tbuckley/cabot-search huggingface dataset:
Vetting new technologies
Authors: T. A Sheldon, A. Faulkner
Journal: BMJ (1996)

Those whose efficacy and safety have not been established will now be registered and evaluated

While it is compulsory to evaluate drugs before their widespread use is permitted, other medical interventions are not subject to the same constraints. This has allowed a tidal wave of new health care technologies, which have diffused through health care systems before (or in spite of) proper evaluation to establish safety, effectiveness, or return on investment. This haphazard and uncontrolled adoption of procedures was brought to public attention most recently by the unseemly haste with which laparoscopic surgical techniques were adopted, the associated cases of severe complications,1 and the increased costs.2 The routine use of ultrasound during early pregnancy despite little evidence of benefit3 and the proliferation of unevaluated hip prostheses4 are other examples of the way in which health technologies or their modification can spread without sufficient caution. Highly …
Pressure index is important in peripheral arterial disease
Authors: R. E Brightwell
Journal: BMJ (2003)

Editor—The clinical review by Burns et al on managing peripheral arterial disease in primary care tackles an important area of practice.1 Despite guidelines from the Department of Health,2 patients with this condition receive suboptimal care. In addition, lack of awareness of the diagnosis and treatment of this disease by patients and primary care doctors was blamed for poor rates of best medical treatment among this group of patients in North America.3

Management starts with diagnosis, of which an accurate ankle-brachial pressure index is an important component. It is a cheap test and provides hard evidence of vascular disease—a correlation between pressure index and overall cardiovascular risk exists. We were disappointed to see no mention of this in the review.

Work by our unit on a cohort of 500 consecutive patients referred by general practitioners showed a diagnostic accuracy of 70% for peripheral arterial disease—fewer than 5% of referrals included a pressure index.

In all, 38% of patients were not taking antiplatelet drugs when indicated, and only 40% were prescribed lipid lowering drugs when indicated. Around half had a resting blood pressure greater than 140/85 mm Hg. We newly diagnosed diabetes in 1.8% of patients referred to the clinic.

Perhaps, for now at least, specialists in vascular disease could supervise primary care until best medical management is widespread. Our unit has used this system with great success for four years. In our dedicated clinic environment we tackle all the common risk factors and consider the more esoteric, such as hyperhomocysteinaemia, that were not mentioned in the review article.
Personality Pathology Underlying Chronic Prostatitis
Authors: Liisa Keltikangas-Järvinen, Juha Ruokolainen, Timo Lehtonen
Journal: Psychotherapy and Psychosomatics (1982)

Personality testing was performed on 56 patients with clinical symptoms of chronic prostatitis. The psychological methods used were RO, TAT, FAM and Beck's Depression Inventory. Q factor analysis of the patients was performed and yielded four factors representing four different personality pathologies, i.e. psychosomatic structure, alexithymic personality, borderline personality and narcissistic personality. The duration of the somatic symptoms correlated positively with the severity of the psychic symptoms. The etiology of the different pathologies expressed by the patients with chronic prostatitis was, according to the researchers, the same. All are disorders of the pregenital level and all can be interpreted as a consequence of disturbance of the first object relationships, the key factor being defective fantasy development.
Tetracycline and Rises in Urea Nitrogen
Authors: Michael R. Alexander
Journal: JAMA (1972)

To the Editor.—  The inhibitory action of the tetracyclines on human protein synthesis has been clearly elucidated,1and it is well known that these antibiotics may create an elevated blood urea nitrogen (BUN) level, particularly in patients with decreased renal function.2,3However, the fact that diuretics may also elevate the BUN was alluded to, but not clearly implicated. Kleit et al4explains that the phenomenon may occur by two mechanisms: a decrease in glomerular filtration rate and an increased reabsorption of filtered urea. Clearly, if one utilizes two agents with the ability to produce increased BUN levels, a rise would be expected more frequently, as well as being of greater magnitude than when one of the drugs was utilized by itself.  Finally, one of the newer congeners of tetracycline, doxycycline, has been heralded as being the only member of that group which does not produce rises in
Increased urinary transferrin excretion predicts microalbuminuria in patients with type 2 diabetes.
Authors: T Kazumi, T Hozumi, Y Ishida, Y Ikeda, K Kishi, M Hayakawa, G Yoshino
Journal: Diabetes Care (1999)

We studied whether increased urinary transferrin excretion rates (TERs) (urinary transferrin-to-urinary creatinine ratio > or = 107 micrograms/mmol, which is the sum of an average and 2 SDs in 431 healthy nondiabetic individuals) would predict the development of microalbuminuria (urinary albumin-to-urinary creatinine ratio > or = 2.8 mg/mmol) in patients with type 2 diabetes and normal urinary albumin excretion rates (AERs) (albumin-to-creatinine ratio < 2.8 mg/mmol). We also studied the influence of blood pressure, glycemic control, and serum levels of lipids and apolipoproteins on the later development of microalbuminuria.In 77 diabetic patients with normal AER, AER and TER were measured at baseline and after 24 months of follow-up. Blood pressure, glycemic control, and serum levels of lipids and apolipoproteins were measured at 1- to 2-month intervals during the follow-up period.Of the 16 patients who initially had increased TER, 5 (31%) developed microalbuminuria. In contrast, of the 61 who initially had normal TER, 4 (7%) developed microalbuminuria (P = 0.016). At baseline, no difference was found in age, sex, diabetes duration, diabetic medications, prevalence of hypertension, blood pressure, HbA1c levels, or serum lipid and apolipoprotein concentrations between the two group of patients with normal and increased TER. There was also no difference in duration of hypertension and prevalence of users of ACE inhibitors between two subgroups of hypertensive patients with normal and increased TER. During the 24 month follow-up period, those whose condition progressed to microalbuminuria had increased serum levels of triglycerides (1.87 +/- 0.49 vs. 1.29 +/- 0.64 mmol/l, P = 0.003) and apolipoprotein B (114 +/- 20 vs. 102 +/- 24 mg/dl, P = 0.05) and tended to have increased HbA1c levels (7.7 +/- 1.0 vs. 7.1 +/- 1.1%, P = 0.10) compared with those in whom microalbuminuria did not develop. Blood pressure, however, did not differ. In multivariate stepwise logistic regression analysis, the association between increased TER at baseline and subsequent development of microalbuminuria was significant (odds ratio 7.04 [95% CI 1.02-48.5], P = 0.04).In patients with type 2 diabetes and normal AER, increased TER may predict the development of microalbuminuria and abnormalities in triglyceride-rich lipoprotein metabolism, and poor glycemic control may be associated with this progression.
Health maintenance organisations drop Medicare beneficiaries
Authors: F. Charatan
Journal: BMJ (2001)

Health maintenance organisations serving nearly half a million older Americans plan to pull out of Medicare, the managed health programme for people aged over 65.

Karen Ignagni, president of the American Association of Health Plans, which represents health maintenance organisations, said, “With health care inflation running at 12% and Medicare reimbursement capped at 2% you have a mathematical formula that does not work.”

Last year the Clinton administration wanted to preserve health maintenance …
Vaccines and Guillain-Barre syndrome
Authors: R. Hughes, J. Rees, N. Smeeton, J. Winer
Journal: BMJ (1996)

EDITOR,—Three cases of Guillain-Barre syndrome were reported to the Committee on Safety of Medicines in Britain during a recent programme which immunised just under 8 million children with measles/rubella vaccine (DM Salisbury, Department of Health, personal communication). This low figure might be due to underreporting but is reassuringly less than the background risk of developing the syndrome (which would have been expected to be about 7.6 cases in the month after immunisation in the United Kingdom, based on the typical …
ATHEROGENIC LIPID LEVELS IN 662,711 ELDERLY PERSONS: THE VERY LARGE DATABASE OF LIPIDS 10A (VLDL 10A)
Authors: Kristopher Swiger, Seth Martin, Michael Blaha, Peter Toth, Khurram Nasir, Gary Gerstenblith, Roger Blumenthal, Steven Jones
Journal: Journal of the American College of Cardiology (2014)
721-1 Percutaneous Balloon Dilation as Initial Treatment for Critical Aortic Stenosis. Results Up to 8.3 Years Follow-up In 46 Consecutives Neonates
Authors: Eryberto S.T. Egilo, John F. Keane, Phillip Moore, John O'Sullivan, Sleven D. Colan, Stanton B. Perry, James E. Lock
Journal: Journal of the American College of Cardiology (1995)
A 240 kDa protein represents the complete β subunit of the cyclic nucleotide-gated channel from rod photoreceptor
Authors: Heinz Gerd Ko¨rschen, Michelle Illing, Reinhard Seifer, Federico Sesti, Andrew Williams, Sebastian Gotzes, Caroline Colville, Frank Muller, Andrea Dose´, Matthias Godde, Laurie Molday, U. Benjamin Kaupp, Robert S. Molday
Journal: Neuron (1995)
Hemin, a heme oxygenase substrate analog, inhibits the cell surface expression of CD11b and CD66b on human neutrophils
Authors: J. A. Andersson, A. Egesten, L. O. Cardell
Journal: Allergy (2002)

Neutrophils are signaled to sites of infection and inflammation by different chemotactic stimuli. In order to reach the airways they have to adhere to, and then migrate through, the endothelium of pulmonary vessels. Carbon monoxide (CO) is a gaseous mediator, endogenously produced in the human airways. Increased CO production has been demonstrated during airway inflammation and CO as well as hemin, a substrate for CO producing enzymes, has been shown to affect neutrophil migration. Our objective was to investigate if the neutrophil cell surface expression of CD11b, CD66b and CD63 was changed during intermittent allergic rhinitis and to establish whether CO could affect the expression of these markers of cellular activation.Blood from 10 healthy volunteers was drawn and incubated with different concentrations of hemin. Blood from 12 other healthy volunteers and from 12 patients with intermittent allergic rhinitis was also drawn during grass pollen season. Neutrophils were then isolated from all these three sets, and their expression of CD antigens measured using flow cytometry.Patients with symptomatic intermittent allergic rhinitis exhibited lower levels of CD11b and CD66b on the neutrophil cell surface. Incubation with hemin decreased the expression of CD11b and CD66b. CD63 was generally weakly expressed and not significantly affected by hemin incubation.Our results demonstrate that expressions of neutrophil cell surface glycoproteins are changed during the season in patents with intermittent allergic rhinitis and that hemin, a substrate for CO production, may act as an inhibitor of neutrophil activation. This indicates a possible role for CO in the immune defense system.
The prevalence of low hemoglobin values among new infantry recruits and nonlinear relationship between hemoglobin concentration and physical fitness
Authors: Victor Novack, Aharon S. Finestone, Naama Constantini, Ofer Shpilberg, Shimon Weitzman, Drorit Merkel
Journal: American Journal of Hematology (2006)

Abstract There is limited information regarding the optimal hemoglobin level for physical activity and most studies followed relatively few participants. The object of this study was to assess iron storage levels in a population of healthy young males and their impact on physical fitness. Blood samples were drawn from 358 consenting infantry recruits for hemoglobin, iron, ferritin, transferrin, folic acid, and B 12 levels. A detailed medical and nutritional history was noted. Recruits performed a field fitness test including a 2,000‐m run. Mean hemoglobin was 13.8 ± 1.0 g/dl. Level of hemoglobin lower than 14 and 12 g/dl were found in 53.6% and 4.5% of the recruits, respectively. Mean ferritin was 57 ± 34 ng/ml, with 15% of the recruits under 25 ng/ml. On multivariate analysis, after adjusting for pre‐induction sports activity ( P &lt; 0.001), intermediate pre‐induction hemoglobin level (12–14 g/dl) was associated with significantly faster 2,000‐m running time (530 ± 69 s, n = 176) than both the lower hemoglobin group (570 ± 77 s, n = 16) and the higher hemoglobin group (552 ± 86 s, n = 166, P &lt; 0.05). The subjects in this study were non‐athletic healthy young men. The high rate of abnormally low hemoglobin and ferritin values probably indicates a nutritional deficit in this population. The slower running results in the group with hemoglobin below 12 g/dl are in line with previous work, indicating the need for iron supplementation. The decrease in running ability with increased hemoglobin above 14 g/dl is surprising and will need further evaluation. Am. J. Hematol., 2006. © 2006 Wiley‐Liss, Inc.
American Drinking Practices: A National Study of Drinking Behavior and Attitudes
Authors: Donald W. Goodwin
Journal: JAMA (1970)

To drink is a Christian diversion Unknown to the Turk or the Persian —CONGREVE (1714) With this quotation Cahalan et al (1969) agree, but go further. They tell us how many Christians drink, which Christians drink the most (Episcopalians), which the least (Baptists), what they drink, when they drink, whom they drink with, and literally hundreds of other things about drinking and Christians (as well as non-Christians) that Congreve neglected to go into. Turks and Persians are not mentioned, but since the book is about American drinkers, it can not be faulted on this score. Nor on any other score that matters. The book is a gem. It describes the most ambitious study of its kind —a survey of American drinking practices involving personal interviews with 2,746 adults conducted by more than 100 trained interviewers. The methodology was impeccable, utilizing a probability sample drawn randomly from 100 sampling areas, as
TREATMENT OF EDEMA
Authors: Harris A. Houghton
Journal: JAMA (1931)

To the Editor:  —My interest in the metabolism of calcium has stimulated the following comment on an excellent article by O'Donnell and Levin (The Treatment of Edema: Effect of Calcium Gluconate on Edema in Children,The Journal, March 14, p. 837), in which the authors call attention to the favorable results obtained in the treatment of nephrosis edema by injections of calcium gluconate.  Edema is largely a problem in osmosis, and the osmotic tension of the plasma in a large measure is dependent on the mineral base balance, in turn largely influenced by the sodium (144): calcium (2.5) ratio. The figures represent millimols per liter in normal plasma, and the principles involved have been clearly laid down by Jacques Loeb (Calcium in Permeability and Irritability, J. Biol. Chem.  23 :423, 1915).  The sodium: calcium ratio may be said to have a one-sided reciprocal relationship in that, if the plasma calcium
Agonist-Stimulated Endothelial Nitric Oxide Synthase Activation and Vascular Relaxation
Authors: David Fulton, Ling Ruan, Sarika G. Sood, Chunying Li, Qian Zhang, Richard C. Venema
Journal: Circulation Research (2007)

Tyr83 in endothelial nitric oxide synthase (eNOS) has been identified previously as a site of Src kinase-mediated phosphorylation of eNOS in bovine aortic endothelial cells (BAECs) that is phosphorylated in response to oxidant stress. In the present study, we have used a phospho-specific antibody to show that Tyr83 in eNOS is also phosphorylated in both BAECs and intact blood vessel segments in response to treatment with a variety of different eNOS-activating agonists, including thapsigargin, vascular endothelial growth factor, bradykinin, ATP, sphingosine-1-phosphate, estrogen, angiopoietin, and acetylcholine. Agonist stimulation of eNOS Tyr83 phosphorylation as well as agonist stimulation of endothelial NO release in BAECs is blocked by Src kinase inhibition by either 4-amino-5-(4-chlorophenyl)-7-(t-butyl) pyrazolo [3,4-d] pyrimidine (PP2) or by dominant negative Src. Mutation of Tyr83 to a nonphosphorylatable Phe blocks agonist stimulation of NO release from eNOS-reconstituted eNOS knockdown endothelial cells. Mutation of Tyr83 also attenuates agonist-induced relaxation of eNOS-reconstituted aortic rings from eNOS knockout mice. Phosphorylation of eNOS at Tyr83 thus appears to be a common covalent modification that is induced, not only by oxidant stress but also by other physiologically relevant extracellular signals known to be important in regulation of eNOS activity in vivo. Moreover, our results demonstrate an important role for Src-mediated phosphorylation of eNOS at Tyr83 in agonist stimulation of eNOS activation and vascular relaxation.
BMA chairman criticises erosion of clinical autonomy
Authors: L. Beecham
Journal: BMJ (2003)

The morale sapping erosion of doctors' clinical autonomy will be one of Dr Ian Bogle's lasting memories of his five years as chairman of the BMA council.

Giving his last address as chairman at the BMA's annual representative meeting in Torquay this week, Dr Bogle criticised the stifling of innovation by excessive, intrusive audit and the imposition …
Experimental models for guided bone regeneration in healthy and medically compromised conditions
Authors: Nikolaos Donos, Xanthippi Dereka, Nikos Mardas
Journal: Periodontology 2000 (2015)

The increased use of dental implants and related bone-augmentation procedures creates a need for reliable proof-of-principle preclinical models for evaluating different bone-regenerative techniques. The simulation of clinical scenarios by such models is of importance when the experiments are designed in order for the outcomes to provide basic points of clinical relevance. At the same time, the increased proportion of the population with different chronic diseases of ageing necessitates the need to reproduce these conditions in the same proof-of-principle preclinical models to allow evaluation of the effect of the relevant chronic disease on the bone-healing process. This review presents a number of 'proof-of-principle' preclinical models in health and in chronic systemic conditions in which the guided bone regeneration principle was evaluated.
Sympathectomy and Sterility
Authors: N. C. Lake
Journal: BMJ (1944)

All of these positive cases proved to be fatal.In one of them the stool was obtained before the patient's death.In one of the 15 cases the result was unsatisfactory owing to the premature death of the monkey.These results suggest that TABLE III.-Results of Stool Tests for Poliomyelitis Virus Day of No No. usts Total Disease No. Positive No. IJnsatis- TypeofCase ~~of factory Patients Stool Patients for Polio.
Abstract 4754: Targeting of Ewing sarcoma by CAR-reengineered GD2-specific T cells
Authors: Sareetha Kailayangiri, Bianca Altvater, Jutta Meltzer, Katharina Leuchte, Marc Hotfilder, Heribert Juergens, Claudia Rossig
Journal: Cancer Research (2011)

Abstract Primary metastatic Ewing sarcoma involving the bone and/or bone marrow has remained largely incurable. Relapses after intensive multimodal treatment regimens are attributed to a rare subpopulation of residual cells capable of reinitiating tumor growth. Cellular immunotherapy with chimeric antigen receptor (CAR) transduced T cells is a promising strategy to eradicate minimal residual disease and prevent relapse. Based on the observation that Ewing sarcoma cells express the ganglioside antigen GD2, we have explored the capacity of T cells transduced with GD2-specific CARs to functionally interact with Ewing sarcoma cells. Surface GD2 expression was detected on 10 of 11 Ewing sarcoma cell lines by flow cytometry analysis, and on 11 of 12 primary Ewing tumor samples by immunofluorescence staining. To obtain GD2-specific effector T cells, CD3/CD28 stimulated T cells from five healthy donors were retrovirally transduced with the second generation GD2-specific CAR 14.G2aCD28ζ, resulting in CAR surface expression in 83.8±2.7% (81.1-87.8%) of the cells. Ewing sarcoma cell lines expressing various levels of GD2 were used as target cell lines for 14.G2aCD28ζ-mediated cytolysis in a 51Cr release assay. Both GD2hi VH-64 and GD2intermediate Cado-ES-1 cells were efficiently lysed by gene-modified T cells (36.6±7.7% and 25.3%±8.2 lysis at a 40:1 effector-to-target cell ratio) in the absence of background cytolysis of GD2-negative tumor cells and by non-transduced T cells. Moreover, efficient and antigen-specific granzyme B secretion was found after coincubation of various Ewing sarcoma cell lines and a primary Ewing sarcoma cell culture with CAR gene-modified T cells. 14.G2aCD28ζ T cells further eradicated Ewing sarcoma cells in a serum-free spheroid model for anchorage-independent micrometastatic tumor growth. Functional activation of CAR-expressing T cells in response to GD2 positive Ewing sarcoma cells was further demonstrated by significant secretion of IFN-γ and TNFα and significant proliferative responses to various cell lines expressing low, intermediate or high levels of GD2. Thus, GD2 is a promising target antigen for the redirected antitumor activity of T cells not only in neuroblastoma and melanoma, but also in Ewing sarcoma. To address the preclinical in vivo efficacy of 14.G2aCD28ζ T cells, we have now established an in vivo model of disseminated disease by intravenous transfer of Ewing sarcoma cells to sublethally irradiated NOD/scid mice. Magnetic resonance imaging allows to visualize metastatic tumor manifestations in xenotransplanted mice. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4754. doi:10.1158/1538-7445.AM2011-4754
Diagnosis of Pneumothorax on F-18 FDG PET After Transbronchial Biopsy
Authors: Mohsen Ghofrani, Benedict Kim
Journal: Clinical Nuclear Medicine (2005)

Transbronchial lung biopsy (TBLB) is associated with pneumothorax, 12% occurring 1 to 4 hours postprocedure (delayed pneumothorax). We report a case of a delayed pneumothorax first diagnosed on a positron emission tomography (PET) scan performed 5 days after TBLB. An early post-TBLB chest radiograph (after 1 hour) had not demonstrated any pneumothorax. The delayed pneumothorax was later confirmed with a repeat radiograph after the PET scan. Often, PET is performed to diagnose or stage pulmonary lesions after TBLB rather than before. Therefore, nuclear physicians must remain vigilant to recognize subtle pneumothoraces on PET scans.
Cognitive impenetrability of early vision does not imply cognitive impenetrability of perception
Authors: Cathleen M. Moore
Journal: Behavioral and Brain Sciences (1999)

Pylyshyn argues that early vision is cognitively impenetrable, and therefore – contrary to knowledge-based theories of perception – that perception is noncontinuous with cognition. Those processes that are included in “early vision,” however, represent at best only one component of perception, and it is important that it is not the component with which most knowledge-based theories are concerned. Pylyshyn's analysis should be taken as a possible source of refinement of knowledge-based theories of perception, rather than as a condemnation of them.