tbuckley/cabot-search huggingface dataset:
Circadian Rhythms During Pregnancy*
Authors: MARÍA SERÓN-FERRÉ, CHARLES A. DUCSAY, GUILLERMO J. VALENZUELA
Journal: Endocrine Reviews (1993)

ADAPTATIONS to our environment are of two types: reactive, in which the adaptation follows an environmental change, and predictive, in which the organism anticipates the environmental change before it takes place. We live in an organized environment in which day and night, seasons, and tides alternate. These events repeat themselves with a given frequency, and organisms living on earth successfully adapt to them in a predictive fashion. The overt expression of these adaptations are cyclic changes in physiological processes known as circadian, tidal, and seasonal rhythms. Circadian rhythms are predictive adaptations to the daily periods of light and dark (day and night) induced by rotation of the earth around its axis (1). They are loosely defined as changes in a physiological function with a period of approximately 24 h. Their presence is established by obtaining frequent measurements of a variable over a period of 24 or 48 h; the data are then analyzed by standard statistical methods such as analysis of variance for repeated measures, lineal contrast analysis, or by fitting a mathematical function to the data such as cosinor analysis or Fourier analysis (2).
Reflex Changes on the Pulmonary and Systemic Pressures Elicited by Stimulation of Baroreceptors in the Pulmonary Artery
Authors: Jose Osorio, Mauricio Russek
Journal: Circulation Research (1962)

The distention of a large branch of the pulmonary artery, with or without occlusion of the circulation, produces pulmonary hypertension. The occlusion of an entire hilum, without adequate stimulation of the arterial baroreceptors produces only a negligible increase in pulmonary arterial pressure. Together with the pulmonary hypertension, variable changes in the systemic pressure were observed. The most frequent reaction was hypotension. The vagal fibers play no role in the pulmonary hypertensive response.
The science and art of medicine
Authors: F. Godlee
Journal: BMJ (2009)

Last week’s BMJ cast yet further doubt on prostate specific antigen as a screening tool for prostate cancer (2009;339:b3572, b3537, b3601), and this week we warm to the theme of tumour markers and their limitations. The Clinical Review (doi:10.1136/bmj.b3527) and the Practice article on rational testing (doi:10.1136/bmj.b3111) make clear that tumour markers are a mixed bag, not to be used in screening, unhelpful for diagnosis in patients with non-specific symptoms, and best reserved for monitoring once a diagnosis has been made. Unfocused requests and inappropriate use of tumour markers cost health services around the world large sums of money. They provide …
Endogenous digoxin-like immunoreactivity in congestive heart failure.
Authors: L Shilo, A Adawi, G Solomon, L Shenkman
Journal: BMJ (1987)

Physiological response to parachute jumpingThe metabolic and hormonal responses to stress in racing drivers, airline pilots, rock climbers, public speakers, and parachutists have been reported.'Most studies have concentrated on catecholamine concentrations and their effects on heart rate; little information is available about changes in the concentrations of other hormones and intermediary metabolites. Subjects, methods, and resultsEight healthy subjects (two women, six men) took part in the study.None had made a parachute jump before.Their ages ranged from 23 to 29, and all were within 10% of their ideal body weight.All subjects fasted from 1300 and jumped between 1900 and 2100.Venous blood was taken through an indwelling cannula before they left for the airfield (basal values); on arrival; after 30 minutes' exercise training on the ground; in the aircraft at 610 m immediately before they jumped from a static line; within 30 seconds after landing; and at 10, 20, and 30 minutes after landing.A Tracker Holter monitor was attached to each subject to give a continuous electrocardiogram, and the tapes were analysed on a Pathfinder 3 analyser.Concentrations of intermediary metabolites were measured fluorimetrically and spectrophotometrically (acetoacetate).Non-esterified fatty acid concentrations were measured by a radiocobalt soap method, potassium concentrations by flame photometry, and hormone concentrations by radioimmunoassay or high performance liquid chromatography (catecholamines).2Data were classified by subject and time and analysed by two way analysis ofvariance.When the variance ratio for a time effect was significant the change from basal values was assessed by Student's t test for paired samples.All eight subjects showed three clear peaks in heart rate: on arriving at the airfield, during ground training, and on jumping out ofthe aeroplane (the greatest increase).Heart rates increased from a basal mean of 78 (range 62-91) beats/min to a peak of 160 (150-183).No ventricular arrhythmias or ST segment abnormalities were recorded.The table shows the changes in concentrations of intermediary metabolites and hormones.In six subjects peak concentrations of non-esterified fatty acids were greater than 1-4 mmolIl, and three had lactate concentrations greater than 5 mmol/l.Concentrations of adrenaline and noradrenaline rose in parallel, reaching peak values when the subjects were in the aeroplane and on landing, respectively.After landing the concentration of adrenaline fell to basal values within 10 minutes but the concentration of noradrenaline was still significantly raised 30 minutes later (p<005).
Risk assessment in a federal regulatory agency: an assessment of risk associated with the human consumption of some species of fish contaminated with polychlorinated biphenyls (PCBs).
Authors: F Cordle, R Locke, J Springer
Journal: Environmental Health Perspectives (1982)

The problem of polychlorinated biphenyls (PCBs) became a national concern in 1971 when several accidental contaminations of foods were reported. Extensive efforts were undertaken by FDA to reduce the residues of PCBs in food. However, the PCB levels in several species of fresh-water fish have raised concern about the PCB residues from environmental contamination, and it is this concern which has prompted a reassessment of the human risk involved from consumption of such fish. The human epidemiology and animal toxicity of PCB exposure are reviewed, as well as risk assessment in general. Specific examples to risk assessment involving extrapolation of animal data to humans, based on several levels of human exposure to PCBs in fish, are presented.
Psoriatic Arthritis and Aortic Regurgitation
Authors: Walinjom F. Muna
Journal: JAMA (1980)

CARDIAC lesions involving pericardium, myocardium, vascular components, conduction tissue, and valves have been described in most of the rheumatic or connective-tissue diseases. In classic rheumatoid arthritis, all of the cardiac components mentioned previously may be involved.<sup>1-4</sup>In ankylosing spondylitis, major cardiac involvement is usually limited to valvular and conduction tissue, with vascular, myocardial, and pericardial involvement occurring infrequently.<sup>3-6</sup>Although ankylosing spondylitis and psoriatic arthritis share several similar clinical and serological features, reports of either myocardial dysfunction or the nature of the cardiac lesion in psoriasis are rare.<sup>3,6-8</sup>We have recently seen a patient with long-standing HLA-B27-positive psoriatic arthritis who had chest pain and a new murmur of aortic regurgitation. Eventual surgical replacement of the aortic valve and histological examination of the resected native valve demonstrated pathological findings indistinguishable from those seen in ankylosing spondylitis. <h3>Report of a Case</h3> A 60-year-old man with a ten-year history of severe
Intensive short‐term chemotherapy regimen induces high remission rate (over 90%) and event‐free survival both in children and adult patients with advanced sporadic Burkitt lymphoma/leukemia
Authors: Giuseppe Todeschini, Massimiliano Bonifacio, Cristina Tecchio, Rita Balter, Giuseppe Carli, Piero Maria Stefani, Fausto Adami, Alberto Zamò, Angelo Paolo Dei Tos, Filippo Marino, Filippo Gherlinzoni, Pierluigi Marradi, Giampietro Semenzato, Giovanni Pizzolo
Journal: American Journal of Hematology (2011)

The optimal treatment of advanced sporadic Burkitt lymphoma in adults is still a matter of debate. The salutary results of pediatric therapies did open the road for improving the adult outcome. Between May 1988 and March 2009, 71 consecutive patients-46 adults, 25 children-affected by Burkitt lymphoma/leukemia were treated with the same intensive pediatric protocol alternating vincristine, adriamycine and fractionated ciclophosphamide (phase A) with high dose methotrexate and high dose cytarabine (phase B) in four Italian institutions. Eighty-nine per cent of patients were in Stage III-IV or had L3 leukemia. Complete remissions were 67/71 (94.4%), 24/25 (96%) in children, and 43/46 (93.5%) in adults. Toxic deaths were 3/71 (4.2%), all in adults. There were nine relapses (one in children, eight in adults), all but one observed early. After a median observation of 94 months (range 23-275), the Event-Free Survival rate is 92% in children and 71.7% in adults (P = 0.067). The 23 more recent adults received also rituximab, without differences in outcome as compared to patients who did not. Our experience confirms that such an intensive pediatric-derived chemotherapy is feasible and improves the long-term outcome of adults with advanced Burkitt lymphoma.
Evidence of Adaptive Evolution of Accessory Gland Proteins in Closely Related Species of the Drosophila repleta Group
Authors: F. C. Almeida, R. DeSalle
Journal: Molecular Biology and Evolution (2008)

Accessory gland proteins (Acps) are part of the seminal fluid of Drosophila species. These proteins have important reproductive functions, being responsible for the proper functioning of several steps of the fertilization process. Acps also contribute indirectly for the reproductive success of males by modulating female behavior. Evidence that Acps participate in sperm competition and sexual conflict includes findings that, on average, Acps have fast evolutionary rates, suggestive of adaptive evolution. This is especially true in species of the Drosophila repleta group. Nevertheless, only in a few occasions have robust statistical tests been used to determine whether observed evolutionary rates are in fact due to positive selection on amino acid substitutions between related species. Here we apply maximum likelihood tests for positive selection on 14 Acps of the D. repleta group. To increase statistical robustness, we use at least 8 sequences, all belonging to species of the Drosophila mulleri complex, for each gene analyzed. We found significant evidence of adaptive evolution for 10 of the tested genes. Among these, the ones with a conserved protein domain had positively selected sites within the functional region of the sequence. We also detected one instance of lineage-specific adaptive evolution in a clade formed by 2 sister species.
Cardiac arrhythmias following the creation of an atrial septal defect in patients with transposition of the great arteries
Authors: R. J. Moene, J. P. Roos, A. Eygelaar
Journal: Thorax (1973)

In 64 children with transposition of the great arteries who underwent a Blalock-Hanlon procedure, pre- and postoperative electrocardiograms were studied regarding the incidence and nature of rhythm disturbances. In another group of 19 patients with transposition of the great arteries, the atrial septal defect was created by a different surgical technique (fossa ovalis resection); this group was studied in the same way and the results were compared. After the Blalock-Hanlon procedure seven patients developed arrhythmias including atrio-ventricular (A-V) dissociation, wandering pacemaker, bradycardia, atrial flutter, supraventricular tachycardia, supraventricular premature beats, and ectopic atrial rhythm. After fossa ovalis resection rhythm disturbances were present in three patients. Despite their relatively high incidence it seems unlikely that arrhythmias are a major factor contributing to death irrespective of the technique used; some arrhythmias are transient and serious disturbances of long duration are rare.
Australias public hospitals are under pressure as doctors transfer patients because of insurance crisis
Authors: C. Zinn
Journal: BMJ (2002)

Australia's surgeons and doctors have cautiously returned to work as the fallout from the collapse of the nation's largest medical defence organisation continued to unsettle both the profession and patients.

Operations were postponed as some doctors suspended services for private patients after United Medical Protection, which covers 90% of practitioners in New South Wales, called in a provisional liquidator.

Public hospitals face increased workloads as surgeons and GPs start transferring private patients to public beds to avoid being liable for malpractice claims, even after the federal government tried to assure them they were safe. …
Website of the week: Growth hormone
Authors: N. Chohan
Journal: BMJ (2002)

We have known about growth hormone for many years. Its natural role in growth and maintaining body mass is well documented. As a study (p 70) and an editorial (p 58) in this week's BMJ show there is interest in its use to treat potentially stunted growth.

There has been little research into the effect of growth hormone therapy on adult height and the internet reflects this. Although there are a few good sites about growth hormone therapy for adults, these are likely to be of more use to general practitioners looking for somewhere to direct worried patients than to paediatricians and other specialists, who are likely to be already familiar with much of the information.

One such site, which contains a concise account of growth hormone physiology and use, is http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/hypopit/gh.html. This site is actually part of an online textbook produced by Colorado State University in the United States and there are also sections on other hormones and diseases. The site is still being built so there are some pieces of information lacking.

Another stop for information on pathologies and treatments in adults regarding human growth hormone is http://neurosurgery.mgh.harvard.edu/e-f-944.htm, a site based at Harvard University and maintained by the Neuroendocrine Clinical Centre and Pituitary Tumor Centre.

If your patients still want to know more, why not try The Pituitary Foundation? www.pituitary.org.uk/sitemap.shtml takes you to the foundation's colourful homepage, where there are clear links to sections on human growth hormone deficiencies and replacement therapies.

It's worth noting that human growth hormone isn't only used for growth problems. Patients are becoming ever more informed and they may ask you about the use of growth hormone in a strictly non-medical setting. For example, some companies now offer the promise of “rapid weight loss, younger looking skin, feeling revitalised and increased sexual potency.” You can visit www.flyhost.net/betterhealth to get an idea of the kind of things patients might want to know about. How exactly a “wrinkle reduction of 61%” is proven is unclear but the use of human growth hormone precursor for such things is apparently based on a study published in the New England Journal of Medicine in 1990 (http://content.nejm.org/cgi/content/abstract/323/1/1).
VALUE OF KILLIP CLASSIFICATION FIRST DESCRIBED IN 1,967 FOR RISK STRATIFICATION OF STEMI AND NSTE-ACS IN THE NEW MILLENNIUM: LESSONS FROM THE EURO HEART SURVEY ACS REGISTRY
Authors: Andrea Papp, Hector Bueno, Marek Gierlotka, Wojtek Wojakowski, Ralf Zahn, Uwe Zeymer, Francois Schiele, Jean-Pierre Bassand, Anselm K. Gitt
Journal: Journal of the American College of Cardiology (2011)
The Spring Meetings -- Are They Dying?
Authors: C S Landefeld
Journal: New England Journal of Medicine (1993)

Sharing hot dogs slathered in ballpark mustard with my former chairman at the 1992 Spring Meetings made me wonder if this rite of spring had lost more than its flavor.Since 1917, the Association of American Physicians (AAP) has held its annual meeting on the first weekend in May, joined over the years by its progeny, the American Federation for Clinical Research (AFCR) and the American Society for Clinical Investigation (ASCI). For 60 years, the Spring Meetings were always held in Atlantic City, and it was said that one could forge a national reputation by presenting outstanding work to one's . . .
Optimising antiemesis in cancer chemotherapy: efficacy of continuous versus intermittent infusion of high dose metoclopramide in emesis induced by cisplatin.
Authors: P S Warrington, S G Allan, M A Cornbleet, J S MacPherson, J F Smyth, R C Leonard
Journal: BMJ (1986)

Thirty three untreated patients being given cisplatin received metoclopramide (7 mg/kg) for antiemesis by either continuous or intermittent infusion in a random order. Each patient received intravenous dexamethasone in addition. High pressure liquid chromatography was used to measure plasma concentrations of metoclopramide. The two regimens were evaluated for antiemetic efficacy and the incidence of side effects. The intermittent metoclopramide regimen resulted in peak and trough plasma concentrations of metoclopramide with accumulation at eight hours, while the loading dose and continuous infusion resulted in mean plasma concentrations greater than 0.85 micrograms/ml (2.8 mumol/l) throughout the eight hour period. The continuous infusion was associated with a significant improvement in nausea and vomiting and reduction in diarrhoea. Major control of emesis (two episodes or fewer) was achieved in 27 patients receiving continuous metoclopramide compared with 18 receiving intermittent metoclopramide.
Service outlines plan to help suspended doctors back to work
Authors: Andrew Cole
Journal: BMJ (2005)

The National Clinical Assessment Service, the UK body that helps hospital trusts manage doctors' performance problems, is proposing a nationwide rehabilitation process for all doctors whose practice has previously given cause for concern.

The proposals—developed by the service over the last 18 months in collaboration with royal colleges, regulatory bodies, lay groups and educationalists—are out for consultation until 12 December, with the aim of producing a resource pack by next spring.

An estimated 1% of doctors are currently suspended or face some form of investigation or assessment because of concerns about the safety …
Pulsatility of luteinising hormone in men with chronic renal failure: abnormal rather than absent.
Authors: T Wheatley, P M Clark, J D Clark, P R Raggatt, D Evans, R Holder
Journal: BMJ (1987)

intravenous and oral acetazolamide, topical steroids, and mydriatics.Radiographical examination excluded any orbital fracture.Over the next 48 hours blood in the anterior chamber had cleared sufficiently to allow fundal views: there was vitreous haemorrhage in the left eye and bilateral commotio retinae.The visual acuity in the right eye returned to 6/5 within 72 hours, and re-examination showed no abnormality apart from residual traumatic mydriasis.Topical timolol was required to control persistently raised intraocular pressure in the left eye.After four weeks the visual acuity was still reduced at 6/18 with peripapillary subretinal haemorrhage, oedema at the posterior pole, and peripheral pigmentary retinal degeneration.CASE 2In this patient the visual acuity was reduced to 6/24 with a 2 mm hyphaema, rupture of the iris sphincter, an unreacting dilated pupil, and inferonasal commotio retinae.The right eye was not injured.The left eye was treated with topical mydriatrics and steroids, and the visual acuity returned to normal within seven days.No further complications were found at the last follow up examination, but the traumatic mydriasis and associated cycloplegia persisted.
Interactions of Rheumatoid Factor with Immune Precipitate containing Antibody of Human Origin
Authors: Morten Harboe
Journal: Annals of the Rheumatic Diseases (1961)

The term "rheumatoid factor" is applied to the macroglobulin component of serum which is responsible for a group of serological reactions used as diagnostic procedures in rheumatoid arthritis.The rheumatoid factor is able to react with antigen-antibody complexes of diverse origins.It agglutinates sheep red cells sensitized with rabbit amboceptor (Waaler, 1940; Rose, Ragan, Pearce, and Lipman, 1948), Rh-positive red cells coated with selected incomplete anti-D antibodies of human origin (Foz and Batalla, 1956; Grubb, 1956; Waller and Vaughan, 1956), and Brucella abortus sensitized with a strong incomplete anti-Brucella antibody of human origin (Foz and Batalla, 1956).Rheumatoid factor is adsorbed on to immune precipitates consisting of various antigens and the corresponding rabbit antibodies (Vaughan, 1956; Edelman, Kunkel, and Franklin, 1958; Vaughan, Ellis, and Marshall, 1958; Corcos, 1960; Mellors, Nowoslawski, Korngold, and Sengson, 1961).Vaughan (1956) observed that absorption with an immune precipitate consisting of diphtheria toxin and human antitoxin did not reduce the activity of one rheumatoid serum in the Waaler-Rose test.Under the experimental conditions, a considerable solubility of the precipitate made the quantitative data uninterpretable.Additional data were not available in the literature concerning reactions of rheumatoid sera with immune precipitates containing antibody of human origin.Recently, we have had the opportunity of studying a strong human precipitin and its reactions with rheumatoid sera.The present paper describes the results of these experiments.After completion of the experiments, we learned of the independent investigations of Aho, Kirpila, Wager, and Virk- kunen (1961) which confirm and extend our findings.