tbuckley/cabot-search huggingface dataset:
Effects of alpha and beta adrenergic blockade on hepatic glucose balance before and after oral glucose. Role of insulin and glucagon.
Authors: Z Chap, T Ishida, J Chou, L Michael, C Hartley, M Entman, J B Field
Journal: Journal of Clinical Investigation (1986)

In conscious dogs, phentolamine infusion significantly increased fasting portal vein insulin, glucagon, and decreased net hepatic glucose output and plasma glucose. Propranolol significantly decreased portal vein insulin, portal flow, and increased hepatic glucose production and plasma glucose. Phentolamine, propranolol, and combined blockade reduced glucose absorption after oral glucose. alpha, beta, and combined blockade abolished the augmented fractional hepatic insulin extraction after oral glucose. Despite different absolute amounts of glucose absorbed and different amounts of insulin reaching the liver, the percent of the absorbed glucose retained by the liver was similar for control and with alpha- or beta blockade, but markedly decreased with combined blockade. Our conclusions are: (a) phentolamine and propranolol effects on basal hepatic glucose production may predominantly reflect their action on insulin and glucagon secretion; (b) after oral glucose, alpha- and beta-blockers separately or combined decrease glucose release into the portal system; (c) net hepatic glucose uptake is predominantly determined by hyperglycemia but can be modulated by insulin and glucagon; (d) direct correlation does not exist between hepatic delivery and uptake of insulin and net hepatic glucose uptake; (e) alterations in oral glucose tolerance due to adrenergic blockers, beyond their effects on glucose absorption, can be, to a large extent, mediated by their effects on insulin and glucagon secretion reflecting both hepatic and peripheral glucose metabolism.
Evidence that insulin resistance is responsible for the decreased thermic effect of glucose in human obesity.
Authors: E Ravussin, K J Acheson, O Vernet, E Danforth, E Jéquier
Journal: Journal of Clinical Investigation (1985)

The thermic effect of glucose was investigated in nine obese and six lean subjects in whom the same rate of glucose uptake was imposed. Continuous indirect calorimetry was performed for 240 min on the supine subject. After 45 min, 20% glucose was infused (609 mg/min) for 195 min and normoglycemia was maintained by adjusting the insulin infusion rate. At 2 h, propranolol was infused (bolus 100 micrograms/kg; 1 microgram/kg X min) for the remaining 75 min. To maintain the same glucose uptake (0.624 g/min), it was necessary to infuse insulin at 3.0 +/- 0.6 (leans) and 6.6 +/- 1.2 mU/kg X min (obese) (P less than 0.02). At this time, glucose oxidation was 0.248 +/- 0.019 (leans) and 0.253 +/- 0.022 g/min (obese) (NS), and nonoxidative glucose disposal was 0.375 +/- 0.011 and 0.372 +/- 0.029 g/min, respectively. Resting metabolic rate (RMR) rose significantly by 0.13 +/- 0.02 kcal/min in both groups, resulting in similar thermic effects, i.e., 5.5 +/- 0.7% (leans) 5.4 +/- 0.9% (obese) (NS) and energy costs of glucose storage 0.35 +/- 0.06 and 0.39 +/- 0.09 kcal/g (NS), respectively. With propranolol, glucose uptake and storage remained the same, while RMR fell significantly in both groups, with corresponding decreases (P less than 0.05) in the thermic effects of glucose to 3.7 +/- 0.6% and 2.9 +/- 0.8% (NS) and the energy costs of glucose storage 0.23 +/- 0.04 and 0.17 +/- 0.05 kcal/g (NS) in the lean and obese subjects, respectively. These results suggest that the defect in the thermic effect of glucose observed in obese subjects is due to their insulin resistance, which is responsible for a lower rate of glucose uptake and hence decreased rate of glucose storage, which is an energy-requiring process.
Results of the Massachusetts Model Systems for Blood Cholesterol Screening Project
Authors: Stephen Havas
Journal: JAMA (1991)

<h3>Objective.</h3> —To evaluate the effectiveness of a model blood cholesterol screening program. <h3>Design.</h3> —Principal components included physician education, communitybased screenings, and follow-up. A lay or professional educator provided counseling and referral advice. Half of the subjects with high blood cholesterol levels received a reminder to see their physician. <h3>Setting.</h3> —135 sites in four Massachusetts communities. <h3>Participants.</h3> —10 428 adults. Males, the young, the poor, the less educated, and minorities were underrepresented. <h3>Main Outcome Measures.</h3> —Referral completion rates, blood cholesterol changes. <h3>Results.</h3> —51.5% of those referred had visited their physicians within 2 to 4 months, increasing to 65.6% within 6 to 12 months. Older age (odds ratio [OR], 1.17 per additional decade), more education (OR, 1.17 per additional level), higher blood cholesterol levels (OR, 1.19 per additional 0.51 mmol/L), previous knowledge of level (OR, 1.34), and receiving a reminder (OR, 1.24) were significantly associated with greater likelihood of referral completion, whereas the type of educator providing counseling was not. Physicians had remeasured the blood cholesterol level of 76% of those seen, given dietary counseling to 70%, and prescribed medication to 15%. Significant changes in dietary fat were reported by both compliers and noncompliers with advice to follow up with their physicians. Six months after screening, blood cholesterol levels were 3.6% lower in noncompliers, 4.4% lower in compliers not taking cholesterol-lowering medications, and 8.8% in compliers taking such medications. <h3>Conclusions.</h3> —An effective, community-based blood cholesterol screening program can attract diverse populations and can result in most participants with high levels following up with their physicians, making dietary changes, and lowering their cholesterol levels. Additional strategies may be needed to attract underrepresented groups and to reduce the apparent overuse of cholesterollowering medications. (<i>JAMA</i>. 1991;266:375-381)
THE IN-HOSPITAL PROGNOSTIC VALUE OF A NEGATIVE ULTRASENSITIVE CARDIAC TROPONIN IN PATIENTS WITH ACUTE PULMONARY EMBOLISM: A POSSIBLE PARADIGM SHIFT IN PATIENT TRIAGE AND MANAGEMENT
Authors: Emad Hakemi, Tareq Alyousef, Jalal Hakmei, Geetanjali Dang, Kapil Yadav, Rami Doukky
Journal: Journal of the American College of Cardiology (2014)
Medical Liability Reform
Authors: Kenneth S. Abraham
Journal: JAMA (1988)

IN THE past decade, proposals for the reform of medical liability law have proliferated. These proposals have in some cases merged with the movement for the general reform of tort law generated by the liability insurance crisis that struck broad areas of business and professional enterprise during 1985 and 1986. The result has been the development of a wide variety of approaches to liability reform. This is, therefore, a pivotal time in the history of medical liability reform; the debate over medical liability has now evolved beyond a focus on litigation technicalities and into a fundamental reexamination of basic options. Different medical liability reforms, of course, would have different implications for a broad range of public policy considerations: health care providers' incentives, the quality of care provided, whether to rely more or less on governmental regulation of health care, systems of medical discipline, and the compensation of patients. For example,
Identification of gallbladder mucin-bilirubin complex in human cholesterol gallstone matrix. Effects of reducing agents on in vitro dissolution of matrix and intact gallstones.
Authors: B F Smith, J T LaMont
Journal: Journal of Clinical Investigation (1985)

The goals of this study were to isolate and characterize the nonlipid matrix of human cholesterol gallstones. The lipid portion of gallstones was dissolved in ethanol/ether, leaving an insoluble, granular, brown-black matrix that constituted 12.5% of solitary large stones and 3.5% of multiple small stones. The matrix was partially solubilized by sonication and studied by exclusion gel chromatography and density gradient ultracentrifugation. On Sepharose 2B column chromatography, bile pigment eluted with glycoprotein in the void volume, suggesting the presence of a high molecular weight complex (Mr greater than 2 X 10(6)). The identity of mucin in this complex was confirmed by its typical buoyant density during ultracentrifugation. The major bile pigments in the matrix were identified as bilirubin (84%) and bilirubin monoglucuronide (15%) by thin-layer chromatography. Because of their ability to solubilize mucin-type glycoproteins, we tested the ability of the reducing agents 2-mercaptoethanol (2ME) and N-acetylcysteine (NAcCys) to solubilize gallstone matrix. Both reducing agents caused a two- to threefold enhancement of matrix dissolution after 4 d compared to aqueous buffer alone (P less than 0.01). Sepharose 2B chromatography revealed that 2ME released a high molecular weight mucin-bilirubin complex as well as unbound pigment from the insoluble matrix. We also tested the effect of reducing agents on dissolution of matched cholesterol gallstones by monooctanoin, a cholesterol solvent. Both 2ME and NAcCys significantly accelerated gallstone dissolution in monooctanoin. Matched human cholesterol stones (n = 10) incubated for 4 d in monooctanoin plus either 2ME or NAcCys (1 M final concentration) weighed approximately half as much (P less than 0.01 for each) as stones incubated in monooctanoin alone. This study describes, for the first time, the isolation of a bilirubin-mucin complex in the insoluble matrix of human cholesterol gallstones. The ability of reducing agents to dissolve the matrix and thereby accelerate gallstone dissolution by monooctanoin in vitro may be relevant to gallstone dissolution in humans.
ON SOME OF THE USES OF PEROXID OF HYDROGEN IN DERMATOLOGY.
Authors: L. DUNCAN BULKLEY
Journal: JAMA (1899)

Specific action of remedies is a thing much desired in medicine, but rarely attained, as relatively few exist whose action can be depended on to be always the same. This is sometimes due to variation in the strength or quality of the remedy, and sometimes to the varying condition of disease. Peroxid of hydrogen is a chemical combination of the ingredients of pure water, which always produces definite effects on the tissues with which it comes in contact, and under similar conditions will produce like results. But in order to have these results it is necessary that the article should be pure and fresh, for it is rather an unstable substance, and liable both to be imperfectly made and to alter and become less effective with time. In order, therefore, to secure the best results, great care should be exercised to secure a good preparation and that it be reasonably
Serum Lactic Dehydrogenase in Acute Renal Infarction and Ischemia
Authors: Isam A. Sakati, Patrick C. Devine, Charles J. Devine, Joseph G. Fiveash, Eugene F. Poutasse
Journal: New England Journal of Medicine (1968)

LACTIC dehydrogenase is an enzyme that catalyzes the reversible conversion of pyruvic acid into lactic acid in the presence of the coenzyme dihydro-nicotinamide adenine dinucleotide (NAD.H2): This enzyme is abundant in various organs such as the myocardium, the liver and the kidneys.The level of the serum lactic dehydrogenase (SLDH) in normal persons is fairly constant and ranges between 200 and 500 Wróblewski1 units per milliliter of serum. The SLDH is elevated in various diseases, notably acute myocardial infarction and acute hepatitis.In a review of the literature five cases of renal infarction were found in which SLDH . . .
Yield of computed tomography and bronchoscopy for the diagnosis of Mycobacterium avium complex pulmonary disease.
Authors: E Tanaka, R Amitani, A Niimi, K Suzuki, T Murayama, F Kuze
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

Mycobacterium avium complex (MAC) pulmonary disease with nodules and bronchiectasis is increasing. But the usefulness of computed tomography (CT) and bronchoscopy for diagnosis and the significance of MAC isolation from respiratory secretions are still unclear. For a 4-yr period, we prospectively examined the role of bronchoscopy with bronchial washing and transbronchial lung biopsy in 26 patients who had clusters of small nodules in the periphery of the lung associated with ectatic changes of the draining bronchi on the CT scan. None of them was infected with human immunodeficiency virus. Thirteen of the 26 patients (50%) had cultures positive for MAC, six in the sputum and 13 in the bronchial washing. Epithelioid granuloma was demonstrated in eight of 13 patients with culture-positive MAC and in two of 13 patients in whom MAC was culture-negative. Rapidly growing mycobacteria were cultured in the two patients. Seven of the eight biopsy-positive patients received treatment and responded by sputum conversion and/or radiographic improvement. We found that the CT finding was a useful clue to suspect MAC pulmonary disease and that the bronchial washing was more sensitive than the routine expectorated sputum for MAC isolation. Demonstration of granuloma in more than half of the MAC-positive patients would suggest that MAC may have invaded the lung tissue rather than colonized in the airways.
Posttraumatic Stress Disorder and Medication Nonadherence in Patients With Uncontrolled Hypertension
Authors: Ian M. Kronish, Jenny J. Lin, Beth E. Cohen, Corrine I. Voils, Donald Edmondson
Journal: JAMA Internal Medicine (2013)

Post-traumatic stress disorder (PTSD) is common in primary care patients1 and is associated with psychological distress, suicide risk, and disability. PTSD also increases risk of incident and recurrent cardiovascular events,2 possibly by reducing medication adherence.3 Prior studies showing an association between PTSD and medication non-adherence3 are limited by their use of self-report to measure adherence as PTSD can bias reporting of negative behaviors.4 We evaluated the association between PTSD and antihypertensive medication adherence using electronic monitoring in primary care patients with uncontrolled hypertension.
Ionic Calcium Determination in Primary Hyperparathyroidism
Authors: James C. Low
Journal: JAMA (1973)

Serum ionic and total calcium levels were measured in 15 patients with clinical diagnosis of primary hyperparathyroidism. Ionic calcium level was measured by a calcium-selective liquid-membrane electrode and total calcium level was measured by atomic absorption spectroscopy. Concurrent determinations of ionic and total calcium in 230 blood donors served as normal values. Of the determinations of ionic calcium in the hyperparathyroid patients, 98.5% (67 of 68) fell outside the normal range of 4.48 to 5.28 mg/100 ml, while 77% (57 of 74) of the determinations of total calcium in the same patients was outside the normal range of 8.3 to 10.1 mg/100 ml. Parathyroid adenomas or hyperplasia were found in 14 of 15 patients. The calcium-selective electrode has proven to be highly discriminatory in separating hypercalcemia from normocalcemia in patients with primary hyperparathyroidism.
Patient‐centered, evidence‐based, and cost‐conscious cancer care across the continuum: Translating the Institute of Medicine report into clinical practice
Authors: Larissa Nekhlyudov, Laura Levit, Arti Hurria, Patricia A. Ganz
Journal: CA A Cancer Journal for Clinicians (2014)

Abstract In 2013, the Institute of Medicine (IOM) concluded that cancer care in the United States is in crisis. Patients and their families are not receiving the information that they need to make informed decisions about their cancer care. Many patients do not have access to palliative care and too few are referred to hospice at the appropriate point in their disease trajectory. Simultaneously, there is a growing demand for cancer care with increases in new cancer diagnoses and the number of patients surviving cancer. Furthermore, there is a workforce shortage to care for this growing and elderly population. The IOM's report, Delivering High‐Quality Cancer Care: Charting a New Course for a System in Crisis , outlined recommendations to improve the quality of cancer care. This article provides an overview of the IOM report and highlights the recommendations that are most relevant to practicing clinicians who care for patients with cancer across the continuum. The implementation of the recommendations in clinical practice will require better patient‐clinician communication, improved care coordination, targeted clinician training, effective dissemination of evidence‐based guidelines and strategies for eliminating waste, and continuous quality assessment and improvement efforts. CA Cancer J Clin 2014;64:408–421. © 2014 American Cancer Society.
Reframing HIV Prevention in Sub-Saharan Africa Using Couple-Centered Approaches
Authors: Kristina L. Grabbe
Journal: JAMA (2010)

This article focuses on couple-centered approaches in the prevention of HIV in sub-Saharan Africa. First it describes the barriers to couples-centered HIV prevention which are social systemic programmatic and historical. Most HIV prevention care and treatment programs have focused on individuals rather than couples making disclosure and partner testing a challenge. Second it discusses opportunities for overcoming the barriers associated with couple-centered approaches which include: addressing gender-imbalanced power dynamics home-based HIV testing and counseling guidelines and delivery of comprehensive maternal and child health services.
BMI Versus the Metabolic Syndrome in Relation to Cardiovascular Risk in Elderly Chinese Individuals
Authors: Yao He, Bin Jiang, Jie Wang, Kang Feng, Qing Chang, Shanxiang Zhu, Li Fan, Xiaoying Li, Frank B. Hu
Journal: Diabetes Care (2007)

The purpose of this study was to evaluate the associations of BMI versus metabolic syndrome with cardiovascular diseases (CVDs) in elderly Chinese individuals.We conducted a population-based cross-sectional study in an urban sample of 2,334 elderly subjects (943 men and 1,391 women). Subjects were classified by BMI (< or = 18.5, < 24, < 28, and > or = 28 kg/m2) and the presence or absence of metabolic syndrome, which was defined by International Diabetes Federation (IDF) criteria. CVDs included clinically diagnosed coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD).The prevalence rates of overweight (BMI > or = 25 kg/m2) and metabolic syndrome according to the IDF criteria were 56.3% (53.9% in men and 57.9% in women) and 46.3% (34.8% in men and 54.1% in women), respectively. Increasing BMI was strongly associated with a higher risk of CHD, stroke, and PAD even after adjustments for metabolic syndrome and other CVD risk factors. Stratified analysis of participants with or without metabolic syndrome showed that BMI was independently associated with CHD, stroke, and PAD.Both overweight and metabolic syndrome are highly prevalent in this elderly Chinese population. BMI, as a measure of overall adiposity, is strongly associated with increased prevalence of CVD independent of metabolic syndrome.
Abstract 1684: 2-Methoxyestradiol reverses the epithelial-mesenchymal transition in Barrett's adenocarcinoma cells
Authors: Indranil Chattopadhyay, Monami Majumder, Inamul Haque, Archana De, Joi Wickliffe, Snigdha Banerjee, Peter J. Van Veldhuizen, Sushanta K. Banerjee, Suman Kambhampati
Journal: Cancer Research (2011)

Abstract 2-Methoxyestradiol (2-ME2) is a novel anti-cancer agent because of its ability to potentiate apoptotic cell death and inhibit cancer cell growth and angiogenesis. In our study, we have investigated whether 2-ME2 is able to modulate epithelial-mesenchymal transition (EMT) in Barrett's esophageal adenocarcinoma cell (OE33), which has been postulated as an absolute requirement for tumor invasion and metastasis. Expression of epithelial (E-cadherin, β-catenin, Keratin-19) and mesenchymal markers (Oct-4, Vimentin) and stem cell markers (CD44, CD24) were studied at mRNA and protein levels in OE33 cells that were treated with 5µmolar/L of 2-ME2 for 24 h and 48 h. Our results indicate expression of β-catenin and E-cadherin is activated in a 2-ME2 dependent fashion in OE33 cells. Expression of Vimentin and Oct-4 is significantly down-regulated in 2-ME2 treated OE33 cells. Altogether, these results provide new insights into the role of 2-ME2 in EMT modulation, which may facilitate development of new therapeutic strategies to prevent the tumor invasion and metastasis. 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 1684. doi:10.1158/1538-7445.AM2011-1684
Atherosclerosis in angiographically “normal” coronary artery reference segments: An intravascular ultrasound study with clinical correlations
Authors: Gary S. Mintz, Jack A. Painter, Augusto D. Pichard, Kenneth M. Kent, Lowell F. Satler, Jeffrey J. Popma, Ya Chien Chuang, Theresa A. Bucher, Lisa E. Sokolowicz, Martin B. Leon
Journal: Journal of the American College of Cardiology (1995)
Nutritional immunity. Host's attempt to withold iron from microbial invaders
Authors: E. D. Weinberg
Journal: JAMA (1975)

WITHIN the past half century, the doctrine of the biochemical unity of living matter has become well established. Metabolic pathways as well as methods of storage, transfer, and use of energy and of genetic information are found to have strong commonality in the cells of microorganisms, plants, and animals. As a consequence, similar kinds of organic and inorganic components are used in the building of protoplasm by the three forms of life. Moreover, the quantities of inorganic nutrilites needed for cell replication are quite similar. For example, to achieve maximal growth, cultures of cells of microorganisms, plants, and animals each require approximately 1μM solution of iron, 1 mM solution of phosphorus, and 1 mM solution of magnesium. <h3>Immunity</h3> In view of these similarities, it is remarkable that plants and animals have been able to develop, during evolution, methods for keeping many of their tissues and organs free of microbial invaders.
Glycosylation of Proteins: Lack of Influence of Aging
Authors: Udaya M Kabadi
Journal: Diabetes Care (1988)

In elderly nondiabetic individuals, increased glycosylation of hemoglobin has been reported. Most elderly subjects suffer from chronic disorders and consume one or more medications. Thus, it is conceivable that the increased glycosylation of hemoglobin may be secondary to factors other than old age. Furthermore, the data are sparse regarding the effect of aging on glycosylation of other proteins. In this study, glycosylated hemoglobin (GHb), glycosylated protein (GP), glycosylated albumin (GA), and fasting plasma glucose (FPG) concentrations were determined in 93 healthy nondiabetic subjects after an overnight fast. Strict criteria were observed to define the healthy status of these subjects to eliminate the influence of all other factors known to facilitate glycosylation of hemoglobin. No significant correlations were noted between age and FPG, GHb, GP, or GA (P &amp;gt; .05 for all correlations). Furthermore, no significant differences were observed between groups according to age for any of the parameters studied. Therefore, this study demonstrates that aging may not influence glycosylation of proteins in healthy subjects, and the previously observed increase in GHb concentrations in elderly populations may be related to associated factors rather than old age.
UK government pledges £370m to improve cancer care
Authors: Caroline White
Journal: BMJ (2007)

All patients with symptoms in a breast, irrespective of whether cancer is suspected, will be seen within two weeks of referral to a specialist under ambitious new government plans announced this week to achieve “world class services” in England.

The move is part of a raft of measures, outlined in the five year cancer reform strategy, to speed up the diagnosis and treatment of cancer and close the gap in survival between England and other countries in Europe.

Announcing the plans, Mike Richards, the NHS’s clinical director for cancer services, said, “We have made good progress on cancer over the past 10 years. …