by the previous bypass. An adequate arteriogram and consideration of distal bypass are frequently indicated in the diabetic patients in whom ischemic necrosis is present. Limb salvage may be feasible even in those diabetic patients in whom popliteal artery is not patent on preoperative arteriogram by bypasses to anterior tibial, posterior tibial, or peroneal artery.
Hyperthyroidism after Iodinated Contrast Medium
Authors: Manfred Blum, Uzi Weinberg, Louis Shenkman, Charles S. Hollander
Journal: New England Journal of Medicine (1974)

INORGANIC iodine administration can precipitate hyperthyroidism in susceptible patients.1 , 2 The patient with an autonomous nodule of the thyroid described below appeared clinically euthyroid despite a slightly elevated serum tri-iodothyronine level, but became clinically hyperthyroid after administration of organic iodine in the course of intravenous pyelography.Case ReportA 57-year-old woman was seen in 1969 because of a thyroid mass. 131I scan of the thyroid revealed uptake mainly by the mass in the right lobe. Thyroidal accumulation of radioiodine was 11 per cent in four hours (normal, less than 15 per cent), and 29 per cent in 24 hours (normal, 15 . . .
Tauroursodeoxycholic acid stimulates hepatocellular exocytosis and mobilizes extracellular Ca++ mechanisms defective in cholestasis.
Authors: U Beuers, M H Nathanson, C M Isales, J L Boyer
Journal: Journal of Clinical Investigation (1993)

To assess the effects of tauroursodeoxycholic acid (TUDCA) on bile excretory function, we examined whether TUDCA modulates vesicular exocytosis in the isolated perfused liver of normal rats in the presence of high (1.9 mM) or low (0.19 mM) extracellular Ca++ and in cholestatic rats 24 h after bile duct ligation. In addition, the effects of TUDCA on Ca++ homeostasis were compared in normal and in cholestatic hepatocytes. In the isolated perfused rat liver, TUDCA (25 microM) stimulated a sustained increase in the biliary excretion of horseradish peroxidase, a marker of the vesicular pathway, in the presence of high, but not low extracellular Ca++ or in the cholestatic liver. In contrast, TUDCA stimulated bile flow to the same extent regardless of the concentration of extracellular Ca++ or the presence of cholestasis. In indo-1-loaded hepatocytes, basal cytosolic free Ca++ ([Ca++]i) levels were not different between normal and cholestatic cells. However, in cholestatic cells [Ca++]i increases induced by TUDCA (10 microM) and its 7 alpha-OH epimer taurochenodeoxycholic acid (50 microM) were reduced to 22% and 26%, respectively, compared to normal cells. The impairment of TUDCA-induced [Ca++]i increase in cholestatic cells could be mimicked by exposing normal cells to low extracellular Ca++ (21%) or to the Ca++ channel blocker NiCl2 (23%). These data indicate that (a) dihydroxy bile acid-induced Ca++ entry may be of functional importance in the regulation of hepatocellular vesicular exocytosis, and (b) this Ca++ entry mechanism across the plasma membrane is impaired in cholestatic hepatocytes. We speculate that the beneficial effect of ursodeoxycholic acid in cholestatic liver diseases may be related to the Ca+(+)-dependent stimulation of vesicular exocytosis by its conjugate.
A Skeletal-Muscle Disorder Associated with Intermittent Symptoms and a Possible Defect of Lipid Metabolism
Authors: W. K. Engel, N. A. Vick, C. J. Glueck, R. I. Levy
Journal: New England Journal of Medicine (1970)

Identical-twin 18-year-old girls have had since early childhood intermittent symptoms of aching muscle "cramps," without weakness, usually mild but occasionally severe, with myoglobinuria. Symptoms have not limited exercise but sometimes were induced by exercise several hours earlier. Defective availability of an energy source to muscle was suspected, but carbohydrate utilization was apparently normal. Identical episodes were precipitated, without increased exercise, by fasting for 24 to 72 hours or an isocaloric high-fat low-carbohydrate diet, and were accompanied by the following: cramping muscle aches without weakness; nausea and malaise; marked rise of serum GOT, GPT, CPK, aldolase and LDH; no ketonemia or ketonuria (abnormal response); unchanged blood glucose, electrolytes, lactate and pyruvate; and normal electrocardiograms. Refeeding with a normal diet corrected the abnormalities. Oral medium-chain triglycerides produced prompt ketonemia and ketonuria (normal response). Free fatty acid mobilization during fasting was normal. A defect of long-chain fatty acid utilization was considered a possible explanation.
Editorial: Another anniversary
Authors: H. H. Hussey
Journal: JAMA (1976)

In 1900 as the 19th century ended, at what was known as the General Meeting of the American Medical Association in Atlantic City, NJ, the following two resolutions were presented without preamble: <i>Resolved</i>, That a committee be appointed by the Association on the organization of the profession throughout the United States to cooperate with the Committee on National Legislation; this committee to consist of one member from each state and territory represented in the Association. <i>Resolved</i>, That a committee of three be appointed by the President to prepare plans in detail for such committee on organization; to enter into correspondence with officers of the various state societies, and to take such action in the premises as it may think advisable, and that the Trustees be requested to appropriate a sum not exceeding $150 for the necessary expenses of the committee. As a consequence, two special committees came into being, known
Antiperinuclear factor in juvenile rheumatoid arthritis.
Authors: G Nesher, T L Moore, M W Grisanti, E el-Najdawi, T G Osborn
Journal: Annals of the Rheumatic Diseases (1992)

The serological diagnosis of juvenile rheumatoid arthritis (JRA) is difficult, with only 7-10% of patients 19S IgM rheumatoid factor positive. About 60-70% of patients are positive for hidden 19S IgM rheumatoid factor, but this test requires serum separation and is not available in most laboratories. Antiperinuclear factor has been described in both seropositive and seronegative adult patients with rheumatoid arthritis, but has not been thoroughly evaluated in children with JRA. This study determined the diagnostic sensitivity and specificity of antiperinuclear factor in patients with JRA. Serum samples from 64 children with JRA, 24 with systemic lupus erythematosus (SLE), and 24 control subjects were tested for the presence of antiperinuclear factor. A total of 10 (83%) of seropositive, polyarticular onset and six (37%) of seronegative, polyarticular onset patients with JRA were positive for antiperinuclear factor. The occurrence of antiperinuclear factor in five (19%) with pauciarticular onset and one (10%) with systemic onset (JRA) as well as in four (17%) with SLE was not increased compared with the control subjects (1/24 (4%)). These data show an overall diagnostic sensitivity and specificity of 34 and 90% respectively in this group of patients. Although less sensitive than the hidden rheumatoid factor assay, the antiperinuclear factor assay is easier to perform and may contribute to the serological diagnosis of JRA.
Modulation of monocyte/macrophage function: A therapeutic strategy in the treatment of acute liver failure
Authors: Lucia A. Possamai, Mark R. Thursz, Julia A. Wendon, Charalambos Gustav Antoniades
Journal: Journal of Hepatology (2014)

Acute liver failure (ALF) is a condition with a high mortality and morbidity for which new treatments are desperately required. We contend that although the initial event in ALF is liver cell death, the clinical syndrome of ALF and its complications including multi-organ dysfunction and sepsis, are largely generated by the immune response to liver injury.Hepatic macrophages fulfil a diversity of roles in ALF, from pro-inflammatory to pro-resolution. Their inherent plasticity means the same macrophages may have a variety of functions depending on the local tissue environment at different stages of disease. A better understanding of the mechanisms that regulate macrophage plasticity during ALF will be an essential step towards realising the potential of immune-modulating therapies that re-orientate macrophages to promote the desirable functions of attenuating liver injury and promoting liver repair/regenerative responses.The key dynamics: temporal (early vs. late phase), regional (hepatic vs. systemic), and activation (pro-inflammatory vs. pro-resolution) are discussed and the potential for novel ALF therapies that modulate monocyte/macrophage function are described.
Myocardial Infarction During Pregnancy
Authors: Meyer Friedenson
Journal: JAMA (1962)

To the Editor:—  Study of the article Myocardial Infarction During Pregnancy by Naden, Johnson, and Murray ( JAMA  178 :659-661 [Nov. 11] 1961) does not convince me that the patient had acute myocardial  In fact, the only indication of myocardial infarction was the unsupported statement of the authors that an electrocardiogram... showed changes consistent with subendocardial anterior myocardial infarction.  The diagnosis appears to have been based on the above (no electrocardiogram was printed) and half a dozen attacks of a burning pressure sensation across the front of the chest... the longest lasting 10 minutes.  Blood pressure was normal, as were temperature and serum transaminase findings.  I would like to state that the above is not enough evidence for acute myocardial infarction in a pregnant female aged 39; and certainly not enough to justify subjecting her to the trouble, expense, and risk of 17 days of anticoagulant medication.
Risks Factors for Exercise-Induced Wheeze Among Asthmatics in NYC Include Neighborhood Asthma Prevalence and Differ by Seroatopy
Authors: T. Mainardi, A. Cornell, L. Acosta, I. Goldstein, A. Rundle, R. Mellins, L. Hoepner, F. Perera, J. Jacobson, R. Miller, M. Perzanowski
Journal: Journal of Allergy and Clinical Immunology (2012)
Evaluation of two regimens to immobilise the knee after injections of yttrium-90.
Authors: J Winfield, J C Crawley, E A Hudson, M Fisher, J M Gumpel
Journal: BMJ (1979)

Two regimens to immobilise the knee after injection were compared in patients receiving intra-articular yttrium-90 for persistent synovitis of the knee, the patients being randomly allocated to receive either complete bed rest or full mobilisation with the affected knee in a firm splint. There was no difference in the percentage of the radioisotope retained in the knee or in that taken up by other tissues between the two regimens. It is concluded that after intra-articular injections of yttrium-90 strict bed rest in hospital is unnecessary.
Left Ventricular Abnormalities in Prolapsed Mitral Leaflet Syndrome
Authors: GREGORY SCAMPARDONIS, SING SAN YANG, VLADIR MARANHÃO, HARRY GOLDBERG, ALDEN S. GOOCH
Journal: Circulation (1973)

Eighty-seven patients with proven mitral leaflet prolapse were studied emphasizing cardiodynamics and left ventricular asynergy. Significant associated features were female preponderance (83%), skeletal anomalies (pectus excavatum, straight back, scoliosis, narrow antero-posterior diameter of the chest), and anomalous coronary arteries (cork-screw patterns, short left main coronary artery, anomalous origin of the coronary arteries). Prolapse of the tricuspid leaflets was found in 15 (54%) who had right ventriculography. Five types of abnormal left ventricular systolic contraction patterns were seen in 82% of the cases and these were categorized as: 1) "ballerina foot" pattern (vigorous posteromedial contraction with anterior convexity), 2) "hour glass" pattern (vigorous ring-like contraction involving the middle portion of the left ventricle), 3) inadequate long axis shortening, 4) posterior akinesis, and 5) cavity obliteration pattern. The over-all left ventricular performance was normal generally, as indicated by normal values for functional parameters including left ventricular end-diastolic pressure, cardiac index, ejection fraction, contractility index (stroke work per end-diastolic volume) and pre-ejection period/left ventricular ejection time (PEP/LVET). The myocardial component of the syndrome of prolapsed mitral (and/or tricuspid) leaflets is expressed as asynergistic patterns of ventricular motion and usually does not impair over-all cardiac dynamics.
Role for Neurokinin-2 Receptor in Interleukin-5-induced Airway Hyperresponsiveness but not Eosinophilia in Guinea Pigs
Authors: ALETTA D. KRANEVELD, FRANS P. NIJKAMP, ANTOON J. M. VAN OOSTERHOUT
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

In the guinea pig, interleukin-5 (IL-5) has been shown to induce airway hyperresponsiveness as well as eosinophilia, which are important symptoms in asthma. IL-5 seems to be a critical cytokine since it selectively affects eosinophil functions. The mechanism of action by which IL-5 leads to airway hyperresponsiveness may be important for our understanding of the pathogenesis of asthma. Neurogenic inflammation, which is mediated by nonadrenergic noncholinergic nerves (NANC), may play a role in the IL-5-induced effects in guinea pig airways. In this study, the role of neuropeptides in the IL-5-induced airway hyperresponsiveness and eosinophilia in the guinea pig was examined using selective neurokinin receptor antagonists. Intra-airway application of IL-5 (1 microgram, twice) induces a selective eosinophil migration (control: 12 [8-22] x 10(5) cells and IL-5: 90 [67-187] x 10(5) cells, p < 0.05) and activation (control: 6.3 +/- 0.9 ng eosinophil peroxidase [EPO]/ml bronchoalveolar lavage [BAL] fluid and IL-5: 29.3 +/- 4.9 ng EPO/ml BAL fluid, p < 0.05) and a pronounced airway hyperresponsiveness in vivo. The maximal responses to histamine are increased by 160 +/- 16% (p < 0.05) after IL-5. Treatment of guinea pigs with either the nonselective neurokinin (NK)-receptor antagonist, FK224, or the selective NK2-receptor antagonist, SR48968, results in a complete inhibition of the in vivo hyperresponsiveness found after application of IL-5. Vice versa, intra-airway administration of substance P (10 micrograms, twice) results in an airway hyperresponsiveness (increased maximal response after substance P: 166 +/- 15% [p < 0.05]) without inducing migration or activation of eosinophils. All examined NK-receptor antagonists do not influence the IL-5-induced eosinophil accumulation. In addition, no effect of the NK-receptor antagonists is observed on the IL-5-induced eosinophil activation, as determined by BAL fluid EPO levels. The release of NK2-receptor active tachykinins plays an important role in the development of IL-5-induced airway hyperresponsiveness. This feature appears to be a step following eosinophil infiltration and activation since there are no effects on eosinophil function by pretreatment of the used NK-receptor antagonists.
UK needs an extra 1000 doctors
Authors: L. Beecham
Journal: BMJ (1997)

British medical schools should increase their intake by 1000 each year to meet the future demands for health care, according to a government committee.

The Medical Workforce Standing Advisory Committee concluded that a range of measures were needed to deal with the current imbalance between the demand for doctors and the domestic supply. Although the committee looked at ways to improve the retention of doctors, it said …
German paediatricians want law changed to make it easier to report child abuse
Authors: N. Stafford
Journal: BMJ (2008)

German paediatricians are asking the government to relax confidentiality laws to give them the legal power to report cases of suspected child abuse without informing parents. The matter has been discussed for the past year and is on the agenda of a federal cabinet meeting in January as part of a child protection initiative.

Ulrich Fegeler, a Berlin based doctor who is spokesman for the German Association of Paediatricians, says that under current confidentiality laws doctors are legally required to notify police or the local department of youth only in cases where there is proof of physical or sexual abuse or neglect. But in …
British Columbia Sends Patients to Seattle for Coronary Artery Surgery
Authors: Steven J. Katz, Henry F. Mizgala, H. Gilbert Welch
Journal: JAMA (1991)

Concern about waiting lists for elective procedures has become a highly visible challenge to the universal health insurance program in Canada. In response to lengthening queues for patients waiting for cardiac surgery, British Columbia made contracts with four Seattle hospitals to send a total of 200 patients for coronary artery bypass surgery. This article examines the cause of the queue for cardiac surgery in British Columbia and the events that led to outside contracting. Global hospital budgets and restrictions on capital expansion have limited hospital capacity for cardiac surgery. This constrained supply, combined with periodic shortages in critical care nurses and cardiac perfusion technologists, has resulted in a rapid increase in the waiting list. Reducing wide variations in the lengths of queues for individual surgeons may afford an opportunity to reduce long waits. While the patient queue for cardiac surgery has sparked a public debate about budget limits and health care needs, its clinical impact remains uncertain. (<i>JAMA</i>. 1991;266:1108-1111)
Methotrexate treatment in juvenile idiopathic arthritis: when is the right time to stop?
Authors: D Foell
Journal: Annals of the Rheumatic Diseases (2004)

To investigate whether prolonged methotrexate (MTX) treatment after induction of remission influences the subsequent duration of remission in patients with juvenile idiopathic arthritis (JIA), and to analyse the usefulness of myeloid related proteins 8 and 14 (MRP8/MRP14) as predictive markers for the stability of remission at the time when MTX is withdrawn.Twenty five patients with oligoarticular and polyarticular JIA who received MTX to induce remission were followed up. MTX treatment was stopped after a mean of 3.8 months (group 1) or 12.6 months (group 2) after remission was documented. Differences in the number of relapses between these groups were looked for. Additionally, MRP8/MRP14 were analysed by ELISA in 22 patients.No difference was found in the number of relapses between patients with prolonged or early discontinued MTX treatment. Patients who were in stable remission had significantly lower MRP levels when MTX was discontinued than patients with relapses. With a cut off point for MRP8/MRP14 at 250 ng/ml, sensitivity and specificity were 100% and 70%, respectively.Longer duration of MTX treatment after induction of remission does not generally improve the status of remission in patients with JIA. Residual synovial inflammation seems to influence the rate of relapses after discontinuation of MTX treatment. MRP8/MRP14 indicate residual activity even in the absence of other laboratory or clinical signs of continuing inflammation. Normal serum concentrations of MRP8/MRP14 in clinical inactive arthritis may help to identify patients in whom MTX can be safely withdrawn after remission is achieved.
HIV in prison: a counseling opportunity
Authors: T. M. Lampinen
Journal: JAMA (1991)

To the Editor.  —Vlahov et al1recently found higher human immunodeficiency virus type 1 (HIV-1) seroprevalence among female than male inmates in nine of 10 US correctional facilities surveyed. Seroprevalence among younger women (  We reviewed the results of an anonymous 1987 survey of 3037 inmates in the Cook County (Illinois) Department of Corrections in order to determine if female inmates were more likely than male inmates to have a history of injectable drug use. In stratified analyses adjusted for differences in race-ethnicity and age, female inmates were almost twice as likely as male inmates to report
Giant Mitochondria in the Myocardium of a Patient With Mitochondrial Cardiomyopathy
Authors: Yumiko Kanzaki, Fumio Terasaki, Makoto Okabe, Kaoru Otsuka, Takashi Katashima, Shuichi Fujita, Takahide Ito, Yasushi Kitaura
Journal: Circulation (2010)
How Cost–Effective Is the Treatment of Dyslipidemia in Patients With Diabetes but Without Cardiovascular Disease?
Authors: Leonard E. Egede
Journal: Diabetes Care (2001)

In the January 2001 issue of Diabetes Care , Grover et al. (1) reported on the cost-effectiveness of dyslipidemia treatment in patients with diabetes but without cardiovascular disease. Although the article was interesting and relevant, further review of the assumptions of the study’s Markov model raise several questions.

First, in the cost-effectiveness model, the choice of years of life saved (YOLS) rather than quality-adjusted life years (QALYs) is debatable. Diabetes is known to have a significant effect on morbidity, mortality, and quality of life. In addition, other aspects of …