tbuckley/cabot-search huggingface dataset:
A STUDY OF HYPOTENSION
Authors: STEWART R. ROBERTS
Journal: JAMA (1922)

Hypotension is one of the indefinite problems of medicine. Few articles have been written on the subject, compared to the large number on hypertension. The studies thus far have been far more pharmacologic, experimental and surgical than clinical, and directly related to internal medicine. This is shown by the researches of Crile,<sup>1</sup>Cannon<sup>2</sup>and Rich,<sup>3</sup>as compared with the paucity of researches by internists. Huchard and Mougeot,<sup>4</sup>Grasset and Calmette,<sup>5</sup>Muenzer,<sup>6</sup>Knapp,<sup>7</sup>Martinet<sup>8</sup>and Reynaud,<sup>9</sup>in Europe, and Piersol,<sup>10</sup>Emerson,<sup>11</sup>Lawrence,<sup>12</sup>McCrae<sup>13</sup>and Goodman,<sup>14</sup>in America, have discussed the subject from various points of view. Faught<sup>15</sup>says that "unfortunately the literature almost entirely lacks exhaustive studies of low blood systolic pressures," and Goepp<sup>16</sup>says that "a little attention has been given to the subject, at least in its relation to chronic disease." Sir Clifford
The Family of Protein Kinase C for Signal Transduction
Authors: Yasutomi Nishizuka
Journal: JAMA (1989)

Protein kinase C, an enzyme that is activated by diacylglycerol resulting from the receptor-mediated hydrolysis of inositol phospholipids, relays information of a variety of extracellular signals across the cell membrane to regulate many intracellular processes. Since this enzyme also serves as a major receptor for phorbol esters, a class of tumor promoters, it has attracted great attention from biologists interested in the mechanism of signal transduction and carcinogenesis. Recent analysis has revealed that protein kinase C is a large family of proteins, with the multiple subspecies that possess subtle individual enzymological characteristics. Biochemical and immunohistochemical studies indicate that the protein kinase C subspecies may be differently distributed in particular cell types and with limited intracellular locations. Presumably, each member of the family plays discrete roles in the processing of various physiological and pathological responses to external signals, such as in the modulation of membrane functions and the activation of gene transcription.
Questions of Priority
Authors: Thomas H. Weller
Journal: New England Journal of Medicine (1963)

IN the course of our sessions on the clinical aspects of parasitic infections we had an opportunity to touch on the humbling complexities posed by the health problems of human populations at various levels of social development. We indicated that an understanding of disease in the patient and of the control of disease in population groups required an appreciation of the ecology of man in its broadest sense. Being deliberately provocative, we referred to the parochial nature of a pattern of medical education that pays little attention to problems of health at the community or national level and tends to . . .
UK should spend more on research into Alzheimer's disease
Authors: Andrew Cole
Journal: BMJ (2005)

The UK government must invest more in research and treatment of brain disorders to avoid building up problems for the future, a major public consultation on contemporary science concludes.

The recommendation comes from the British arm of the “meeting of minds” project, funded by the European Commission, in which a group of 126 citizens from nine countries has been meeting over the last 18 months to consider the implications of developments in brain science.

“Over the next decade we are very likely to see unparalleled changes to what we can …
Role of Endogenous Serotonin in Modulating Genioglossus Muscle Activity in Awake and Sleeping Rats
Authors: Sandeep Sood, Janna L. Morrison, Hattie Liu, Richard L. Horner
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Exogenous serotonin at the hypoglossal motor nucleus (HMN) stimulates genioglossus (GG) muscle activity. However, whether endogenous serotonin contributes to GG activation across natural sleep-wake states has not been determined, but is relevant given that serotonergic neurons have decreased activity in sleep and project to pharyngeal motoneurons.To determine the role of endogenous serotonin at the HMN in modulating GG activity across natural sleep-wake states.Ten rats were implanted with electroencephalogram and neck muscle electrodes to record sleep-wake states, and GG and diaphragm wires for respiratory muscle recordings. Microdialysis probes were implanted into the HMN for perfusion of artificial cerebrospinal fluid and the serotonin receptor antagonist mianserin (100 microM).In room air, there was no effect of mianserin on respiratory-related or tonic GG activities across sleep-wake states (p > 0.300). In hypercapnia, however, the normal declines in GG activity from non-REM to REM sleep, and wakefulness to REM sleep, were reduced with mianserin (p < 0.005). These data demonstrate a normally low endogenous serotonergic drive modulating GG activity unless augmented by reflex inputs. We also demonstrated a significant serotonergic drive modulating GG activity in vagotomized rats, but not in vagi-intact rats, under anesthesia, suggesting that previous results in reduced preparations may have been influenced by vagotomy.The results show a minimal endogenous serotonergic drive at the HMN modulating GG activity across sleep-wake states, unless augmented by reflex inputs. This result has implications for pharmacologic strategies aiming to increase GG activity by manipulating endogenous serotonin in patients with obstructive sleep apnea.
James Jackson, Jr. (1810-1834): A Great Student of Medicine
Authors: WILLIAM B. SPAULDING
Journal: Annals of Internal Medicine (1973)

The life of this New England medical student of a century and a half ago (1810-1834) is reconstructed chiefly from the writings of his father, the second Hersey Professor of Medicine at Harvard, and of contemporaries, particularly his classmate Oliver Wendell Holmes. After a first-class American medical education he went to Paris to become the favorite pupil of P. C. A. Louis. He wrote a monograph on cholera and, as an original member of the Paris Society of Medical Observation, described a physical sign useful in the diagnosis of pulmonary tuberculosis. While abroad he met Thomas Hodgkin, Astley Cooper, and other "greats." In addition to providing information about medical education and medical science in the early nineteenth century, his letters and other contemporary documents reflect his qualities, which are those that remain perennially desirable in medical students and physicians: warmth, an insatiable desire to learn, and productive scientific curiosity.
Penicilloyl-Polylysine Skin-Test Reactions
Authors: John J. Condemi
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The sensitivity would have been established by scratch tests without the danger of systemic reaction. Subsequent to the initial systemic reaction, the patient was given small doses of penicillin G. These doses were sufficient to immunize the individual, and one would have predicted a rise in antibody titer had this been obtained. The second skin test at a concentration nine times the strength of the initial test, would, therefore, have been expected to give the reaction obtained. In addition to the above precautions, one should be additionally cautious on repeated skin tests. I have had the opportunity on several occasions to skin test individuals to both penicillin and insulin to find that initial skin tests were negative, but one month later the patient had significant positive intradermal reactions. In these situations the amount of antigen injected was sufficient to stimulate antibody production. Skin-test reactivity decreases following an
The Beginnings of the Growth and Development of an Adolescent Unit in the Cassel Hospital
Authors: Doreen Martin
Journal: Psychotherapy and Psychosomatics (1965)

Research Articles| February 11 2010 The Beginnings of the Growth and Development of an Adolescent Unit in the Cassel Hospital Subject Area: Psychiatry and Psychology Doreen Martin Doreen Martin The Cassel Hospital, Ham Common, Richmond, Surrey Search for other works by this author on: This Site PubMed Google Scholar Psychother Psychosom (1965) 13 (4): 309–313. https://doi.org/10.1159/000285790 Article history Published Online: February 11 2010 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Doreen Martin; The Beginnings of the Growth and Development of an Adolescent Unit in the Cassel Hospital. Psychother Psychosom 1 April 1965; 13 (4): 309–313. https://doi.org/10.1159/000285790 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsPsychotherapy and Psychosomatics Search Advanced Search This content is only available via PDF. 1965Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Article PDF first page preview Close Modal You do not currently have access to this content.
Cardiac Resynchronization Therapy in Patients With Heart Failure and a QRS Complex &lt;120 Milliseconds
Authors: Bernard Thibault, François Harel, Anique Ducharme, Michel White, Kenneth A. Ellenbogen, Nancy Frasure-Smith, Denis Roy, François Philippon, Paul Dorian, Mario Talajic, Marc Dubuc, Peter G. Guerra, Laurent Macle, Léna Rivard, Jason Andrade, Paul Khairy
Journal: Circulation (2013)

Background— Although the benefits of cardiac resynchronization therapy are well established in selected patients with heart failure and a prolonged QRS duration, salutary effects in patients with narrow QRS complexes remain to be demonstrated. Methods and Results— The Evaluation of Resynchronization Therapy for Heart Failure (LESSER-EARTH) trial is a randomized, double-blind, 12-center study that was designed to compare the effects of active and inactive cardiac resynchronization therapy in patients with severe left ventricular dysfunction and a QRS duration &lt;120 milliseconds. The trial was interrupted prematurely by the Data Safety and Monitoring Board because of futility and safety concerns after 85 patients were randomized. Changes in exercise duration after 12 months were no different in patients with and without active cardiac resynchronization therapy (−0.7 minutes [95% confidence interval (CI), −2.9 to 1.5] versus 0.8 minutes [95% CI, −1.2 to 2.9]; P =0.31]. Similarly, no significant differences were observed in left ventricular end-systolic volumes (−6.4 mL [95% CI, −18.8 to 5.9] versus 3.1 mL [95% CI, −9.2 to 15.5]; P =0.28) and ejection fraction (3.3% [95% CI, 0.7–6.0] versus 2.1% [95% CI, −0.5 to 4.8]; P =0.52). Moreover, cardiac resynchronization therapy was associated with a significant reduction in the 6-minute walk distance (−11.3 m [95% CI, −31.7 to 9.7] versus 25.3 m [95% CI, 6.1–44.5]; P =0.01), an increase in QRS duration (40.2 milliseconds [95% CI, 34.2–46.2] versus 3.4 milliseconds [95% CI, 0.6–6.2]; P &lt;0.0001), and a nonsignificant trend toward an increase in heart failure–related hospitalizations (15 hospitalizations in 5 patients versus 4 hospitalizations in 4 patients). Conclusions— In patients with a left ventricular ejection fraction ≤35%, symptoms of heart failure, and a QRS duration &lt;120 milliseconds, cardiac resynchronization therapy did not improve clinical outcomes or left ventricular remodeling and was associated with potential harm. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT00900549.
Too Much Therapy: A Philosophic Issue
Authors: David Daughton
Journal: JAMA (1983)

To the Editor.—  At times, the practice of medicine seems to be guided by a   is better treatment mentality. The rationale for this mentality is simple. If research has indicated that a given  may be of some therapeutic benefit, then why not add it to the patient's total medical program? Thus, the medical regimen for a patient with chronic bronchitis who has hypoxemia and cor pulmonale has evolved to such an extent that a not-too-hypothetical  program might include one or more pulmonary or cardiac medications, aerosol therapy, an oral expectorant agent, oxygen therapy (which may require different settings for sleep, rest, and exercise), postural drainage, chest vibration or percussion, vaccination for pneumococcal pneumonia and influenza, prophylactic use of antibiotics, low-salt diet, recommendations to stop smoking as well as initiate and maintain a general physical conditioning program, and, in some cases, antianxiety or antidepressant medications. The number
Vitamin B12 uptake by intestinal microorganisms: mechanism and relevance to syndromes of intestinal bacterial overgrowth
Authors: R. A. Giannella, S. A. Broitman, N. Zamcheck
Journal: Journal of Clinical Investigation (1971)

The mechanism of bacterial uptake of vitamin B(12), the spectrum of microorganisms capable of such uptake, and the factors involved were the subject of this study. Bacterial uptake of vitamin B(12) was found to be at least a two stage process. A primary uptake phase which was rapid (1 min or less), pH dependent, nontemperature dependent, did not require viable organisms and was insensitive to either the metabolic inhibitor dinitrophenol or to the sulfhydryl inhibitor N-ethyl-maleimide. Protein denaturation (formalin treatment or autoclaving) abolished all B(12) uptake. This primary uptake phase is thought to represent adsorption to binding or "receptor" sites on the cell wall. Second stage uptake was slower, pH and temperature dependent, required living bacteria, and was abolished by either dinitrophenol or N-ethyl-maleimide. This phase is dependent upon metabolic processes and may reflect transfer of B(12) from surface "receptor" sites into the bacterial cell. Although differences among organisms were observed in total 1 hr uptake, number of surface "receptor" sites, and relative avidities for B(12), all organisms except Streptococcus fecalis shared the two stage mechanism. Two Gram-positive organisms. Bacillus subtilis and Group A streptococcus, demonstrated the highest 1 hr vitamin B(12) uptake values; Gram-negative bacteria required 2,000-10,000 the number of organisms for comparable uptake. Binding constants (K(m)) varied from 5.05 +/-1.67 x 10(-10)M for B. subtilis to 6.18 +/-3.08 x 10(-9)M for Klebsiella pneumoniae which approximate the Km for human intrinsic factor (0.38 x 10(-10)M). Competition between bacteria and intrinsic factor for vitamin B(12) may be inferred from the similarity of these constants. These observations suggest that a variety of enteric and nonenteric organisms, not requiring exogenous B(12), may play a role in the pathogenesis of the vitamin B(12) malabsorption found in the intestinal bacterial overgrowth syndromes.
The Perils of Drowsy Driving
Authors: William C. Dement
Journal: New England Journal of Medicine (1997)

The problem of drowsiness in commercial truck drivers has received considerable attention. Many people believe that drowsy truckers are only the most obvious example of sleep-deprived workers in all forms of transportation and in many different jobs. In this issue of the Journal, Mitler et al.1 report the results of recording electroencephalograms and videotaping 80 long-haul truckers continuously while they drove. The study provides convincing evidence that the drivers obtained less sleep than was required for alertness on the job. Total daily sleep was objectively measured, allowing the authors to attribute the drowsiness mainly to the subnormal amount of sleep . . .
Cigarette Smoking, Serum Estrogens, and Bone Loss during Hormone-Replacement Therapy Early after Menopause
Authors: Jytte Jensen, Claus Christiansen, Paul Rødbro
Journal: New England Journal of Medicine (1985)

To elucidate the effect of smoking on estrogen metabolism, we examined 136 postmenopausal women treated for one year with one of three different doses of combined estrogen—progestogen or placebo. The women were grouped according to smoking status, and serum levels of estrone and estradiol were measured before and after treatment. The results showed reduced levels of both estrogens in smokers as compared with nonsmokers in all three dosage groups. This reduction was most pronounced in the high-dose group (4 mg of estradiol), in which the serum levels of estrone and estradiol in smokers were only 50 per cent of those in nonsmokers (P<0.001 and <0.05, respectively). In contrast, no significant changes could be demonstrated in the corresponding placebo groups. Moreover, it was possible to demonstrate significant inverse correlations between the number of cigarettes smoked daily and the changes in the levels of serum estrone and estradiol, respectively, (P<0.001). This study suggests that an increased hepatic metabolism of estrogens results in lower estrogen levels among postmenopausal smokers. This may contribute to the reported risk of osteoporosis among smokers. (N Engl J Med 1985; 313:973–5.)
Rapid cryoglobulin screening: an aid to the clinician.
Authors: A E Kalovidouris, R L Johnson
Journal: Annals of the Rheumatic Diseases (1978)

A rapid screening method for serum cryoblobulin is reported. It requires only common laboratory equipment and is based upon the detection of light scattering (500 millimicron) in the early phase of cryoaggregation. All of 28 sera negative for cryoglobulins by the conventional 5-day incubation method were negative by the screening method. Conversely, all sera containing 60 microgram/ml or more of mixed cryoglobulins were positive by the screening method. The initiation phase of cryoprecipitation in mixed cryoglobulins was found to be prompt, as reported previously for monoclonal cryoglobulins. This sensitive method of cryoglobulin detection provides results to the clinician within 2 hours, a helpful insight where consideration of possible immune complex vasculitis exists.
Visits to VA Clinics
Authors: Joseph H. McNinch
Journal: JAMA (1965)

<h3>To the Editor:—</h3> I have read the annual report in the Oct 26, 1964, issue ofThe Journal(<b>190</b>:355), in which the patient load of the Veterans Administration is discussed. This report permits the inference that a large growth occurred at VA clinics through provision of additional services. I wish to bring to your attention the fact that the sharp rise in the number of visits at VA clinics is almost entirely due to a change in the reporting system. On July 1, 1962, the VA redefined its outpatient program to include certain services which had theretofore been identified as inpatient. This definitional change, which is generally in line with hospital practice, included the admitting and follow-up functions as outpatient services. There has been no change in our policy concerning hometown care. The distribution of treatments between private physicians and VA clinics remains essentially constant.
Do we need an Ofhealth?
Authors: C. Propper
Journal: BMJ (1995)

The internal market was introduced into the NHS to improve patient care by freeing relationships between purchasers and providers. As markets in gas, water, and telephone services have been liberalised, regulatory bodies have been set up to promote competition and limit the behaviour of monopoly suppliers. Does the internal market need an Ofhealth, along the line of Ofgas (the Office of Gas Supply), Ofwat, and Oftel?

To get the benefits of a market there must be scope for comparison and choice between providers and for comparison between purchasers. But several features of the current internal market limit choice and comparison. For example, hospitals are likely to be monopoly suppliers of some of their services. Information on the quality of services may be poor. To enable suppliers to make decisions on investment they need longer term contracts, but these bring the danger of exploitation by one or other party to the contract.

Under current arrangements, purchasers do not directly compete with each other, which is not necessarily a bad thing—competition for patients among purchasers can be accompanied by selection of patients. But if purchasers don't have to worry about losing patients if the services they purchase for them are poor then limited incentive exists for purchasers to be very responsive to the populations on whose behalf they …
Dilated Azygos Vein Simulating a Mediastinal Tumor
Authors: Melchor H. Magbitang, Franklyn C. Hayford, James M. Blake
Journal: New England Journal of Medicine (1960)

CASES reported in the literature have included dilatation of the azygos vein simulating a mediastinal tumor from various causes such as right-sided heart failure, obstruction of the superior and inferior vena cava and portal-vein hypertension.1 2 3 4 It therefore seems appropriate to present a case of dilatation of the azygos vein to such a size as to suggest strongly a mediastinal tumor requiring surgery.Case ReportMrs. P.C., a 35-year-old woman, was admitted to Glenridge Hospital on June 1, 1959, with the complaint of mid-lumbar back pain radiating bilaterally to both flanks and anteriorly toward the mid-line since the previous December. The . . .