tbuckley/cabot-search huggingface dataset:
Quantitation of globin chains using cellulose acetate electrophoresis: Analysis of fetal globin chain production
Authors: Jennifer Barton, Merran B. Smith, M. N. Cauchi
Journal: American Journal of Hematology (1978)

A technique involving the quantitative estimation of globin chains using cellulose acetate electrophoresis is described, and applied to the analysis of fetal globin chain production. When cord blood was analyzed, there was poor correlation between the globin chain ratios namely beta/alpha, gamma/alpha and beta/gamma ratios with either age or weight of newborn babies between 36-40 weeks gestation: best correlations were obtained for the beta/gamma ratio against weight (P less than 0.05). However, there was highly significant correlation between the various globin chain ratios and either age or weight of the newborn infant up to 12 weeks of age (P less than 0.001). This technique allows visual demonstration and quantitation of abnormal haemoglobins in a single procedure.
USE OF PROCAINE IN PAINFUL ARTICULAR CONDITIONS
Authors: J. C. Weisman
Journal: JAMA (1934)

To the Editor.—  In reply to Dr. Ralph R. Fitch's communication (The Journal, January 13, p. 148), I would say that he seemed a bit hasty and unfair in his condemnation of the Paris correspondent's report of the use of procaine in certain painful articular conditions (The Journal, Nov. 4, 1933, p. 1492). I can understand his objection to permitting patients with severe sprains and luxations to use the part immediately, but the correspondent apparently referred to mild sprains and luxations in which the patient is grateful for relief locally. It appears to me a superior method of pain relief to the use of narcotics in cases in which the latter would be indicated.  As to the use of this method in selected cases of long standing painful mono-arthritic conditions, I have two grateful patients on whom this mode of treatment was tried. I am not referring to cases of
How much do doctors know about consent and capacity?
Authors: E. Jackson, J. Warner
Journal: Journal of the Royal Society of Medicine (2002)

To assess knowledge of capacity issues across different medical specialties we conducted a cross-sectional survey with a structured questionnaire at academic meetings, lectures and conferences. Of 190 individuals who received the questionnaire 129 (68%) responded-35 general practitioners, 31 psychiatrists, 29 old-age physicians [corrected] and 34 final year medical students. Correct answers on capacity to consent to or refuse medical treatment were given by 58% of the psychiatrists, 34% of the geriatricians, 20% of the general practitioners and 15% of the students. 15% of all respondents wrongly believed that a competent adult could lawfully be treated against his or her will, with no obvious differences by specialty. As judged by this survey, issues of capacity and consent deserve more attention in both undergraduate and postgraduate medical education.
Intravenous beta agonist in severe acute asthma.
Authors: B. Cheong, S. R. Reynolds, G. Rajan, M. J. Ward
Journal: BMJ (1988)

STUDY OBJECTIVE--To determine whether salbutamol is more effective in treating severe asthma when given intravenously or by inhalation. DESIGN--Randomised trial of short term response to intravenous versus nebulised salbutamol in acute severe asthma. SETTING--District general hospital (secondary care centre). PARTICIPANTS--76 patients aged 16-70 admitted to hospital with acute severe asthma (peak expiratory flow rate less than 50% of predicted) during study period. Five withdrawn because of adverse effects of treatment or non-response. Of remaining 71, 34 allocated to nebuliser group and 37 to intravenous treatment group. Patients with history of cardiovascular disease or recent corticosteroid or intravenous bronchodilator treatment excluded. Admission characteristics similar in the two groups. INTERVENTIONS--All patients given 5 mg nebulised salbutamol on admission before randomisation plus 200 mg hydrocortisone bolus intravenously and 35% inspired oxygen throughout. Nebuliser group received two more 5 mg doses of nebuliser salbutamol at 30 minutes and 2 hours; intravenous group received 4 hours9 continuous salbutamol infusion (12 micrograms/min) starting at 30 minutes plus supplementary intravenous potassium chloride. No other bronchodilators used. ENDPOINT--Change in peak expiratory flow rate over 4 hours. MEASUREMENTS and MAIN RESULTS--Peak expiratory flow rate improved more in intravenous group (25.2%) than in nebuliser group (14.3%) (p less than 0.01, 95% confidence interval 2.4 to 19.1%). Tachycardia caused two withdrawals from intravenous group; non-response caused three withdrawals from nebuliser group. CONCLUSIONS--Intravenous salbutamol is more effective than nebulised salbutamol in acute severe asthma but may have unacceptable cardiovascular effects.
The History and Role of Accrediting in Higher Education
Authors: William K. Selden
Journal: JAMA (1962)

THE EDUCATION NUMBER ofThe Journal of the American Medical Association dated Nov. 11, 1961, contains a short historical section which has particular relevance to the subject of this afternoon's discussions. Even though most of you are familiar with its contents I wish to quote from this report because of the dramatic way in which medical education exemplifies the history of higher education in the United States.  The report states:  It is eminently clear that this history (of medical education) cannot be ignored for most of it is of a nature that would be disastrous to repeat.... During the course of the nation's history, 444 medical schools were organized and of these only 86 or 20% are in existence today. Up to the end of the last century, 357 schools had been organized and 165 of them were in operation as the century came to a close. Our system of
Changes in diastolic properties of the regional myocardium during pacing-induced ischemia in human subjects
Authors: Shigetake Sasayama, Hiroshi Nonogi, Shunichi Miyazaki, Tsunetaro Sakurai, Chuichi Kawai, Shigeru Eiho, Michiyoshi Kuwahara
Journal: Journal of the American College of Cardiology (1985)
Abstract 2321: Rapid induction of apoptosis by PI3K inhibitors is dependent upon their transient inhibition of RAS signaling.
Authors: Marie Will, Weiyi Toy, Zhan Yao, Poulikos Poulikakos, Vanessa Rodrik-Outmezguine, Claudia Schneider, Juliane Paul, Jose Baselga, Ningshu Liu, Neal Rosen, Sarat Chandarlapaty
Journal: Cancer Research (2013)

Abstract Hyperactivation of the PI3K/AKT/mTOR pathway in tumors causes feedback inhibition throughout the signaling network, including inhibition of receptor tyrosine kinase (RTK) expression and function. Exposure of these tumors to mTOR or AKT inhibitors relieves this feedback and reactivates RTK signaling. RTK reactivation promotes PI3K activity and attenuates the antitumor effects of the drugs. We have now characterized the details of PI3K-induced feedback using a selective class 1 PI3K inhibitor and compared its effects with those elicited by a selective allosteric inhibitor of AKT. In breast cancer cell lines with dysregulation of PI3K signaling, both drugs cause marked inhibition of AKT phosphorylation and relief of feedback inhibition of HER3, IGF1, and insulin RTKs. Whereas both inhibitors cause tumor cells to undergo growth arrest, only the PI3K inhibitor causes a rapid induction of apoptosis within 2 hours of drug addition. As opposed to the PI3K inhibitor, the AKT inhibitor induces PI3K activity and a set of substrates that are inhibited by the PI3K inhibitor. We therefore sought to identify processes that are selectively inhibited by the PI3K inhibitor to explain its selective induction of apoptosis. AKT inhibition causes the induction of ERK phosphorylation in these cells. In contrast, we found that PI3K inhibition causes rapid inhibition of RAS-GTP levels, RAF activation and ERK phosphorylation in tumor cells with wild type RAS, but not those with mutant RAS. Inhibition of RAS is transient, recovering 2-3 hours after drug addition. We determined that adding MEK inhibitors to AKT inhibitors is similarly associated with a rapid induction of apoptosis within 2 hours. Moreover, addition of EGF to tumor cells co-treated with PI3K inhibitors prevents ERK inhibition and apoptosis, whereas addition of MEK inhibitors to the PI3K inhibitor, EGF treated cells restores the apoptotic phenotype. We conclude that PI3K is upstream of both RAS and AKT in RAS wild type tumors. Inhibitors of PI3K cause sustained inhibition of AKT and transient inhibition of RAS with both effects required for rapid induction of apoptosis. These data suggest that pulsatile inhibition of PI3K may maximize the therapeutic efficacy of this approach. Citation Format: Marie Will, Weiyi Toy, Zhan Yao, Poulikos Poulikakos, Vanessa Rodrik-Outmezguine, Claudia Schneider, Juliane Paul, Jose Baselga, Ningshu Liu, Neal Rosen, Sarat Chandarlapaty. Rapid induction of apoptosis by PI3K inhibitors is dependent upon their transient inhibition of RAS signaling. [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 2321. doi:10.1158/1538-7445.AM2013-2321
Xeroderma pigmentosum group C in a French Caucasian patient with multiple melanoma and unusual long-term survival
Authors: S. Jacobelli, N. Soufir, J.J. Lacapere, S. Regnier, A. Bourillon, B. Grandchamp, G. Hétet, D. Pham, A. Palangie, M.F. Avril, N. Dupin, A. Sarasin, I. Gorin
Journal: British Journal of Dermatology (2008)

We report the case of an 83-year-old French woman with multiple melanomas showing a severe DNA repair deficiency, corrected after transfection by XPC cDNA. Two biallelic mutations in the XPC gene are reported: an inactivating frameshift mutation in exon 15 (c.2544delG, p.W848X) and a missense mutation in exon 11 (c.2108 C>T, P703L). We demonstrate that these new mutations are involved in the DNA repair deficiency and confirm the diagnosis of xeroderma pigmentosum from complementation group C (XP-C). We speculate that the coexistence of a MC1R variant may be involved in the phenotype of multiple melanomas and that the unusual long-term survival may be related to a lower ultraviolet radiation exposure and to a regular clinical follow-up. This patient appears to be the first French Caucasian XP-C case and one of the oldest living patients with XP reported worldwide.
Hepatitis-B surface antigen and cirrhosis in Iraq.
Authors: E H Boxall, T H Flewett, A Paton, S W Rassam
Journal: Gut (1976)

Hepatitis-B surface antigen was found in 58% of 64 patients with cirrhosis in Iraq using counter immunoelectrophoresis (CIE), radioimmunoassay (RIA), and three commercial haemagglutination tests--Auscell (Abbott Laboratories), Hepatest (Wellcome Reagents Ltd.), and Hepanosticon (Organon Teknika). CIE detected about half as many positives as the other methods; RIA was the most sensitive. The number of positive reactions was much higher than in any previously reported series of patients with cirrhosis and seven times higher than in a normal hospital control population.
Tedizolid Phosphate vs Linezolid for Treatment of Acute Bacterial Skin and Skin Structure Infections
Authors: Philippe Prokocimer, Carisa De Anda, Edward Fang, Purvi Mehra, Anita Das
Journal: JAMA (2013)

Acute bacterial skin and skin structure infections (ABSSSIs), including cellulitis or erysipelas, major cutaneous abscesses, and wound infections, can be life-threatening and may require surgery and hospitalization. Increasingly, ABSSSIs are associated with drug-resistant pathogens, and many antimicrobial agents have adverse effects restricting their use. Tedizolid phosphate is a novel oxazolidinone in development for the treatment of ABSSSIs.To establish the noninferiority of tedizolid phosphate vs linezolid in treating ABSSSIs and compare the safety of the 2 agents.The Efficacy and Safety of 6-day Oral Tedizolid in Acute Bacterial Skin and Skin Structure Infections vs 10-day Oral Linezolid Therapy (ESTABLISH-1) was a phase 3, randomized, double-blind, noninferiority trial that was conducted from August 2010 through September 2011 at 81 study centers in North America, Latin America, and Europe. The intent-to-treat analysis set consisted of data from 667 adults aged 18 years or older with ABSSSIs treated with tedizolid phosphate (n = 332) or linezolid (n = 335).A 200 mg once daily dose of oral tedizolid phosphate for 6 days or 600 mg of oral linezolid every 12 hours for 10 days.The primary efficacy outcome was early clinical response at the 48- to 72-hour assessment (no increase in lesion surface area from baseline and oral temperature of ≤37.6°C, confirmed by a second temperature measurement within 24 hours). A 10% noninferiority margin was predefined.In the intent-to-treat analysis set, the early clinical treatment response rates were 79.5% (95% CI, 74.8% to 83.7%) of 332 patients in the tedizolid phosphate group and 79.4% (95% CI, 74.7% to 83.6%) of 335 patients in the linezolid group (a treatment difference of 0.1% [95% CI, -6.1% to 6.2%]). The sustained clinical treatment response rates at the end of treatment (day 11) were 69.3% (95% CI, 64.0% to 74.2%) in the tedizolid phosphate group and 71.9% (95% CI, 66.8% to 76.7%) in the linezolid group (a treatment difference of -2.6% [95% CI, -9.6% to 4.2%]). Results of investigator-assessed clinical treatment success rates at a posttherapy evaluation visit (1-2 weeks after the end-of-treatment visit) were 85.5% (95% CI, 81.3% to 89.1%) in the tedizolid phosphate group and 86.0% (95% CI, 81.8% to 89.5%) in the linezolid group (a treatment difference of -0.5% [95% CI, -5.8% to 4.9%), and were similar for 178 patients with methicillin-resistant Staphylococcus aureus isolated from the primary lesion.Tedizolid phosphate was a statistically noninferior treatment to linezolid in early clinical response at 48 to 72 hours after initiating therapy for an ABSSSI. Tedizolid phosphate may be a reasonable alternative to linezolid for treating ABSSSI.clinicaltrials.gov Identifier: NCT01170221.
THE EFFECT OF TETRAETHYLAMMONIUM ON THE SMALL BOWEL OF MAN
Authors: William P. Chapman, John B. Stanbury, Chester M. Jones, Audrey Y. Dennison
Journal: Journal of Clinical Investigation (1948)

Present evidence indicates that tetraethylammonium ion blocks autonomic effector systems at their ganglia.Injection of the drug prevents the passage through the superior cervical ganglion of nerve impulses to the nictitating membrane of the cat (1).Similarly, there occurs inhibition of the effect on the decentralized heart of preganglionic stimulation of either vagal cardio-inhibitory fibers or of the cardio-accellerators (2).The sharp fall in arterial blood pressure accompanying intra- venous injection results from ganglionic blockade of the sympathetic vasoconstrictor nerves (2).The action of tetraethylammonium has been ex- tensively studied in man by Lyons and his as- sociates (3 to 5).After single intravenous injec- tion of 200 to 300 mgm. of the chloride salt there is a fall in blood pressure and a rise in heart rate.These values have usually returned to normal in 10 to 15 minutes after injection.There is an ac- companying sensation of tingling and warmth of the face and extremities and sometimes drowsiness and momentary paralysis of accommodation.
PUBLIC HEALTH PROBLEMS IN SYPHILIS CONTROL
Authors: Theodore J. Bauer
Journal: JAMA (1953)

Several factors affect the incidence of syphilis. The number of infectious cases in the population, sexual promiscuity, the high rate of communicability and mass shifts in population, such as those caused by mobilization, militate towards its increase. Conversely intensive casefinding, including contact investigation, public education and mass testing, diagnosis and treatment, prophylaxis, and other preventive measures, militates towards its reduction.  Chart 1 shows the rapid decline of early syphilis in the United States since 1947. The decline in the estimated annual minimum incidence of syphilis derives mainly from more than a decade of intensive effort to find and treat persons with the early stages of the disease. They are not easy to find. Over the years a method of early case finding known as contact investigation has been developed and refined. Early syphilis patients are interviewed to obtain names, addresses, and other identifying data of all their sexual partners. Skilled
Four Untoward Reactions to Sodium Dehydrocholate, Including 2 Fatal Cases
Authors: Guillermo C. Sanchez, Leslie E. Morris
Journal: New England Journal of Medicine (1954)

THE use of sodium dehydrocholate (Decholin) in the measurement of the circulation time was first advocated in 1931 by Winternitz, Deutsch and Brüll.1 They described their results in 700 determinations of the circulation time in 300 patients, the majority of whom had received this preparation. No undesirable side effects were reported.In 1933 Tarr et al.2 and Gargill3 also presented favorable reports of their experience with Decholin in estimating the circulation time, and again no untoward reactions were recorded. Sodium dehydrocholate has since gained widespread acceptance because of its simplicity of application, sharp end point and apparent safety. Hitzig,4 in . . .
Effect of Body Build on the QRS Voltage of the Electrocardiogram in Normal Men
Authors: STANLEY E. KILTY, EUGENE LEPESCHKIN
Journal: Circulation (1965)

Various sets of QRS voltages that are used in the diagnosis of left ventricular hypertrophy were determined from the electrocardiograms of 300 normal men judged to be free from cardiopulmonary disease, and these were correlated to body build expressed in terms of ponderal index. A correlation was found for all voltages studied and a highly significant correlation was found for the criteria "R I + S III " "greatest R + greatest S in the precordial leads" and "greatest R + S in a single precordial lead." Age or activity did not appear to be specific factors in the population studied. Graphs were constructed for the latter three sets of voltages defining upper limits of normal for various values of the ponderal index. By using these sets of voltage criteria in conjunction with this index, one would hopefully improve both accuracy and specificity in the electrocardiographic diagnosis of early left ventricular hypertrophy.
Safe handling of radio-isotopes.
Authors: H E Farran
Journal: Annals of the Rheumatic Diseases (1973)

Stabilization exercises have been a focus and mainstay of many therapeutic and performance training programs in the past decade. Whether the focus is core stabilization for the spine or scapular stabilization, clinicians and trainers alike have endorsed these programs, largely on the basis of conceptual theory and anecdotal experience. The notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted, but is it accurate? The aim of this perspective article is to challenge the concept of scapular stabilization through the application of biomechanical and motor control constructs. The objectives are to critically examine current beliefs about scapular stabilization, to discuss definitions of stabilization and stability in the context of the scapulothoracic region, and to evaluate key evidence regarding scapular stabilization and scapular dyskinesia. Several new approaches that may affect the understanding of normal and atypical scapula motion are explored. Finally, a historical analogy is presented and future research and clinical directions are suggested. The aims are to lead readers to the essential concepts implied on scapular stabilization, to increase the critical thought process in rehabilitation practice, and to suggest some open topics to be explored in future research.
Effectiveness of Home Blood Pressure Monitoring, Web Communication, and Pharmacist Care on Hypertension Control
Authors: Beverly B. Green, Andrea J. Cook, James D. Ralston, Paul A. Fishman, Sheryl L. Catz, James Carlson, David Carrell, Lynda Tyll, Eric B. Larson, Robert S. Thompson
Journal: JAMA (2008)

<h3>Context</h3>Treating hypertension decreases mortality and disability from cardiovascular disease, but most hypertension remains inadequately controlled.<h3>Objective</h3>To determine if a new model of care that uses patient Web services, home blood pressure (BP) monitoring, and pharmacist-assisted care improves BP control.<h3>Design, Setting, and Participants</h3>A 3-group randomized controlled trial, the Electronic Communications and Home Blood Pressure Monitoring study was based on the Chronic Care Model. The trial was conducted at an integrated group practice in Washington state, enrolling 778 participants aged 25 to 75 years with uncontrolled essential hypertension and Internet access. Care was delivered over a secure patient Web site from June 2005 to December 2007.<h3>Interventions</h3>Participants were randomly assigned to usual care, home BP monitoring and secure patient Web site training only, or home BP monitoring and secure patient Web site training plus pharmacist care management delivered through Web communications.<h3>Main Outcome Measures</h3>Percentage of patients with controlled BP (&lt;140/90 mm Hg) and changes in systolic and diastolic BP at 12 months.<h3>Results</h3>Of 778 patients, 730 (94%) completed the 1-year follow-up visit. Patients assigned to the home BP monitoring and Web training only group had a nonsignificant increase in the percentage of patients with controlled BP (&lt;140/90 mm Hg) compared with usual care (36% [95% confidence interval {CI}, 30%-42%] vs 31% [95% CI, 25%-37%]; P = .21). Adding Web-based pharmacist care to home BP monitoring and Web training significantly increased the percentage of patients with controlled BP (56%; 95% CI, 49%-62%) compared with usual care (P &lt; .001) and home BP monitoring and Web training only (P &lt; .001). Systolic BP was decreased stepwise from usual care to home BP monitoring and Web training only to home BP monitoring and Web training plus pharmacist care. Diastolic BP was decreased only in the pharmacist care group compared with both the usual care and home BP monitoring and Web training only groups. Compared with usual care, the patients who had baseline systolic BP of 160 mm Hg or higher and received home BP monitoring and Web training plus pharmacist care had a greater net reduction in systolic BP (−13.2 mm Hg [95% CI, −19.2 to −7.1]; P &lt; .001) and diastolic BP (−4.6 mm Hg [95% CI, −8.0 to −1.2]; P &lt; .001), and improved BP control (relative risk, 3.32 [95% CI, 1.86 to 5.94]; P&lt;.001).<h3>Conclusion</h3>Pharmacist care management delivered through secure patient Web communications improved BP control in patients with hypertension.<h3>Trial Registration</h3>clinicaltrials.gov Identifier: NCT00158639
Varicella Vaccine, Cost-effectiveness Analyses, and Vaccination Policy
Authors: Matthew M. Davis
Journal: JAMA (2005)

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