tbuckley/cabot-search huggingface dataset:
REST—A NEGLECTED FACTOR IN THE TREATMENT OF GASTRO-INTESTINAL DISORDER.
Authors: C. D. SPIVAK
Journal: JAMA (1898)

It is not within the province of my paper to enter into the discussion of the subject of rest from a physiologic standpoint. The question of rest is only being at present approached by the physiologists of the day through the study of muscle and nerve irritability, waste and repair, sleep and the still less explored domain of "fatigue." Not until sufficient experimental data will have been accumulated will we be in a position to form a rational physiologic theory of rest. I will use the word "rest" in its most comprehensive sense—the antithesis of action. Life is action, but action is made possible by the period of rest during which the spent energies are renovated. All our organs manifest periods of action and repose alternately; some are absolutely rhythmic, as the circulation of blood; others are only intermittent, as the secretions and excretions. The organs of vegetative life are
Toward a model of the legal doctrine of informed consent
Authors: Alan Meisel, Loren H. Roth, Charles W. Lidz
Journal: American Journal of Psychiatry (1977)

The authors draw together the disparate scholarly and judicial commentaries on consent to medical treatment to develop a model of the components in the decision-making process regarding consent to or refusal of psychiatric treatment. The components consist of the precondition of voluntariness, the provision of information, the patient's competency and understanding, and, finally, consent or refusal. They offer two models of valid consent: the objective model, which focuses on the congruence or lack of it between the patient and a "reasonable" person, and the subjective model, which focuses entirely on the patient's actual understanding.
Antiviral drug resistance
Authors: D. Pillay, M. Zambon
Journal: BMJ (1998)

The development of effective antiviral drugs is an important biomedical scientific achievement of the late 20th century. Highly potent drugs are now available against herpes viruses, HIV, hepatitis B virus, and influenza virus. This list will extend to papillomaviruses, respiratory viruses, enteroviruses, and hepatitis C virus over the next 5-10 years. Viruses that maintain latency (the herpes viruses) or persistence (HIV and hepatitis B virus) are not specifically cleared from the body by these drugs, but their replication can be effectively suppressed. Currently, 18 specific antiviral drugs (excluding interferons) are licensed in the United Kingdom, with many more in phase 3 clinical trials or available on expanded access. For the common viral infections, prescribing will shift into primary care, as has already occurred for shingles and herpes simplex infections.

Against this exciting background comes the news of drug resistance. Virally encoded drug resistance has been documented against nearly all compounds with antiviral activity, and the genetic basis of resistance is now known.

#### Summary points

Resistance has developed to nearly all specific and effective antiviral agents

Resistance has developed to all drugs against HIV, and treating hepatitis B with nucleoside analogue monotherapy gives rise to drug resistant variants

Resistance develops rapidly when viral replication is not maximally suppressed

Drug resistant viruses may be transmitted

Assays to measure drug resistance are available in specialised laboratories

Drug resistance is defined as a reduced susceptibility to a drug in a laboratory culture system and is expressed as an altered IC50 or IC90 (drug concentration required to inhibit viral growth by 50% or 90% respectively). This is termed the phenotype. This phenotype is determined by specific mutations in the viral genome (the genotype), which leads to alterations in the viral target protein (for example, HIV reverse transcriptase) or the viral drug activator (for example, herpes …
Long-term survival after resection of carcinoma of the oesophagus.
Authors: R H Franklin
Journal: BMJ (1978)

Our observation of an ac-cell response to arginine stimulation comparable with that seen in idiopathic diabetes agrees with the observations of Passa et a14 and contrasts with the impaired responses found in patients with transfusional haemosiderosis, suggesting that factors other than iron deposition play a part in the genesis of diabetes associated with IH.In IH, however, there may possibly be a selective destruction of the 5-cell, the high plasma glucagon values thus merely reflecting insulin lack, and it is of interest that McGavran et al,5 in necropsy studies, observed more iron in the n-cells than in the ax-cells.This predisposition of the p-cell .oriron deposition was, how- ever, also noted in transfusional haemosiderosis.Clearly further histological studies using modern techniques are indicated.Hepatic cirrhosis (proved in nine of our cases) may contribute to the diabetes associated with IH, but is unlikely to be the cause of the high glucagon concentrations, since liver function values were abnormal in only two of our cases and there was no evidence of portocaval shunting.These findings add to the accumulating evidence that diabetes in patients with IH is not due solely to islet cell damage by iron.' 2 4 Several factors, including hepatic cirrhosis, genetic influences, or iron deposition, might play a part.Each of these may operate to varying degrees in individual cases.
Interleukin 1 alpha and beta production by cells isolated from membranes around aseptically loose total joint replacements.
Authors: C I Westacott, G Taylor, R Atkins, C Elson
Journal: Annals of the Rheumatic Diseases (1992)

Background: The Cancer and Leukemia Group B (CALGB) 9343 trial demonstrated that adjuvant radiation therapy (RT) can be omitted in women 70 years or older, with small (≤2 cm), negative lymph nodes, estrogen receptor (ER)-positive breast cancer. We examined whether RT usage following the CALGB publication had decreased over time and evaluated sociodemographic and clinical factors associated with RT omission. Materials and Methods: From the National Cancer Data Base, we analyzed a cohort of 120,308 women aged 70 years or older with stage I, ER-positive breast cancer who underwent lumpectomy. Patients were classified into two groups based on the time of CALGB 9343 publication: (i) pre-CALGB (up to 2004), and (ii) post-CALGB (2005-2012). Clinicopathological and sociodemographic variables were compared between pre- and post-CALGB groups. Chi-square and multivariable logistic regression were employed, with the omission of adjuvant RT as the primary outcome in the regression analysis. Results: Radiation therapy usage decreased by 4.1% after CALGB publication (on average 71.6% pre-CALGB vs. 67.5% post-CALGB; p&lt;0.0001). Almost one-third of women aged ≥85 years received RT in the post-CALGB group. In a multivariable model, the variables significantly associated with increased odds for omission of RT in the post-CALGB group were: advanced age, African-American, increased great circle distance, therapy under academic research program, residents of East South-Central region, living in a rural population &lt;2,500 not adjacent to a metropolitan area, low income level, Medicaid recipients, high comorbidity index, small tumor, well-differentiated histology, residual tumor, and lack of receipt of chemotherapy and anti-hormonal therapy. Conclusion: During the study period, the CALGB trial publication had a minimal impact on the rate of adjuvant RT use among elderly women with small, ER-positive breast cancers. Significant variation in RT usage existed across sociodemographic strata.
High doses of deferiprone may be associated with cerebellar syndrome
Authors: F Beau-Salinas, M A Guitteny, J Donadieu, A P Jonville-Bera, E Autret-Leca
Journal: BMJ (2009)

We report two cases of cerebellar syndrome after treatment with deferiprone, a metal chelator used to treat iron overload in thalassaemia major.

Case 1 —A 9 year old boy was treated for two years with 119 mg/kg/day deferiprone, but this dose was not sufficiently effective (increased ferritin and hepatic cytolysis were noted) and was increased to 238 mg/kg/day. Sixteen months later, the patient developed cerebellar syndrome (dizziness, axial hypotonia, nystagmus, diplopia) and obsessive compulsive disorder. Magnetic resonance imaging, electroencephalogram, and …
A CASE OF PULMONARY ASBESTOSIS
Authors: H. E. Seiler, M. D. Gilmour
Journal: BMJ (1931)

The question -of treatment is outside the scope ofthe present-paper, and would take up too much space.The essential point is to recognize -the ankylopoietic form as early as possible and to deal with any focus of infection, to take steps to prevent the development of kyphosis, ankylosis of the hips, etc.,-by rest, supports, or by other methods, and to pay special attention to the defective calcium metabolism by correcting vitamin deficiency and other disorders of nutrition.Freund recommends treat- ment at a spa, preferring Gastein, a spa of a type well represented in this country.
Abstract 1448: Interaction between decorin and E-cadherin/beta-catenin signaling attenuates colorectal cancer growth and metastasis in vitro and in decorin knockout mice
Authors: Xiuli Bi, George R. Yang, Yuan Gou, Nicole Pohl, Grace Guzman, Andre Kajdacsy-Balla, Renato V. Iozzo, Wancai Yang
Journal: Cancer Research (2011)

Abstract Decorin is a small leucine-rich proteoglycan. Previous studies have demonstrated that decorin expression is significantly reduced in colorectal cancer tissues and cancer cells, and genetic deletion of the decorin gene caused intestinal tumor formation in mice, which was linked to a downregulation of p21, p27kip1 and E-cadherin and an upregulation of β-catenin signaling. However, the regulation of E-cadherin by decorin and its implication in cancer formation and metastasis is largely unknown. Using manipulated colorectal cancer cells and decorin knockout mouse model (Dcn-/- mice), we found that increasing decorin expression in colorectal cancer cells delayed cancer cell growth, accelerated apoptosis, and importantly, attenuated cancer cell migration, invasion and wound healing. Mechanistic study revealed that the attenuation of cancer cell malignancy was resulted from the interaction between decorin and E-cadherin, a protein that regulates cell-cell adhesion, epithelial-mesenchymal transition and metastasis. First, overexpression of decorin led to upregulation of E-cadherin through increasing of E-cadherin protein stability, while E-cadherin mRNA and promoter activity were not affected; Second, co-immunoprecipitation assay showed that decorin physically bound E-cadherin. In addition, the upregulation of E-cadherin was associated with reduction of β-catenin, c-myc and CDK4. cDNA microarray analysis also showed that the levels of two proteins involved in metastasis were altered, the extracellular proteinase inhibitor (EXPI) was significantly downregulated and Claudin 2 was upregulated in intestinal epithelial cells of the Dcn-/- mice. Moreover, loss of decorin accelerated murine cancer cell MC38 growth and invasion in the flank of Dcn-/- mice. Taken together, our results provide direct evidence that decorin-mediated inhibition of colorectal cancer formation and metastasis is through the interaction between decorin and E-cadherin/beta-catenin signaling. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1448. doi:10.1158/1538-7445.AM2011-1448
Lipid screening: is it enough to measure total cholesterol concentration?
Authors: H A Neil, D Mant, L Jones, B Morgan, J I Mann
Journal: BMJ (1990)

To determine whether measurement of total cholesterol concentration is sufficient to identify most patients at lipoprotein mediated risk of coronary heart disease without measurement of triglyceride and high density lipoprotein (HDL) cholesterol concentrations.Cross sectional screening programme.Six general practices in Oxfordshire.1901 Men and 2068 women aged 25-59.Cardiovascular risk as assessed by fasting venous plasma concentrations of total cholesterol, triglyceride, and HDL cholesterol.2931 Patients (74% of those screened) had a total cholesterol concentration of less than 6.5 mmol/l. If the triglyceride concentration had not been measured in these patients isolated hypertriglyceridaemia (greater than or equal to 2.3 mmol/l) would have remained undetected in 185. Among these 185 patients, however, 123 were overweight or obese and only 18 (0.6% of those screened) had an increased risk associated with both a raised triglyceride concentration (greater than or equal to 2.3 mmol/l) and a low HDL cholesterol concentration (less than 0.9 mmol/l). Conversely, in the 790 patients with predominant hypercholesterolaemia (cholesterol concentration greater than or equal to 6.5 mmol/l and triglyceride concentration less than 2.3 mmol/l) measurement of HDL cholesterol concentration showed that 348 (9% of those screened) had only a moderately increased risk with a ratio of total to HDL cholesterol of less than 4.5 and 104 had a low risk with a ratio of less than 3.5.Fasting triglyceride and HDL cholesterol concentrations identify few patients at increased risk of coronary heart disease if the total cholesterol concentration is less than 6.5 mmol/l. HDL cholesterol and triglyceride concentrations should, however, be measured in patients with a total cholesterol concentration exceeding this value. Total cholesterol concentration alone may overestimate risk in a considerable number of these patients, and measurement of HDL cholesterol concentration allows a more precise estimate of risk. Measurement of the triglyceride concentration is required to characterise the lipoprotein abnormality. A patient should not be started on a drug that lowers lipid concentrations without having had a full lipoprotein assessment including measurement of HDL cholesterol concentration.
Toll-like receptor-3 and the regulation of intrahepatic immunity: Implications for interferon-alpha therapy
Authors: Patrick Bertolino, Lauren E. Holz, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2006)

The liver is known to be a classical immunoprivileged site with a relatively high resistance against immune responses. Here we demonstrate that highly activated liver-specific effector CD8+ T cells alone were not sufficient to trigger immune destruction of the liver in mice. Only additional innate immune signals orchestrated by TLR3 provoked liver damage. While TLR3 activation did not directly alter liver-specific CD8+ T cell function, it induced IFN-alpha and TNF-alpha release. These cytokines generated expression of the chemokine CXCL9 in the liver, thereby enhancing CD8+ T cell infiltration and liver disease in mice. Thus, nonspecific activation of innate immunity can drastically enhance susceptibility to immune destruction of a solid organ.
Maternal Pulmonary Embolism by Amniotic Fluid
Authors: G. Kenneth Mallory, Nelson Blackburn, H. Judd Sparling, Donald A. Nickerson
Journal: New England Journal of Medicine (1950)

MATERNAL pulmonary embolism by amniotic fluid was first described by Steiner and Lushbaugh1 in 1941. The authors based this study on 8 cases in human beings and successfully produced the picture by intravenous inoculation of amniotic fluid and meconium into dogs and rabbits. In the following year they2 presented 2 additional cases. Since then other studies3 4 5 6 have brought the total number of cases reported up to the time of this writing to 17.It is our purpose to present 3 additional cases of this unusual complication of pregnancy to emphasize the characteristic symptomatology and pathology. To the best of our knowledge, . . .
Intrapleural Tetracycline for Spontaneous Pneumothorax
Authors: Robert C. Goldszer
Journal: JAMA (1979)

SPONTANEOUS pneumothorax may be treated by observation, needle aspiration, intercostal drainage, chemical pleurodesis, and surgical pleurodesis. Persistent air leak (longer than five to seven days) or recurrent pneumothoraxes are considered indications for thoracotomy and surgical repair, with or without pleurodesis. The risk of surgical treatment increases with increasing age and the presence of underlying disease. In this group, chemical pleurodesis may avoid the risk of surgery. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 57-year-old man was admitted with increasing dyspnea and pleuritic pain for two days. The past medical history and a review of systems were unremarkable. He smoked two packs of cigarettes per day for the past ten years. Physical examination findings showed the patient to be in mild respiratory distress. The respiratory rate was 22/min, the blood pressure (BP) was 130/80 mm Hg, the heart rate was 86 beats per minute, and the temperature was 37 °C. There was
Diabetes and the State Capital
Authors: Mark J. Nicolich
Journal: Diabetes Care (2002)

In a recent letter in Diabetes Care , Lockwood (1) pointed out that there was a strong correlation ( r = 0.54, P = 0.000057) between the statewide self-reported diabetes prevalence in 2000 and the total statewide air toxic release inventory (TRI) in 1999 for the 50 states and Washington, D.C. He pointed out that “\[although\] \[…\] the correlation between air emissions and the prevalence of diabetes does not prove a cause-and-effect relationship, the significance of the relationship demands attention.”

I agree that the correlation does not prove …
Plasma cholesterol concentration and primary brain tumours.
Authors: G. D. Smith, M. J. Shipley
Journal: BMJ (1989)

Change in physical dependence, change in residence, strain on caregiver, and life satisfaction in elderly women with femoral fractures Treatment group ControlsKatz index of independence in the activities of daily living: Before fracture v at discharge from orthopaedic inpatient care* {Better or no change 156 y2 (with continuity correction)=3-88, df= 1, p=0-048 fWorse 34 43 Before fracture v 1 year after fracturet JBetter or no change 21 7 x2 (with continuity correction)=5 78, df= 1, p=0016 Worse 22 28 Residence: Before fracture v at discharge from orthopaedic inpatient care JBetter or no change 4026 X2(with continuity correction)=8 49, df= 1, p=0-004 iWorse 9 24 Before fracture v 1 year after fracture JBetter or no change 38 21 y2 (with continuity correction)=6-65, df= 1, p=0 010 |Worse 6 15Caregiver strain index2 1 year after fracture (n= 30; no family carer= 50) Median 1 1Wilcoxon rank sum test (correction for tied ranks) T=206 5, p=0-83 tRange 0-11 0-9 Life satisfaction index' 1 year after fracture (n=65; not testablet= 15) JMedian 17 18 Wilcoxon rank sum test (correction for tied ranks) T=976, p=0-85 [Range 6-22 6-21 *N=98; data missing= 1. tN=78; data missing 2.
Men in White
Authors: Howard Markel
Journal: JAMA (2009)

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Fat Cell α<sub>2</sub>-Adrenoceptors: The Regulation of Fat CellFunction and Lipolysis*
Authors: MAX LAFONTAN, MICHEL BERLAN
Journal: Endocrine Reviews (1995)

THE fat cell is the functional entity of white adipose tissue and brown adipose tissue. Briefly, white adipose tissue is the main long-term energy store, whereas brown adipose tissue is the major site of compensatory thermogenesis for maintaining body temperature while also contributing to energy dissipation. The fat cell is of key significance to the physiologist investigating the mechanisms controlling lipid storage, lipid mobilization, and utilization as well as other specific functions of the adipose tissue. It also enables the pharmacologist to study the cellular signaling of the autonomic nervous system and to understand the impact of the physiological amines on cell function. Over the 10 last years, there has been a rapid accumulation of experimental data demonstrating the existence of multiple adrenoceptor subtypes (e.g. nine different subtypes) (1, 2). The control of fat cell function by the catecholamines involves at least five different adrenoceptor subtypes; three β- (e.g. β1-, β2-, and β3-), one α2-, and one α1B-adrenoceptors. The adrenergic receptors that activate adenylylcyclase (three j3-adrenoceptors) coexist on the same fat cell as those that inhibit (one α2-adrenoceptor) the plasma membrane enzyme. All of them share the same physiological agonists (norepinephrine and epinephrine) delivered at highly variable concentrations depending on the level of activation of the sympathetic nervous system (SNS). The functional importance of these receptors varies according to the species, the sex and the age of the animals, and the nature of the fat deposits. It is also highly variable within an individual tissue deposit, adapting to the physiological and/or pathological situations encountered.
AN X-RAY TUBE WITH ADJUSTABLE FOCUS.
Authors: R. V. WAGNER
Journal: JAMA (1904)

If one examines the outline of a shadow from a light emanating from a large area—e. g., a gaslight—it will be seen to compare favorably with the outlines on a fluoroscope or on a picture, when the<i>x</i>-ray is used from a tube having the anode out of focus. On the other hand, the outlines of a shadow emanating from a small area—e. g., an are lamp—resemble the outlines on a fluoroscope or on a picture, when an<i>x</i>-ray tube having a sharply focused anode is used ( Figs. 1 and 2 ). The<i>x</i>-ray emanates from the molecular bombardment of the rarefied air in the tube on the surface of the anode. The structures of rarefied air are repelled from the concave disc or cathode forming the cathode rays or stream. This cathode stream striking the surface of the anode or disc in the center of the tube
THE USE OF CATHARTICS
Authors: E. O. Harrold
Journal: JAMA (1927)

<h3>To the Editor:</h3> —I appeal to the fountainhead of medical knowledge for information on a subject of greatest personal and community importance. Shall I take a physic? And shall I give a physic to practically all my patients? I have not taken a physic for more than fifteen years and am in perfect health. My intestinal exit operates as faithfully as the inlet, with an almost unvarying ratio of one to three. Traffic occasionally slows up a bit and as a consequence terminal unloading facilities may be put to some test, but this is never extreme and there have been no failures nor needed repairs. Once in a long time I have a cold but in no instance has a cold ever slowed up deliveries. Years ago I always took a physic for my colds, which always did two ugly things to me: They always gave me a bellyache and