tbuckley/cabot-search huggingface dataset:
WEAKNESS AND DILATATION OF THE HEART IN CHRONIC NUTRITIONAL DISEASE.
Authors: G. W. McCASKEY
Journal: JAMA (1903)

I wish to invite your attention for a few minutes to some practical questions concerning certain aspects of cardiac pathology and therapeutics. These questions will be discussed with especial reference to my own experience. This experience, or at least that part of it which I have chosen as the basis of this discussion is perhaps sufficiently indicated by the title. It might be well, however, to add that the material among which cases of weakness and dilatation were found comprised about 600 cases of chronic gastritis, with about the same number of other forms of chronic diseases. These cases all occurred in private office and consultation practice. In all cases the heart was subjected to a careful examination with reference to the clinical changes of volume, either transient or permanent in character, which occur with varying states of tonicity of the cardiac muscle. In perhaps no other department of practical
Forensic Medicine and Toxicology: Drug Addiction
Authors: T. H. Bewley
Journal: BMJ (1967)

During the past ten years there has been a change in the pattern of drug addiction in the United Kingdom.Before 1950 there was relatively little, and virtually none among people who had obtained drugs illicitly.Now cannabis, amphetamines, com- binations of amphetamines and barbiturates, lysergic acid diethylamide, cocaine, and heroin are all increasingly obtained illegally.Those who start obtaining drugs illicitly, and become addicted, commonly have a severe personality disorder.They may experiment with any drugs they can obtain. Sources of DrugsHeroin and cocaine, each of which has been sold for £1 for 60 mg.for the past ten years, appear to originate from legitimate prescriptions for other addicts who do not always use the amount prescribed.Cannabis (marihuana), commonly known as " pot," " weed," or " hemp," is increasingly widely smoked, and not only by recent immigrants.People generally smuggle it into the country in small amounts for themselves and their friends, though some appears to be smuggled for profit.Amphetamines and amphetamine-barbiturate combinations are sold widely in capsule and tablet form for ls. to 2s. each in cafes under such names as " purple hearts," " french blues," or " black bombers."The price is higher at weekends when the demand by young people to become " high " or " blocked " is greater.These have probably been stolen in bulk or otherwise * Consultant Psychiatrist, Tooting Bec Hospital, London.also obtains some information from hospitals, doctors, social workers, and similar sources.
Abnormal splitting of the second heart sound in renal failure.
Authors: D G Gibson
Journal: BMJ (1967)

Fructose Intolerance-Black and Simpson-BJomus,.141 from the depletion of intracellular phosphate after its immo- bilization as fructose-l-phosphate, though this is still uncertain (Desbuquois, 1965).The severe hypoglycaemia resulting from a dose of fructose appears to be the resultant of a failure of glycogenolysis in the liver, with continued peripheral utilization of glucose by the tissues.The cause of the liver damage itself remains unexplained ; it is possible that the intrinsic metabolism of the liver cell is damaged, owing to depletion of cellular adenosine triphosphate (Levin et al., 1963). Treatment and PrognosisTreatment consists in the exclusion of sucrose and fructose from the diet, with the addition of ascorbic acid, as the daily intake is otherise likely to be low.Difficulties often arise in the prescription of medicines or antibiotic syrups, and the patients and their doctors need to be warned specifically about this point.Severe or fatal liver damage is likely to occur in infancy if the diagnosis is not suspected.As the case histories show, the diagnosis is commonly made by an observant mother if she has already had a similarly affected infant, but the exclusion of fructose-containing substances from the diet by the mother, or later by a self-selected diet, is not usually strict enough to prevent the development of hepatomegaly.It is probable, therefore, though there is as yet no certain evidence of this, that the fatty infiltration of the liver will in due course be followed by cirrhosis.Our own observations suggest that a strict fructose-free diet in children will cause a complete return to normality, though a long follow-up has not yet been possible. SummaryFructose intolerance is a genetically determined metabolic disorder inherited as an autosomal recessive.It is probably as common as the more widely recognized galactose intolerance.In affected individuals fructose given orally or intravenously causes profound hypoglycaemia, with a rise of the level of fructose in the blood to 20 mg./100 ml. or more.The essential abnormality is an absence of the liver enzyme fructose-l-P.aldolase.The condition may present in infancy as neonatal jaundice with hepatomegaly, or with vomiting and failure to thrive: in older children hypoglycaemic fits may occur or glycogen storage disease may be suspected on account of the enlarged liver.In adults the symptoms are less obvious, and may be dismissed as "neurotic ill-health."The diagnosis is made by an oral or I.V. fructose tolerance test or by estimation of the activity of the specific aldolase in a fresh or frozen liver biopsy.Treatment is by the exclusion of fructose and sucrose from the diet.Five children with this condition are described.We wish to thank Dr. A.
The Road to Recovery from Depression – Don’t Drive Today with Yesterday’s Map
Authors: Giovanni A. Fava, Elena Tomba, Silvana Grandi
Journal: Psychotherapy and Psychosomatics (2007)

The issue of recovery is getting increasing attention in depression research, particularly after the publication of the STAR*D results. The paper analyzes some issues which may hinder effective treatment of major depressive disorders: the inadequacies of a cross-sectional DSM assessment without clinical differentiation of the extent, development and seriousness of the disturbances (staging); over-emphasis on and prolongation of drug treatment, without paying attention to problems related to tolerance; neglect of the active role of the patient in achieving recovery, with the integration of psychotherapeutic strategies in a sequential model. If we are able to remove the conceptual obstacles which obstruct our view of depression and silence the sound of propaganda, we may then become aware of a different scenario in mood disorders and be able to develop therapeutic strategies of enduring quality.
Effect of suryanamaskar practice on the body composition of female students
Authors: Shivesh Shukla
Journal: British Journal of Sports Medicine (2010)

The present experiment was conducted on randomly selected 30 female students, their age ranging from 14 to 16, intended to measure the effect of suryanamaskar practice on the body composition of female students. Estimated body fat percentage was assessed by skinfold caliper at the biceps, triceps, suprailiac and subscapular. The experiment was of 6 weeks, 5 days a week for duration of 30 min. Percentage of fat is taken according to the assessment of body composition chart by JVGA Durnin and MM Rahaman. Paired t test was applied at the result was tested for significance 0.05 level. The obtained ‘t’ value between the pre-means of experimental group and control group was 0.18 which is less than the required value of 2.14 (0.05 level). The obtained ‘t’ value between the pre- and post-means of experimental group was 0.10 which is less than the required value of 2.14 (0.05 level). The ‘t’ value of the pre- and post-means of control group was 0.40 which is less than the required value of 2.14 (0.05 level). It shows that both the having similar total body fat of body composition. The ‘t’ value of the pre- and post-means of experimental group and control group was 0.01 which is very less than the required value of 2.14 (0.05 level). The finding reveals that no significant differences between the pre- and post-test of experimental and control group, may be attributed to the fact that the selected age group was active participant and have hectic schedule which keep the fat percentage to a very low level. This indicated that the suryanamaskar practice have no effect on the body composition of female students.
Increased serum CRH levels with decreased skin CRHR-1 gene expression in psoriasis and atopic dermatitis
Authors: Magdalini Vasiadi, Anastasia Therianou, Kyriaki Sideri, Marilena Smyrnioti, Nikolaos Sismanopoulos, Danae A. Delivanis, Shahrzad Asadi, Alexandra Katsarou-Katsari, Theodora Petrakopoulou, Athanasios Theoharides, Christina Antoniou, Evaggelia Papadavid, Nikolaos Stavrianeas, Dimitrios Kalogeromitros, Theoharis C. Theoharides
Journal: Journal of Allergy and Clinical Immunology (2012)
The Physician's Responsibility for Suicide. II. Errors of Omission
Authors: GEORGE E. MURPHY
Journal: Annals of Internal Medicine (1975)

Forty-nine out of 60 persons who committed suicide had been under the care of 71 physicians within 6 months or less before committing suicide. Over two thirds of the patients had histories of suicide attempts or threats. These histories were known to only two fifths of the physicians responsible for their care, despite the information being readily available from other sources. There was substantial evidence of depressive illness in three quarters of the patients, yet the diagnosis was rarely made except by psychiatrists, and therefore the depression was rarely treated. Although a few patients had been recognized as representing suicidal risk, the great majority had not. The failure to diagnose and to treat depressive illness and the failure to be informed about the risk factors in these cases represent missed opportunities for preventive intervention.
The MCAT Malady
Authors: Norman D. Anderson
Journal: New England Journal of Medicine (1984)

IN the past year, the lay press has described medical education in the United States as being "brutal" and "dehumanizing." Matriculating medical students have been categorized as "aggressive, competitive, narrow, dishonest, unfriendly individuals — in other words, nerds," 1 selected from an undergraduate population afflicted by the "premed syndrome," whose selfish pursuit of high test scores has led to their designation by classmates as "throats" and "grunts." Although it is appealing to dismiss such criticism as distorted journalistic hyperbole, the problems arising from the competitive selection and rigorous education of medical students are very real and are now under review by . . .
MUNICIPAL REGULATION OF THE MILK SUPPLY.
Authors: GEORGE W. GOLER
Journal: JAMA (1907)

"We can't do too much to help them. The future of this country depends on its poor children. If they are to do right, they must be saved from ill health, and ignorance and vice; and the first step is to give them good food and air so that they shall have strong little bodies."—Paul Leicester Ford, in "The Honorable Peter Stirling." If we take this statement at its worth, it means that the food of a child determines the future of the citizen and the physical strength of the potential fathers and mothers of the state. In guarding the milk supply we are not then confronted solely with the question of infantile sickness and death, with possible outbreaks of infectious disease through milk, but with a far larger problem, one of the greatest of social problems, that of the future of the race. The first duty of man
Review: In noncardiac surgery, β-blockers started before surgery increase 30-day mortality
Authors: Prashant Vaishnava, Kim Eagle
Journal: Annals of Internal Medicine (2013)

Source Citation Bouri S, Shun-Shin MJ, Cole GD, Mayet J, Francis DP. Meta-analysis of secure randomised controlled trials of β-blockade to prevent perioperative death in non-cardiac surgery. Heart. 2013; Jul 31 [Epub ahead of print]. 23904357
Abstract 4397: Regulation of tamoxifen sensitivity by a PAK1-EBP1 signaling pathway in breast cancer.
Authors: Smita Awasthi*, Arundhati Ghosh*, Jeffrey R. Peterson, Anne W. Hamburger
Journal: Cancer Research (2013)

Abstract EBP1, an ErbB3 binding protein isolated in our laboratory, sensitizes breast cancer cells to tamoxifen in part by decreasing ErbB2 protein levels. The p21 regulated serine/threonine kinase PAK1, implicated in tamoxifen resistance, phosphorylates EBP1 in vitro and in vivo at T261. Phosphorylation of EBP1 at this site induces tamoxifen resistance. We thus postulated that inhibition of PAK1 activity, by restoring EBP1 function, could ameliorate the hormone refractory phenotype of ErbB2 overexpressing breast cancer cells. Transient transfection studies indicated that an EBP1 T261E mutant, which mimics EPB1 phosphorylated by PAK1, increased ErbB2 protein levels. An EBP1 T261A mutant, unable to be phosphorylated by PAK1, ameliorated PAK1-induced tamoxifen resistance, suggesting that phosphorylation of EBP1 by PAK1 contributes to tamoxifen resistance. We then tested if pharmacological inhibition of PAK1 activity might render hormone resistant cells, which endogenously overexpress PAK1 and ErbB2, tamoxifen sensitive. Transfection of EBP1 sensitized cells to tamoxifen. The T261A EBP1 mutant more potently sensitized cells to tamoxifen than wild type EBP1. IPA-3, a specific small MW PAK1 inhibitor, sensitized cells to tamoxifen only when EBP1 was ectopically expressed. However, IPA-3 did not further affect sensitivity of T261A overexperssing cells, suggesting that the phosphorylation of EBP1 by PAK1 played a role in the EBP1-induced hormone sensitivity. IPA had no effect on tamoxifen resistance in T47D cells in which EBP1 protein had been ablated by shRNA. The IPA-induced increase in tamoxifen sensitivity was accompanied by a decrease in ErbB2 levels in EBP1 overexpressing, but not vector control cells. These studies suggest that phosphorylation of EBP1 may be a novel additional mechanism of PAK1-induced hormone resistance. In addition, strategies that increase the pool of functional EBP1 and decrease PAK1 activity may affect hormone resistant cell growth. Our results also suggest that PAK1 directed therapies may be more effective in patients that express high levels of EBP1. *contributed equally to this work Citation Format: Smita Awasthi*, Arundhati Ghosh*, Jeffrey R. Peterson, Anne W. Hamburger. Regulation of tamoxifen sensitivity by a PAK1-EBP1 signaling pathway in breast cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4397. doi:10.1158/1538-7445.AM2013-4397
Medicine and the Racial Divide
Authors: Elizabeth G. Phimister
Journal: New England Journal of Medicine (2003)

The role of race in the cause and treatment of disease has been the subject of much discussion during the past year, in the pages of the Journal and elsewhere. Two Sounding Board articles in this issue of the Journal are the most recent contributions to the debate over whether race — defined broadly as the sharing of a common ancestry — should be considered by those who study disease and patients' responses to treatment.As both sets of authors point out, the subject is fraught with sensitivities fueled by past abuses and the potential for future abuses. But whereas . . .
Association between impaired glucose tolerance and circulating concentration of Lp(a) lipoprotein in relation to coronary heart disease.
Authors: M Farrer, F L Game, C J Albers, H A Neil, P H Winocour, M F Laker, P C Adams, K G Alberti
Journal: BMJ (1993)

OBJECTIVE--To examine whether impaired glucose tolerance and raised Lp(a) lipoprotein concentrations are associated in subjects with coronary artery disease. DESIGN--Study of two subject populations, one with and one without symptomatic coronary artery disease. Case-control analysis of patients with impaired glucose tolerance and normal glucose tolerance performed in each subject population independently. SETTING--A general practice and a hospital ward in Newcastle upon Tyne. SUBJECTS--517 apparently healthy subjects, 13 with impaired glucose tolerance, and 245 patients who had undergone coronary artery bypass graft surgery 12 months before, 51 with impaired glucose tolerance. MAIN OUTCOME MEASURES--Serum Lp(a) lipoprotein concentration, plasma glucose concentration before and after oral challenge with 75 g glucose monohydrate, and Lp(a) lipoprotein isoforms. RESULTS--In both the asymptomatic subjects and the subjects with coronary artery disease there was no significant difference between subjects with impaired glucose tolerance and subjects with normal and body mass index in serum Lp(a) lipoprotein concentrations (geometric mean 61 (geometric SD 4) mg/l v 83 (5) mg/l for asymptomatic subjects, 175 (3) v 197 (2) for subjects with heart disease), nor was there any difference in the proportion of subjects who had Lp(a) lipoprotein concentrations &gt; 300 mg/l (31% v 23% for asymptomatic subjects, 37% v 37% for subjects with heart disease). For both subject groups there was no significant correlation between Lp(a) lipoprotein concentration and plasma glucose concentration after a glucose tolerance test, nor did Lp(a) lipoprotein concentration vary by quintile of glucose concentration after the test. Examination of Lp(a) lipoprotein isoforms in the subjects with coronary artery disease revealed an inverse relation between isoform size and plasma Lp(a) lipoprotein concentration, but there was no evidence that impaired glucose tolerance was associated with particular Lp(a) lipoprotein isoforms. CONCLUSION--Raised Lp(a) lipoprotein concentrations are not responsible for the association between impaired glucose tolerance and coronary artery disease.
A 61-Year-Old Man With Psoriasis, 1 Year Later
Authors: Thomas L. Delbanco
Journal: JAMA (1997)

At Dermatology Grand Rounds held approximately 1 year ago, Dr Richard Baughman discussed the evaluation and management of a 61-year-old man with psoriasis that first appeared when he was a young child.<sup>1</sup>The patient had tried many different approaches to managing the illness, including some that he felt were too risky, and others that gave little benefit over time, despite short-term gains. Dr Baughman discussed the pathogenesis and natural history of psoriasis and an orderly approach to the management of the illness, noting that risks may accompany some of the treatments that seem to show the most promise. We asked the patient and his doctor to comment on the year that has passed. <h3>MR J, THE PATIENT</h3> In December 1996,I vacationed in Puerto Rico and revisited a beach which, because of its secluded location, allows for maximal sun exposure. For 9 days, I took advantage of every opportunity for such
The real irony of The Doctor
Authors: J. Moore
Journal: BMJ (2010)

<h3>Objective</h3> To measure the incidence of long-term benzodiazepine receptor agonist (BZRA) use among individuals with anxiety, mood and/or sleep disorders. To identify factors associated with long-term use following the first prescription. <h3>Methods</h3> This was a population-based retrospective cohort study using administrative databases in Manitoba, Canada. Individuals with anxiety/mood or sleep disorder who received their first BZRA between 1 April 2001 and 31 March 2015 were included. Long-term use was defined as ≥180 days. Logistic regression modelling was used to examine predictors of long-term use. <h3>Results</h3> Among 206 933 individuals included, long-term BZRA use in the first episode of use was 4.5% (≥180 days) following their first prescription. Factors associated with ≥180 days of use included male sex (adjusted OR (aOR) 1.33, 95% CI 1.27 to 1.39), age ≥65 (aOR 5.15, 95% CI 4.81 to 5.52), income assistance (aOR 1.68, 95% CI 1.55 to 1.81), previous non-BZRA psychotropic (aOR 1.93, 95% CI 1.83 to 2.02) or opioid use (aOR 1.16, 95% CI 1.11 to 1.22), high comorbidity (aOR 1.43, 95% CI 1.32 to 1.55), high healthcare use (aOR 1.46, 95% CI 1.33 to 1.60) and psychiatrist prescriber (aOR 2.11, 95% CI 1.93 to 2.32). <h3>Conclusions</h3> Less than 1 in 20 patients use BZRAs ≥180 days in their first treatment episode. Several factors were associated with long-term use following the first prescription and further investigation into whether these factors need to be considered at the point of prescribing is warranted. In light of these findings, future research should examine the predictors of cumulative repeat episodes of BZRA exposure.
Circulating Insulin-Like Growth Factors and IGF-Binding Proteins in PSA-Detected Prostate Cancer: The Large Case–Control Study ProtecT
Authors: Mari-Anne Rowlands, Jeff M.P. Holly, David Gunnell, Jenny Donovan, J. Athene Lane, Freddie Hamdy, David E. Neal, Steven Oliver, George Davey Smith, Richard M. Martin
Journal: Cancer Research (2011)

Abstract Circulating insulin-like growth factor-I (IGF-I) has been studied extensively in prostate cancer, but there is still little information about IGFs and IGF-binding proteins (IGFBP) in cancers detected by the prostate-specific antigen (PSA) test. Here, we report the findings of a U.K.-based case–control study to investigate circulating IGFs and IGFBPs in PSA-detected prostate cancer with regard to their potential associations with different cancer stages or grades. PSA testing was offered to 110,000 men aged 50 to 69 years from 2002 to 2009. Participants with an elevated level of PSA (≥3.0 ng/mL) underwent prostate biopsy and measurements of blood serum IGF-I, IGF-II, IGFBP-2, and IGFBP-3 obtained at recruitment. We found that serum levels of IGF-II (OR per SD increase: 1.16; 95% CI: 1.08–1.24; Ptrend &amp;lt; 0.001), IGFBP-2 (1.18; 1.06–1.31; Ptrend &amp;lt; 0.01) and IGFBP-3 (1.27; 1.19–1.36; Ptrend &amp;lt; 0.001), but not IGF-I (0.99; 0.93–1.04; Ptrend = 0.62), were associated with PSA-detected prostate cancer. After controlling for IGFBP-3, IGF-II was no longer associated (0.99; 0.91–1.08; Ptrend = 0.62) and IGF-I was inversely associated (0.85; 0.79–0.91; Ptrend &amp;lt; 0.001) with prostate cancer. In addition, no strong associations existed with cancer stage or grade. Overall, these findings suggest potentially important roles for circulating IGF-II, IGFBP-2, and IGFBP-3 in PSA-detected prostate cancer, in support of recent in vitro evidence. Although our findings for IGF-I agree with previous results from PSA screening trials, they contrast with positive associations in routinely detected disease, suggesting that reducing levels of circulating IGF-I might not prevent the initiation of prostate cancer but might, nonetheless, prevent its progression. Cancer Res; 72(2); 503–15. ©2011 AACR.
Demographic variation in cancer in relation to industrial and environmental influence.
Authors: E J Macdonald
Journal: Environmental Health Perspectives (1976)

Mortality data (183,064 deaths in a 30-year period, 1940-1969) by sex and three ethnic groups (white excluding Spanish-surnamed, nonwhite, and Spanish-surnamed) in 15 regions within the city (Houston), grouped around the air pollution sample collection stations have been analyzed. Valid contrast studies were possible in only one region within the city for all three groups and in six regions for white excluding Spanish-surnamed and nonwhite. There is evidence that the environmental factors of exposure over time to air and industrial pollutants in Houston has had a demonstrable effect in increasing regional mortality from cancer of the respiratory tract as well as from all other diseases and conditions of the respiratory tract and heart disease. This study points out the need for mutually sustained collaboration of effort of the scientific and industrial communities to redirect their attention and research efforts to the exploration of the carcinogenic potential of the microchemical environment.