tbuckley/cabot-search huggingface dataset:
Inhibition by Raw Eggs of Vitamin B12 Absorption
Authors: A. Doscherholmen
Journal: JAMA (1978)

<h3>To the Editor.—</h3> Radiocyanocobalamin (<sup>57</sup>Co-B<sub>12</sub>), mixed separately in vitro with ovalbumin and egg yolks, cooked and served to normal volunteers, was poorly absorbed as compared with a dose of crystalline<sup>57</sup>Co-B<sub>12</sub>.<sup>1</sup>This finding led to the conclusion that ovalbumin and egg yolk inhibit the gastrointestinal assimilation of vitamin B12. The validity of this conclusion may be open to question, since it was based on a comparison between the absorption of cooked radioactive vitamin B12 in the eggs and noncooked crystalline radiocyanocobalamin. The present study eliminated this inconsistency of design by comparing the gastrointestinal absorption of noncooked radioactive vitamin B12 administered in a watery solution with that of a similar dose incorporated into raw egg yolks and ovalbumin (Table). Crystalline<sup>57</sup>Co-B<sub>12</sub>mixed with the raw yolks of two eggs was ingested by a normal volunteer. The test was repeated two weeks later with
DNA microarray analysis of the progressive arterialization and intimal hyperplasia of venous grafts in a canine model
Authors: Matthew D. Bacchetta, Ying Zhou, Ronda Chen, Sanjay A. Samy, Arash Salemi, Adam Hamawy, Lufei Hu, Karl H. Krieger, O.Wayne Isom, Wilson Ko, Daniel F. Catanzaro
Journal: Journal of the American College of Cardiology (2002)
Predicting anticoagulant-related bleeding in patients with venous thromboembolism: a clinically oriented review
Authors: Frederikus A. Klok, Judith Kooiman, Menno V. Huisman, Stavros Konstantinides, Mareike Lankeit
Journal: European Respiratory Journal (2014)

Diagnosis of venous thromboembolism (VTE) requires prompt treatment with anticoagulants in therapeutic doses. Since these drugs are associated with the occurrence of haemorrhage, identification of patients at increased risk of major bleeding is of utmost clinical importance for defining the optimal treatment regimen and duration of anticoagulation. Current suggested prediction scores for bleeding risk in VTE patients have been derived from observational studies of moderate quality, or from patients with various indications for therapeutic anticoagulation other than VTE. To date, none of the scores have been adequately validated in cohorts that underwent dedicated monitoring and independent adjudication of bleeding complications. In addition, while the scarce available evidence has focused on patients treated with heparins and/or vitamin K antagonists, risk stratification scores for bleeding complications in VTE patients treated with non-vitamin K dependent anticoagulants have not yet been developed. This clinically oriented review covers the incidence and risk factors of anticoagulation-related bleeding in VTE patients treated with different anticoagulant drugs as well as the available bleeding-prediction scores. Further, we attempt to provide guidance for bleeding-prevention in clinical practice and speculate on developments in the near future that may fundamentally change our current thinking on VTE management.
Quantitative analysis of walking in patients with knee osteoarthritis: a method of assessing the effectiveness of non-steroidal anti-inflammatory treatment.
Authors: O Blin, J Pailhous, P Lafforgue, G Serratrice
Journal: Annals of the Rheumatic Diseases (1990)

Most therapeutic tests of osteoarthritis treatments are assessed by criteria based either on fundamental data or on clinical data, which is often subjective. A quantified analysis of locomotion can be used to determine the spatiotemporal indices (stride length and duration), kinematic indices (walking speed, velocity peak), and symmetry criteria that are relevant to the assessment of locomotor handicaps in patients with osteoarthritis. This study examined the progression of locomotor abilities in 11 subjects aged 49-69 (mean 60.9) years with knee osteoarthritis before and after treatment with a non-steroidal anti-inflammatory drug. Naproxen sodium (1100 mg) was given once a day for seven days. The condition before and after treatment was evaluated by quantitative analysis of locomotion, estimation of pain on a visual analogue scale, and assessment of the degree of functional disability. Significant improvement in locomotor indices (proportional increase in walking speed 17.8%) and in degree of pain (proportional decrease 27%) as estimated on the analogue scale was found after non-steroidal anti-inflammatory drug treatment. The lack of a significant correlation between the decrease in pain experienced by the patients and the objective improvement of their functional capabilities emphasises the need in further studies of new treatments to accompany the patients9 own assessments of self improvement with a quantitative analysis of the way in which they walk.
Thyroid Failure in the Elderly
Authors: Mark J. Rosenthal, William C. Hunt, Philip J. Garry, James S. Goodwin
Journal: JAMA (1987)

Thyrotropin (thyroid-stimulating hormone [TSH]) levels were elevated above 4.0 mU/L (μU/mL) in serum samples from 13.2% of 258 healthy elderly subjects. To investigate the natural history of progressive thyroid failure, serial thyroid functions were measured for four years in 26 of these subjects with elevated TSH levels. In one third of these subjects, biochemical thyroid failure developed (thyroxine level&lt;58 nmol/L [4.5 μg/dL]) within the course of the study. All subjects with initial TSH levels above 20 mU/L (μU/mL), and 80% of those with high-titer thyroid antimicrosomal antibodies (regardless of initial TSH level), became overtly hypothyroid. Compared with subjects with high-titer antibody, those with antibody titer less than 1:1600 had lower TSH and higher thyroxine levels, and thyroid failure developed in none during the study. These results suggest that among older patients with isolated elevations of the TSH level, only those with markedly elevated TSH levels or high-titer antimicrosomal antibodies should be prophylactically treated with levothyroxine sodium replacement. (<i>JAMA</i>1987;258:209-213)
CONTRIBUTING FACTORS TO HIGH ON-TREATMENT RESIDUAL PLATELET REACTIVITY IN PATIENTS WITH ACUTE CORONARY SYNDROMES
Authors: Manabu Nitta, Hideto Yano, Tsutomu Endo, Kengo Tsukahara, Kiyoshi Hibi, Kazuo Kimura, Satoshi Umemura
Journal: Journal of the American College of Cardiology (2012)
EXPEDITION TO SOUTH AMERICA
Authors: Brian Acworth
Journal: JAMA (1953)

<h3>To the Editor:—</h3> I would like to place before your readers details of a project that might interest them. An expedition has been planned for late this fall. The members of the expedition will drive two sports cars, towing small trailers, down the Pan-American Highway to Rio de Janeiro. We hope to complete the journey entirely under the power of the cars, and, as many readers ofThe Journalmay know, this is a pioneering venture. There are three of us at present, an American who is a graduate of Massachusetts Institute of Technology, with motor engineering experience, and two Englishmen who both are Oxford graduates, with some years in the United States, and one who has a master's degree in business administration from Harvard. We need a fourth man to complete the group. As the fourth man we want to recruit a young American medical graduate, preferably with some
A Case of Periostitis Secondary to Voriconazole Therapy in a Heart Transplant Recipient
Authors: Steven M. Wise, Michael A. Wilson
Journal: Clinical Nuclear Medicine (2011)

A 66-year-old man with a history of heart transplant for idiopathic dilated cardiomyopathy presented with progressive bone pain and myalgias. He has been on voriconazole for a pulmonary Aspergillus infection for 9 months. He had an elevated alkaline phosphatase of 280. There is no history of rheumatologic disease. Drug-induced periostitis has recently been reported in patients on long-term voriconazole therapy after lung transplantation for prophylaxis and treatment of Aspergillus infection. This case demonstrates the same phenomenon in a heart transplant patient. This patient's symptoms improved after discontinuation of voriconazole.
Effects of growth hormone and insulin-like growth factor-I singly and in combination on<i>in vivo</i>capacity of urea synthesis, gene expression of urea cycle enzymes, and organ nitrogen contents in rats
Authors: T Grøfte, T Wolthers, S A Jensen, N Møller, J O Jørgensen, N Tygstrup, H Ørskov, H Vilstrup
Journal: Hepatology (1997)

Improvement of nitrogen balance is desirable in patients with acute or chronic illness. Both growth hormone (GH) and insulin-like growth factor-I (IGF-I) are promising anabolic agents, and their combined administration has been shown to reverse catabolism more efficiently than each of the peptides alone. This is believed to be mediated primarily through increased peripheral protein synthesis, whereas little attention has focused on a possible participation of amino acid metabolism in the liver. Four groups of rats were given: 1) placebo; 2) GH (200 micrograms/d); 3) IGF-I (300 micrograms/d); and 4) both GH and IGF-I. After 3 days, the maximum capacity of urea-nitrogen synthesis was determined by saturating infusion of alanine (n = 8 in each group), together with measurements of liver messenger RNA (mRNA) levels for urea cycle enzymes (n = 5 in each group) and N-contents of muscles, heart, and kidney. Basal plasma alpha-amino acid concentrations were similar in all groups. The capacity of urea-N synthesis [mumol/(min x 100 g body weight)] was reduced in a stepwise manner (placebo: 8.25 +/- 1.2; GH treatment: 6.52 +/- 0.8; IGF-I treatment: 5.5 +/- 0.6; and GH/IGF-I: 4.22 +/- 1.6 [P < .001 by ANOVA]), each step being lower than the former. Serum IGF-I increased stepwise from placebo (699 +/- 40 to 1,579 +/- 96 micrograms/L in the combined GH/IGF-I group), and was correlated negatively with the capacity of urea-nitrogen synthesis (P < .01). mRNA levels for urea cycle enzymes in the liver decreased after GH and IGF-I treatment, and the effect was more pronounced after the combined treatment in which the rate-limiting enzyme, argininosuccinate synthetase, was halved. Nitrogen contents of organs increased after both GH and IGF-I treatment, and even more so after the combination treatment, reaching an increase of 30% (P < .05). Data suggest that GH and IGF-I singly and, even more so in combination, additively inhibit urea synthesis. This is supposed to favor protein buildup in organs. We speculate that this inhibitory effect on the capacity of urea synthesis is caused by a decreased translation rate of the urea cycle enzymes caused by GH and IGF-I's down-regulatory effect on urea cycle enzyme gene transcription. The findings may indicate a novel mechanism of the protein anabolic action of GH and IGF-I.
Magnetism. A new method for stimulation of nerve and brain
Authors: M. Hallett
Journal: JAMA (1989)

<h3>SELECTED CASE</h3> A 34-YEAR-OLD woman was well until age 22 years, when she experienced transient numbness of both hands. At age 24 years she had her first bout of urinary incontinence, a problem that continued intermittently. At age 26 years she experienced double and "faded" vision. Subsequently, she noted the gradual development of weakness and stiffness of both legs, making walking difficult. Examination showed decreased visual acuity and pale discs on funduscopic evaluation. Tone was moderately increased in the legs, but there was only minimal weakness in distal flexors. Sensation was minimally impaired distally in the legs. Reflexes were brisk and there were bilateral Babinski's responses. Visual evoked potentials were increased in latency, right side more than left. Brain-stem auditory evoked potentials from the right ear were abnormal. Somatosensory evoked potentials were normal. Magnetic stimulation of the motor areas of the brain showed delayed motor evoked potentials in abductor pollicis
Effects of cyclophosphamide o immune arthritis in the guinea-pig.
Authors: J M Gumpel, P M Ford, F W Webb
Journal: Annals of the Rheumatic Diseases (1971)

Certain drugs, originally developed for the chemo- therapy of cancer, are now also used in the control of autoimmune diseases in man.Cyclophosphamide, a potent alkylating agent, has an established place in the treatment of the nephrotic syndrome in children (Cameron, 1968) and has been used with some success in systemic lupus erythematosus (Seah, Wong, Chew, Jayaratnam, 1966) and in the lupus-like nephritis of the NZB and NZW F1 hybrid mouse (Russell and Hicks, 1968).More recently cyclophosphamide (Fosdick, 1968; Smyth, 1968) and also azathioprine (Mason, Currey, Barnes, Dunne, Hazleman, and Strickland, 1969) have been used in the treatment of rheumatoid arthritis, a more chronic and usually less life-threatening disease.Using an experimental immune arthritis histo- logically resembling rheumatoid arthritis that can be induced in guinea-pigs (Loewi, 1968), we have attempted to evaluate the effect of cyclophos- phamide, both the immunosuppressive effect on the induction of an immune arthritis and also the immunosuppressive and anti-inflammatory effects on established arthritis in guinea-pigs.Materials and methods Cyclophosphamide (Endoxana) was kindly supplied by Ward Blenkinsop Ltd. INDUCTION OF ARTHRITISAn immune arthritis was induced in Duncin-Hartley guinea-pigs weighing 250 to 500 mg.after the method of Dumonde and Glynn (1962). 1 mg.ovalbumin (Koch- Light Laboratories Ltd., 5X crystallized), emulsified in 1 ml.Freund's complete adjuvant, was injected intrader- mally.After 10 days each animal was skin-tested, using
Administer tranexamic acid early to injured patients at risk of substantial bleeding
Authors: R. L. Gruen, M. C. Reade
Journal: BMJ (2012)

#### Key points

Haemorrhage is the principal cause of 30-40% of all trauma deaths, and half of these occur before admission to hospital.1 Many bleeding patients develop coagulopathy, making control of haemorrhage more difficult. In some patients this coagulopathy develops early2 and seems to be associated with excessive fibrinolysis and breakdown of clots.3 Current protocols for massive transfusions of blood products (variably defined as >10 red cell units or >50% blood volume in 24 hours, or >5 units in four hours) to patients with haemorrhagic shock prescribe plasma and cryoprecipitate to replace lost, consumed, diluted, or dysfunctional clotting factors, but these do not specifically treat fibrinolysis. There is now compelling evidence that tranexamic acid (1 g loading dose plus 1 g over eight hours), a relatively safe and inexpensive antifibrinolytic, should be administered within three hours of injury in patients at risk of severe bleeding.

Tranexamic acid was discovered in the 1950s and has been used during surgery to minimise blood loss. A systematic review evaluated 126 randomised controlled trials in elective surgery and three in emergency surgery (total of 10 488 patients) that had been conducted between 1972 and 2011. This showed that tranexamic acid reduced blood transfusions by a third (risk ratio 0.62, 95% confidence interval 0.58 to 0.65),4 an effect that persisted when only trials with adequate allocation concealment were considered (0.68, 0.62 to 0.74). In these higher quality trials the effect on mortality was uncertain (0.67, 0.33 to 1.34), as was …
Blood samples collected under venous oxygen pressure from patients with sickle cell disease contain a significant number of a new type of reversibly sickled cells: Constancy of the percentage of sickled cells in individual patients during steady state
Authors: Toshio Asakura, Kenji Asakura, Kazuo Obata, Julian Mattiello, Samir K. Ballas
Journal: American Journal of Hematology (2005)

We found various levels of a new type of reversibly sickled cell (RSC) with blunt edges in 44 blood samples obtained from 32 steady-state patients with sickle cell disease (SCD) without exposure to air (UnExp-blood). Because these RSCs could be generated in vitro by partial oxygenation of once-deoxygenated SS cells to venous oxygen pressure, we named them "partially oxygenated sickled cells" (POSCs). These RSCs were classified into elongated and non-elongated RSCs, depending on the ratio of the short axis to long axis. The presence of these cells was previously unknown because the standard blood collection method oxygenates most of the POSCs to discocytes due to oxygen in the air space in the needle, syringe, and blood collection tube (Exp-blood). Although the shape of elongated POSCs is similar to that of irreversibly sickled cells (ISCs), POSCs revert to discocytes upon exposure to air. We found the following: (1) the percentage of total sickled cells (total POSCs + ISCs) in UnExp-blood (29.0 ± 14.5%) was significantly higher than the percentage of sickled cells (mainly ISCs) in Exp-blood (7.3 ± 5.7%); (2) the percentage of sickled cells in UnExp-blood was specific to individual patients during steady state, while it decreased at the onset of a vaso-occlusive event; and (3) the percentage of sickled cells in UnExp-blood varied widely among steady-state patients (4–56%). This new type of RSC may be used as an internal biomarker to evaluate the disease state of individual patients. Am. J. Hematol. 80:249–256, 2005. © 2005 Wiley-Liss, Inc.
Outcome of special types of luminal breast cancer
Authors: M. Colleoni, N. Rotmensz, P. Maisonneuve, M.G. Mastropasqua, A. Luini, P. Veronesi, M. Intra, E. Montagna, G. Cancello, A. Cardillo, M. Mazza, G. Perri, M. Iorfida, G. Pruneri, A. Goldhirsch, G. Viale
Journal: Annals of Oncology (2011)
Robin Trevor Pinto
Authors: S. Pinto
Journal: BMJ (2008)

At his funeral, Robin Trevor Pinto was referred to as the “father of psychiatric services in South Beds.” His role in service provision and patient care was recognised in the renaming of his psychiatric unit as the Robin Pinto Unit in July.

Robin arrived in Britain in 1965 full of self confidence, after a glittering student career. Flirting briefly with a career in cardiology, he found his …
Single photon emission computed tomography to determine effective hepatic blood flow and intrahepatic shunting
Authors: Motoh Iwasa, Kazuyoshi Nakamura, Tsuyoshi Nakagawa, Shozo Watanabe, Hiroshi Katoh, Yasutomi Kinosada, Hisato Maeda, Jun Habara, Shiro Suzuki
Journal: Hepatology (1995)

The noninvasive determination of effective hepatic blood flow, intrahepatic shunted blood flow, intrahepatic shunt index, and total hepatic blood flow was investigated by using the sequential single photon emission computed tomography. This method was performed for a period of 10 minutes following an intravenous injection of 99mTc-(Sn)-N-pyridoxyl-5-methyltryptophan and a venous blood sampling. This study comprised 8 healthy volunteers, 16 patients with chronic hepatitis, and 33 patients with liver cirrhosis. The intrahepatic shunt index measured with this method coincided with the intrahepatic shunt index determined by catheterization, indicating the high reliability of this procedure. The effective hepatic blood flow in patients with liver cirrhosis was significantly lower than that in the healthy controls and the chronic hepatitis group. The intrahepatic shunted blood flow was significantly higher in patients with liver cirrhosis compared with the flow in healthy controls. The intrahepatic shunt index was also significantly higher in patients with liver cirrhosis compared with the index of healthy controls and those with chronic hepatitis. No substantial differences were noted in the total hepatic blood flow among the three groups. The effective hepatic blood flow, the intrahepatic shunted blood flow, and the intrahepatic shunt index, correlated with the serum albumin concentration, the serum cholinesterase level, and the plasma indocyanine green attenuation rate. From these results, it was concluded that the present procedure constitutes a reliable and effective method for the noninvasive determination of hepatic blood flows. Consequently, it will be of high clinical value for assessing the functional and the pathological alterations of the liver.
Systemic Symptoms in the Progression of Cutaneous to Systemic Lupus Erythematosus
Authors: Isabela T. Wieczorek, Kathleen J. Propert, Joyce Okawa, Victoria P. Werth
Journal: JAMA Dermatology (2014)

Patients with cutaneous lupus erythematosus (CLE) who develop systemic lupus erythematosus (SLE) may have few and mild systemic symptoms.To characterize the types and severity of systemic symptoms in a longitudinal cohort of patients with CLE.Prospective, longitudinal cohort study of 77 patients with CLE who presented between January 2007 and April 2011 at a university autoimmune skin disease clinic.Systemic symptoms and severity were determined from data recorded at each study visit and from medical records.Of 77 patients with CLE, 13 (17%) went on to meet criteria for SLE, with a mean (SD) time from CLE diagnosis to SLE of 8.03 (6.20) years. Of the 13 patients, 1 (8%) solely met the mucocutaneous American College of Rheumatology (ACR) criteria of malar rash, discoid rash, photosensitivity, and oral ulcers, and 3 (23%) met the mucocutaneous ACR criteria plus positive antinuclear and other antibody titers. After a mean (SD) follow-up time of 2.81 (1.34) years, only 5 of the 13 patients with CLE (38%) who progressed to meet SLE criteria developed moderate to severe additional systemic disease.Patients with CLE who developed SLE during our study did so mostly by meeting the mucocutaneous ACR criteria, and the majority developed none to mild additional systemic disease during the study period. Thus, our study suggests that a small percentage of patients with CLE eventually develop SLE and that even if they do, most patients will have mild systemic disease.
Serum levels of tissue inhibitor of metalloproteinase-1 and 2 in patients with eosinophilic fasciitis
Authors: M. Jinnin, H. Ihn, K. Yamane, Y. Asano, N. Yazawa, K. Tamaki
Journal: British Journal of Dermatology (2004)

Serum levels of tissue inhibitor of metalloproteinases (TIMPs) have been reported to be elevated in patients with various connective tissue diseases. However, there has been no report that evaluates TIMPs in patients with eosinophilic fasciitis (EF).To determine serum TIMP-1 and TIMP-2 levels in patients with EF and to investigate their clinical significance.Immunohistochemical stainings were performed in normal and EF skin samples. Serum TIMP-1 and TIMP-2 levels of 11 patients with EF and 12 healthy individuals were also measured with specific enzyme-linked immunosorbent assays.The fascia of EF patients was stained only by TIMP-1. Serum TIMP-1 levels (mean +/- SD) were significantly higher in EF patients than in healthy individuals (206.3 +/- 65.4 vs. 145.2 +/- 36.2 ng mL(-1), P < 0.01). Serum TIMP-1 levels in EF patients were significantly correlated with serum gamma-globulin and IgG levels (r = 0.86, P < 0.05; r = 0.83, P < 0.005, respectively).These results suggest that TIMP-1 is involved in the pathogenesis of EF, and that TIMP-1 may be a useful marker for the disease activity as well as serum gamma-globulin or IgG levels.
Palliation and Pleurodesis in Malignant Pleural Effusion: The Role for Tunneled Pleural Catheters
Authors: Kei Suzuki, Elliot L. Servais, Nabil P. Rizk, Stephen B. Solomon, Camelia S. Sima, Bernard J. Park, Stefan S. Kachala, Maria Zlobinsky, Valerie W. Rusch, Prasad S. Adusumilli
Journal: Journal of Thoracic Oncology (2011)
Government is attacked for interference over Herceptin
Authors: Claire Laurent
Journal: BMJ (2005)

The NHS should not use the fact that the National Institute for Health and Clinical Excellence (NICE) has not yet provided guidance on a treatment to refuse that treatment, Jane Kennedy, minister for quality and patient safety, has said. She was speaking to delegates at a NICE conference in Birmingham last week.

“NICE does not exist to ‘kitemark’ all the drugs which are licensed for use in the UK. Therefore, the NHS will have to continue to make informed decisions about the use of these drugs,” she said.

In a challenge from the floor, Iain Chalmers, founder of the Cochrane Library, asked why …