tbuckley/cabot-search huggingface dataset:
On adjusting measurements of airway responsiveness for lung size and airway caliber.
Authors: J K Peat, C M Salome, W Xuan
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

It has been suggested that during bronchial challenge with a pharmacologic agent, subjects with small lungs receive a proportionally greater dose of agonist than do those with larger lungs. This infers that measurements of airway hyperresponsiveness (AHR) between different age and gender groups may not be comparable. To examine this, we analyzed data from population samples of 1,613 children 7 to 12 yr of age and 1,484 adults 25 to 50 yr of age in whom we measured airway responsiveness by histamine inhalation test. We used FVC as a surrogate measurement for lung size and FEV1/FVC as a surrogate measurement for airway caliber. When AHR was adjusted for FVC, FEV1/FVC, and gender, the differences in prevalence between age groups was reduced. The prevalence of AHR in those between 7 and 9 yr of age decreased from 20.2% (95% CI, 17.7 to 22.7) to 15.7% (95% CI, 13.4 to 18.0), but the prevalence of AHR in those 35 to 44 yr of age remained the same at 7.6% (95% CI, 5.9 to 9.3). We conclude that FVC and FEV1/FVC have a small but significant effect on the measurement of airway responsiveness and that more precise measurements of the prevalence of AHR can be obtained by standardization for these parameters.
Consent for Autopsy
Authors: Neil L. Ghayet
Journal: New England Journal of Medicine (1966)

OBTAINING proper consent for an autopsy poses many problems. Unfortunately, this is an area in which there are many questions, but few clear answers. This column will attempt to set forth prevailing legal principles that offer some guidance for the physician.Certain autopsies may be performed without consent and even in the face of affirmative opposition from the spouse or next of kin. These are cases that are under the jurisdiction of the medical examiner or coroner. Massachusetts law, for example, provides that the medical examiner may perform an autopsy without consent on any person who dies suddenly, is found . . .
Treating the premenstrual syndrome.
Authors: K. Callender, C. S. Thomas
Journal: BMJ (1988)

threat, although a link with the excess or extent of coronary disease is not yet proved.Preliminary age specific results in our current study of the population of north west London show this too clearly.According to tests of glucose tolerance (75 g glucose) and World Health Organisation criteria for the 269 people aged 50-69 years randomly sampled (about 75% of those eligible), over half of the Gujerati community have "ab- normal" glucose tolerance and heart disease is common.This compares with 37% in evenly sampled Afro-Caribbeans and 25% in whites.With other ethnic matters also in the BMJ may I make a further plea for the careful use of descrip- tive terms without subconscious bias?In their letter on psychiatric illness (30 July, p 359) Drs Gabrielle Milner and Gwilym Hayes describe their patients as Afro-Caribbean, Asian, and British.If the term "Asian" is unsatisfactory "British" is unacceptable; all three groups are British - "white" and "of European origin" are appropriate and without other scientifically creditable terms seem the least objectionable.
970 Molecular characterization of hepatitis B virus surface antigen negativity caused by spontaneous loss or antiviral therapy
Authors: H CHANG, K KIM, C CHON, S AHN, J PARK, J KIM, Y MOON, K HAN
Journal: Hepatology (2003)

OBJECTIVES:We aimed to study the relationship between the hepatitis B virus (HBV) genotypes, core promoter/precore stop codon mutations, and histological liver damage among hepatitis B e antigen (HBeAg)-negative patients.METHODS:Liver biopsy specimens of 55 HBeAg-negative chronic HBV-infected patients were studied. A histological activity index was scored for degree of necroinflammation (HAI-NI) and fibrosis (HAI-F) as described by Knodell et al. HBV DNA was determined by a cross-linking assay and polymerase chain reaction (PCR) at the core promoter/precore region and the S region. PCR-positive samples were directly sequenced for core promoter and precore mutations and examined by restriction fragment length polymorphism for genotyping.RESULTS:Forty-one males and 14 females at a median age of 43 were studied. HBV DNA was detectable in 32 (58%) and 37 (67%) patients by the cross-linking assay and PCR, respectively, at the time of liver biopsy. The median (range) HAI-NI and HAI-F scores were 5 (1–10) and 2 (0–4), respectively. HBV DNA detectable by either the cross-linking assay or PCR was associated with a higher HAI-NI score. Eleven and 31 patients had genotypes B and C HBV, respectively. Genotype C HBV was associated with higher HAI-NI than genotype B HBV. Core promoter mutations and precore stop codon mutation were detected in 74% and 40% patients, respectively, but they were not associated with higher HAI-NI or HAI-F scores.CONCLUSIONS:Detectable HBV DNA and genotype C HBV, but not core promoter or precore stop codon mutations, are associated with more severe liver damage in HBeAg-negative patients.
Endogenous prostaglandin endoperoxides and prostacyclin modulate the thrombolytic activity of tissue plasminogen activator. Effects of simultaneous inhibition of thromboxane A2 synthase and blockade of thromboxane A2/prostaglandin H2 receptors in a canine model of coronary thrombosis.
Authors: P Golino, M Rosolowsky, S K Yao, J McNatt, F De Clerck, L M Buja, J T Willerson
Journal: Journal of Clinical Investigation (1990)

We tested the hypothesis that simultaneous inhibition of TxA2 synthase and blockade of TxA2/PHG2 receptors is more effective in enhancing thrombolysis and preventing reocclusion after discontinuation of tissue plasminogen activator (t-PA) than either intervention alone. Coronary thrombosis was induced in 35 dogs by placing a copper coil into the left anterior descending coronary artery. Coronary flow was measured with a Doppler flow probe. 30 min after thrombus formation, the animals received saline (controls, n = 10); SQ 29548 (0.4 mg/kg bolus + 0.4 mg/kg per h infusion), a TxA2/PGH2 receptor antagonist (n = 8); dazoxiben (5 mg/kg bolus + 5 mg/kg per h infusion), a TxA2 synthase inhibitor (n = 9); or R 68070 (5 mg/kg bolus + 5 mg/kg per h infusion), a drug that blocks TxA2/PGH2 receptors and inhibits TxA2 synthase (n = 8). Then, all dogs received heparin (200 U/kg) and a bolus of t-PA (80 micrograms/kg) followed by a continuous infusion (8 micrograms/kg per min) for up to 90 min or until reperfusion was achieved. The time to thrombolysis did not change significantly in SQ 29548-treated dogs as compared with controls (42 +/- 5 vs. 56 +/- 7 min, respectively, P = NS), but it was significantly shortened by R 68070 and dazoxiben (11 +/- 2 and 25 +/- 6 min, respectively, P less than 0.001 vs. controls and SQ 29548-treated dogs). R 68070 administration resulted in a lysis time significantly shorter than that observed in the dazoxiben-treated group (P less than 0.01). Reocclusion was observed in eight of eight control dogs, five of seven SQ 29548-treated dogs, seven of nine dazoxiben-treated dogs, and zero of eight R 68070-treated animals (P less than 0.001). TxB2 and 6-keto-PGF1 alpha, measured in blood samples obtained from the coronary artery distal to the thrombus, were significantly increased at reperfusion and at reocclusion in control animals and in dogs receiving SQ 29548. R 68070 and dazoxiben prevented the increase in plasma TxB2 levels, whereas 6-keto-PGF1 alpha levels were significantly increased with respect to control and SQ 29548-treated dogs. Thus, simultaneous inhibition of TxA2 synthase and blockade of TxA2/PGH2 receptors is more effective than either intervention alone in this experimental model in enhancing thrombolysis and preventing reocclusion after t-PA administration.
Targeting APOC3 in the Familial Chylomicronemia Syndrome
Authors: Daniel Gaudet, Diane Brisson, Karine Tremblay, Veronica J. Alexander, Walter Singleton, Steven G. Hughes, Richard S. Geary, Brenda F. Baker, Mark J. Graham, Rosanne M. Crooke, Joseph L. Witztum
Journal: New England Journal of Medicine (2014)

The familial chylomicronemia syndrome is a genetic disorder characterized by severe hypertriglyceridemia and recurrent pancreatitis due to a deficiency in lipoprotein lipase (LPL). Currently, there are no effective therapies except for extreme restriction in the consumption of dietary fat. Apolipoprotein C-III (APOC3) is known to inhibit LPL, although there is also evidence that APOC3 increases the level of plasma triglycerides through an LPL-independent mechanism. We administered an inhibitor of APOC3 messenger RNA (mRNA), called ISIS 304801, to treat three patients with the familial chylomicronemia syndrome and triglyceride levels ranging from 1406 to 2083 mg per deciliter (15.9 to 23.5 mmol per liter). After 13 weeks of study-drug administration, plasma APOC3 levels were reduced by 71 to 90% and triglyceride levels by 56 to 86%. During the study, all patients had a triglyceride level of less than 500 mg per deciliter (5.7 mmol per liter) with treatment. These data support the role of APOC3 as a key regulator of LPL-independent pathways of triglyceride metabolism.
Effects of pre- and postnatal exposure to chlorinated dioxins and furans on human neonatal thyroid hormone concentrations.
Authors: H J Pluim, J J de Vijlder, K Olie, J H Kok, T Vulsma, D A van Tijn, J W van der Slikke, J G Koppe
Journal: Environmental Health Perspectives (1993)

Animal studies have shown that dioxins influence plasma thyroid hormone concentrations. To investigate the effect of chlorinated dioxins and furans on thyroid hormone concentrations in humans, we studied 38 healthy breast-fed infants. The study population was divided into two groups according to the dioxin concentrations in milk fat of their mothers. Blood samples were taken at birth and at the ages of 1 and 11 weeks. At birth a tendency to higher total thyroxine (tT4) concentrations was found in the high exposure group. At the ages of 1 and 11 weeks the increase of mean tT4 concentrations and tT4/thyroxine-binding globulin ratios in the high exposure group reached significance as compared to the low exposure group. At birth and 1 week after birth, mean thyrotropin (TSH) concentrations were similar in both groups, but at the age of 11 weeks the mean TSH concentrations were significantly higher in the high exposure group. We postulate that the observed plasma tT4 elevation in infants exposed to dioxins before and after birth is the result of an effect on the thyroid hormone regulatory system.
Lipoprotein(a) is an independent risk factor for cardiovascular disease in hemodialysis patients.
Authors: M D Cressman, R J Heyka, E P Paganini, J O'Neil, C I Skibinski, H F Hoff
Journal: Circulation (1992)

BACKGROUND Although serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerosis in the general population and Lp(a) levels are increased in hemodialysis patients, an association of Lp(a) with the risk of clinical events attributed to atherosclerosis has not been established in the chronic hemodialysis patient population. We therefore determined the association between Lp(a) levels and the risk of clinical events of presumed atherosclerotic etiology in a prospective study of an outpatient hemodialysis population. METHODS AND RESULTS Lp(a) was measured by radioimmunoassay in a baseline cardiovascular disease risk assessment in a consecutive series of 129 hemodialysis patients. The relation between baseline Lp(a) and clinical events of presumed atherosclerotic etiology was determined during 48 months of follow-up. Hemodialysis patients had a median Lp(a) concentration that was approximately four times as high as the median Lp(a) concentration in normal controls and twice as high as the levels in controls with angiographic evidence of coronary artery disease [median Lp(a), 38.4 versus 16.9 mg/dl; p less than 0.001]. Baseline Lp(a) levels were no different in participants with or with no history of a previous clinical event at the time of the baseline examination. However, baseline Lp(a) concentration (p less than 0.001) and a history of atherosclerotic clinical events (p = 0.001) were associated with clinical events during the period of follow-up. In contrast, baseline serum total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, age, gender, race, or duration of hemodialysis were unrelated to this risk in the prospective study. Stepwise multiple logistic regression analysis demonstrated that serum Lp(a) concentration (p = 0.001) and the presence of a previous clinical event (p = 0.004) were the only independent contributors to the risk of a clinical event during the period of follow-up. CONCLUSIONS Lp(a) is an independent risk factor for clinical events attributed to atherosclerotic cardiovascular disease in patients receiving chronic hemodialysis treatment of end-stage renal disease.
Doctors should tell patients who is paying them and why
Authors: F. Godlee
Journal: BMJ (2014)

How much should your patients and colleagues know about who is paying you and why? Pretty much everything, argue two articles published this week.

In an open letter to the UK General Medical Council, Margaret McCartney and colleagues say that patients should be able easily to find out what drug companies and others are paying their doctors (doi:10.1136/bmj.g236). At the moment there is no formal mechanism for doing this, despite evidence that such payments influence clinical decisions.

Leana Wen agrees (doi:10.1136/bmj.g167). As a physician in Washington, DC, she has become increasingly troubled by conflicts of interest that are apparent to doctors but hidden from patients. She sees full transparency as part of “a renewed …
Should not be implanted in isolation after infarction
Authors: M. James
Journal: BMJ (2011)

Disappointingly, Liew states that the optimal time to implant a cardioverter defibrillator after acute myocardial infarction remains “unresolved.”1 However, the timing of implantation has become enigmatic because of a too simplistic approach. 

Sudden death remains a large risk soon after infarction, and its causes, not just its symptoms, must be treated early. Sudden cardiac death happens …
Hodgkin's Disease in Patients with Previous Infectious Mononucleosis: 30 Years' Experience
Authors: N. Rosdahl, S. O. Larsen, J. Clemmesen
Journal: BMJ (1974)

Seventeen out of 17,073 people in Denmark who had had a positive reaction to a Paul-Bunnell test between the years 1940 and 1969 developed Hodgkin9s disease after an interval of at least 12 months. This number was significantly (P &lt; 0·0002) greater than the expected number of two women and four men. Sixteen of those developing Hodgkin9s disease were men. Case records, which were available for 12 of them, confirmed that they had had infectious mononucleosis. The number of cases of leukaemia that developed in the sample population was no greater than expected.
Immunocytochemical detection of interleukin 1 within stimulated human monocytes.
Authors: E K Bayne, E A Rupp, G Limjuco, J Chin, J A Schmidt
Journal: The Journal of Experimental Medicine (1986)

We have used synthetic peptides coupled to KLH to raise high titer antisera to human IL-1 beta, and in the present report show the usefulness of these sera for immunocytochemical analyses of IL-1 production. Using indirect immunofluorescence, we have been able to specifically identify IL-1 within human monocytes and to monitor its accumulation with time. After indirect immunofluorescent staining of LPS- and PHA-stimulated mononuclear cell cultures, intense cytoplasmic fluorescence was observed in 93% of the monocytes, but not in lymphocytes or platelets present in the same preparation. Unstimulated monocytes did not contain immunocytochemically detectable IL-1. When put into culture, however, some of the otherwise unstimulated monocytes subsequently showed a transient accumulation of intracellular IL-1. Monocytes cultured in the presence of LPS and PHA exhibited detectable fluorescence after 2.5 h, and the fluorescent intensity of these cells continued to increase over the course of 21 h. Fluorescent staining was abolished by preincubation of the sera with relevant but not irrelevant peptide, and while preimmune or anti-KLH serum produced no staining, antisera against either the amino terminus or an internal region of IL-1 beta produced identical staining patterns. Immunoblot analyses of lysates from stimulated monocytes showed that the antisera against IL-1 recognize a single intracellular species with an apparent molecular weight (33 kD) similar to that predicted for IL-1 precursor from the nucleotide sequence of IL-1 cDNA. The ability to specifically identify and immunocytochemically localize IL-1 within producing cells should prove extremely useful for studying the in situ production of IL-1 in immune-based and inflammatory diseases.
Extracts from Three Lectures on Tubercular Diseases of Bones and Joints
Authors: W. W. Cheyne
Journal: BMJ (1890)

LECTURE I1.-TUBERCULAR CHANGES IN BONB.THE changes which occur in bone as the result of tuber- cular disease are very vari- ous, and to some extent merge into one another.The following are, however, the chief forms:-(1) Miliary tubercu- losis of bone; (2) soft caseating deposits in bone; (3).tubercular deposits with sclerosis of bone and necrosis;; (4) superficial tubercular dis- ease of bone (caries) in con-
THE INCIPIENT PULMONARY PHTHISIS OF SCHOOL CHILDREN
Authors: W. Overend
Journal: BMJ (1914)

I-O A 91A ( IIL'TISIS, 01' SC'1001f CII:1 N. L 'I7;;H1rLJ animial is nowv 4 rears old, it assumlnes tlhe formn of tlle perfect insect, and is capable of reproduiction.The later ntiouilting falls in the sumnler time, and so does, fertilization an(d ovipos'tion.Male cockroaclhes may be distinguislhed fromli thc females by tlhcir well-developed wings and wing covers.They stanid higlher oni their legs than do the female, whose abdomen ofteni trails upon tllh grounid.In spite of the nioxious secretion of their abdominal glands there are creatuLres wlho habitually feed on cockroaclies-ledgellogs, for inistance, are frequently imported into oUtr houses to check these pests.-Rats, cats, polecats, frogs, and wasps lhave been known to eat t-lem, and-some few of the digging -wasps lay theiii downi in their larders for the use of their proogeny.Some birds will also tackle them.But even the mlost devoted friend of the cockroach can find little to say in its favoulr, except that it is currently reported to torm the basis of the flavouring of a very popular sauce, bult even wild cockroaches will not draag from me -which p)articular sauce that is.
PROGRESS OF BREAST FEEDING IN NEW YORK STATE
Authors: FRANK HOWARD RICHARDSON
Journal: JAMA (1927)

Any one who has followed medical literature in general, and pediatric literature in particular, for the last two decades, must have been impressed with the steadily increasing place occupied by breast feeding in the minds of the profession. Even though much of this enlarging volume of medical attention has been concerned with public health measures rather than with private practice, still there has been a steadily increasing tendency on the part of students of infant health and nutrition to concern themselves with some of the multifarious problems connected with the natural feeding of children, as compared with an earlier (and still altogether too prevalent) tendency to experiment with artificial methods of nourishing babies. And whereas Sedgwick has secured for Minnesota the honor of being the state where this renascence of interest had its origin, through his Minneapolis demonstration of the universal applicability of breast feeding, it has remained for New
Apolipoprotein E Genotype, Cortisol, and Cognitive Function in Community-Dwelling Older Adults
Authors: Brian K. Lee, Thomas A. Glass, Gary S. Wand, Matthew J. McAtee, Karen Bandeen-Roche, Karen I. Bolla, Brian S. Schwartz
Journal: American Journal of Psychiatry (2008)

Elevated cortisol indicates stress and may be a risk factor for cognitive decline in aging. Genetic factors may influence individual vulnerability to the adverse effects of stress on cognitive function in aging.The authors investigated whether the gene-environment interaction between the genotype for the apolipoprotein E gene (APOE) and cortisol predicted cognitive performance in older urban adults. Cross-sectional data were analyzed from a population-based sample of 50-70-year-old men and women. Cognitive performance, salivary cortisol levels, and APOE genotype were assessed in 962 subjects. Scores on 20 standard cognitive tests were combined into seven domain scores (language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, visual memory and learning, visuoconstruction).In adjusted models, while a higher cortisol level was associated with worse cognitive scores, the slopes of the adverse relations were steeper in persons with at least one APOE-epsilon4 allele. Effect sizes were large: for example, the effect of having one epsilon4 allele plus a cortisol area under the curve greater than the 75th percentile was equivalent to a decrease in language score expected from an age increase of 8.0 years (95% confidence interval=1.7-14.4), while having two epsilon4 alleles and a cortisol area under the curve greater than the 75th percentile was equivalent to an age increase of 33.4 years (95% CI=14.8-52.0).These data suggest that APOE genotype modifies cortisol's relations with cognitive functioning and that the epsilon4 allele increases vulnerability of the aging brain to adverse effects of stress.
An Evaluation of a Plastic Strip Thermometer
Authors: Eugene M. Lewit
Journal: JAMA (1982)

The Clinitemp® Fever Detector (a registered trademark of the Clinitemp Co, Indianapolis) is a plastic strip thermometer designed to be placed on the forehead and to detect body temperature by changing color. In a sample of 613 patients, we evaluated the ability of the Clinitemp to detect fevers detected by traditional mercury/glass thermometers. When a Clinitemp reading of 37.8 °C (100 °F) was used to demark fever, the Clinitemp detected 34% of the clinically significant fevers detected by the mercury/glass thermometers. The sensitivity of the Clinitemp rose to.81 when a Clinitemp reading of 37.2 °C (99 °F) was used to demark fever. The accuracy of the Clinitemp was affected by variations in ambient air temperature. A reassessment of previously published evaluations of plastic strip thermometers suggests that our results are consistent with other experimental findings. We conclude that the Clinitemp is unacceptable as a substitute for the mercury/glass thermometer. (<i>JAMA</i>1982;247:321-325)