tbuckley/cabot-search huggingface dataset:
Muscle Metaboreflex Contribution to Sinus Node Regulation During Static Exercise
Authors: Ferdinando Iellamo, Paolo Pizzinelli, Michele Massaro, Gianfranco Raimondi, Giuseppe Peruzzi, Jacopo Maria Legramante
Journal: Circulation (1999)

It is currently assumed that during static exercise, central command increases heart rate (HR) through a decrease in parasympathetic activity, whereas the muscle metaboreflex raises blood pressure (BP) only through an increase in sympathetic outflow to blood vessels, because when the metaboreflex activation is maintained during postexercise muscle ischemia, BP remains elevated while HR recovers. We tested the hypotheses that the muscle metaboreflex contributes to HR regulation during static exercise via sympathetic activation and that the arterial baroreflex is involved in the HR recovery of postexercise muscle ischemia.Eleven healthy male volunteers performed 4-minute static leg extension (SLE) at 30% of maximal voluntary contraction, followed by 4-minute arrested leg circulation (ALC). Autonomic regulation of HR was investigated by spectral analysis of HR variability (HRV), and baroreflex control of heart period was assessed by the spontaneous baroreflex method. SLE resulted in a significant increase in the low-frequency component of HRV that remained elevated during ALC. The normalized high-frequency component of HRV was reduced during SLE and returned to control levels during ALC. Baroreflex sensitivity was significantly reduced during SLE and returned to control levels during ALC when BP was kept elevated above the resting level while HR recovered.The muscle metaboreflex contributes to HR regulation during static exercise via a sympathetic activation. The bradycardia that occurs during postexercise muscle ischemia despite the maintained sympathetic stimulus may be explained by a baroreflex-mediated increase in parasympathetic outflow to the sinoatrial node that overpowers the metaboreflex-induced cardiac sympathetic activation.
Sizing up sialic acid in glomerular disease
Authors: Susan E. Quaggin
Journal: Journal of Clinical Investigation (2007)

A new study by Galeano and colleagues in this issue of the JCI reports the first glomerular disease caused by a genetic defect in sialic acid biosynthesis (see the related article beginning on page 1585). Mice that harbor mutations in the Gne/Mnk gene produce lower amounts of sialic acid, suffer from hematuria, proteinuria, and structural defects in the glomerulus and die within days after birth. Remarkably, the lesion can be reversed through dietary addition of N-acetylmannosamine, a sialic acid precursor, raising the intriguing possibility that this approach might have therapeutic benefit in patients with glomerular disease.
Sex-Related Trends in Mortality in Hospitalized Men and Women After Myocardial Infarction Between 1985 and 2008
Authors: Sjoerd T. Nauta, Jaap W. Deckers, Ron T. van Domburg, K. Martijn Akkerhuis
Journal: Circulation (2012)

We aimed to study sex-related differences in temporal trends in short- and long-term mortality from 1985 to 2008 in patients hospitalized for acute myocardial infarction.We included a total of 14 434 consecutive patients admitted to our intensive coronary care unit between 1985 and 2008 for myocardial infarction. A total of 4028 patients (28%) were women. Women were more likely to present with a higher risk profile and were equally likely to receive pharmacological and invasive reperfusion therapy compared with men. Women had a higher unadjusted mortality rate at 30 days (odds ratio, 1.3; 95% confidence interval, 1.1-1.5) and during 20 years (hazard ratio, 1.1; 95% confidence interval, 1.0-1.2) of follow-up. After adjustment for baseline characteristics, 30-day mortality was equal (adjusted odds ratio, 1.0; 95% confidence interval, 0.85-1.2) but the hazard for 20-year mortality was lower (adjusted hazard ratio, 0.77; 95% confidence interval, 0.66-0.90) in women compared to men. For 30-day mortality, there was no significant interaction between sex and age, diagnosis, or diabetes mellitus. Survival improved between 1985 and 2008. Temporal mortality reductions between 1985 and 2008 were at least as high in women as in men with myocardial infarction for both 30-day mortality and long-term mortality hazard.The fact that adjusted mortality rates for men and women treated for myocardial infarction in an intensive coronary care unit were similar and declined markedly over a 24-year period suggests that both sexes benefit from the evidence-based therapies that have been developed and implemented during this time period.
Drug Company Sponsorship of Education: The Response to the FDA Draft Concept Paper
Authors: Eliot J. Lazar
Journal: JAMA (1992)

To the Editor.  —The recent US Food and Drug Administration (FDA) initiative in the area of industry support of scientific and educational activities led to the release of a draft concept paper (DCP) in late October 1991. 1-3 The stated objective of this initiative was to define more clearly a category of drug company—supported scientific and educational  that is not subject to the rules governing advertising and labeling. This clarification is deemed essential so as not to chill industry support of nonpromotional, educational, and scientific programs. Food and Drug Administration officials have stated that the agency's policy is to avoid undue intrusion into continuing medical education and scientific exchange.  The DCP describes this category as independent scientific and educational activity and identifies four criteria: independence, objectivity, balance, and scientific rigor, which distinguish it from promotional activity. A number of specific factors are listed for each criterion, which would serve
Industry association suspends drug company for entertaining doctors
Authors: Michael Day
Journal: BMJ (2006)

One of the world's biggest drug companies has been suspended from its UK trade organisation after two of its employees went with a doctor to a lap dancing club and for providing other extensive hospitality.

Abbott Laboratories has admitted providing senior hospital consultants with tickets to the Wimbledon tennis tournament and trips to greyhound racing. As a result the Association of the British Pharmaceutical Industry has decided to suspend the company's membership for a minimum of six months—the severest penalty handed out by the organisation in 10 years.

In its ruling on 10 …
Early Detection of Prostate Cancer by Routine Screening
Authors: Gerald W. Chodak
Journal: JAMA (1984)

In an attempt to detect prostate cancer when the disease was still localized, a free screening clinic was established for men over the age of 45 years. Digital rectal examinations were performed for 811 men. Prostate biopsy was recommended to 43 in whom abnormalities were found by digital rectal examination; only 38 complied. Prostate cancer was detected in 11 men. The patients with cancer ranged in age from 60 to 79 years, with the highest incidence of cancer in the group aged 70 to 79 years. The overall incidence in men between 51 and 80 years old was 1.7%. Staging evaluation revealed that none of the patients with prostate cancer had metastases to the bone or elevated serum acid phosphatase levels. Five men (45%) were found by clinical or pathological methods to have stage B disease. Two others (18%) showed radiographic evidence of lymph node metastases (stage D1). The cost of detecting each cancerous prostate tumor was approximately +6,300. Routine screening can be a cost-effective method for diagnosing prostate cancer in patients with less extensive disease. The ability of early detection to prolong survival of patients with this disease will require further investigation.
Causes of Dark Urine
Authors: Walter W. Noll
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Riyad Said, MD (242:748, 1979), concluded that the tea-colored urine passed by a 7-year-old girl a few hours after an appendectomy was discolored by povidoneiodine used as a preoperative skin cleanser. Although he demonstrated that povidone-iodine added to urine is capable of producing a false-positive test for occult blood, that this, in fact, was the cause in the patient he describes was not proved, nor was myoglobinuria excluded. The postoperative serum creatine kinase level of 1,840 IU/L found in the case Said reported is much higher than one would expect from operative trauma alone. Rather, this level suggests diffuse muscle injury, capable of producing myoglobinuria, possibly caused by an anesthetic agent or muscle relaxant used during surgery. Asymptomatic myoglobinemia-myoglobinuria following succinylcholine use is not uncommon, especially in young children.<sup>1</sup>
Drugs in the Institutionalized Elderly-Reply
Authors: Jerry Avorn
Journal: JAMA (1989)

<h3>In Reply.—</h3> We agree with Dr Loebel that the presence or absence of a given diagnosis recorded in a patient's nursing home record cannot be regarded as a "gold standard" of appropriate drug therapy. Indeed, as he points out, many of these medications were probably being used to treat specific behaviors (such as wandering or a reluctance to go to bed on time) rather than to treat a specific psychiatric syndrome. Concern about overuse of psychoactive drugs in this population comes not from the lack of correlation between medications and diagnoses, but rather from the sheer level of use of such agents in a nonpsychiatric population. (Because of the unreliability of nursing home diagnoses, this correlation was not part of our original article, but was added at the request of the editors.) The dearth of articles describing medication use in long-term care facilities during the last 10 years indicated to
Deposition of Inhaled Pollen and Pollen Extract in Human Airways
Authors: Archie F. Wilson, Harold S. Novey, Raymond A. Berke, Edgar L. Surprenant
Journal: New England Journal of Medicine (1973)

IT is generally assumed that airborne grass-pollen grains are directly inhaled into the lungs and thereby lead to the development of the signs and symptoms of asthma in susceptible persons. This seemingly reasonable assumption, however, is confounded by aerodynamic calculations indicating that airborne particles of that size (20 to 30 μ in diameter) should not penetrate very deeply into the respiratory system.1 In addition, since aerodynamic calculations are basically statistical descriptions, there is some uncertainty about possible deep penetration of occasional pollen grains into the lung, with subsequent symptom production. Because of the importance of this problem and the availability . . .
Routine Prenatal Genetic Screening
Authors: Sherman Elias, George J. Annas
Journal: New England Journal of Medicine (1987)

Standards of medical practice have traditionally been set by physicians on the basis of their best judgment of what constitutes good patient care. This tradition is in danger. The structure of medical practice — factors such as cost containment, the profit motive, government regulations, fear of medical-malpractice suits, media hype, and risk-management schemes — may influence actual practice more than professional standards. Whether a prenatal screening test is offered may depend as much on the patient's health insurance and the physician's perception of possible legal liability as on the physician's view of the patient's welfare.There is widespread ethical, legal, . . .
Antigranulocyte Antibody Bone Marrow Scans in Cancer Patients With Metastatic Bone Superscan Appearance
Authors: LLUIS BERN??, GUSTAVO TORRES, IGNASI CARRI??, MONTSERRAT ESTORCH, JOSEP RAM??N GERM??, CARMEN ALONSO
Journal: Clinical Nuclear Medicine (1994)

In clinical practice, it may be difficult to distinguish a metastatic bone superscan appearance from a normal bone scan. To determine if assessment of bone marrow is helpful in the diagnosis of bone invasion in patients with suspected bone superscans, the authors performed antigranulocyte antibody bone marrow scans in 10 consecutive cancer patients who had a conventional bone scan interpreted as metastatic superscan appearance. All patients presented with bone marrow scans showing marked absence of tracer uptake in the central skeleton suggesting tumour replacement. Laboratory tests showed decreased peripheral blood cells in 9 patients. Bone radiographs showed metastatic involvement with diffuse osteoblastic lesions in 9 patients. Antigranulocyte bone marrow scans show extensive bone marrow invasion in cancer patients with suspected bone superscans. This result reinforces the concept of these patients having extensive bone invasion despite mild abnormalities in the bone scan. Confirmation of extensive bone invasion on patients with suspected bone superscans may contribute to a proper staging of these patients.
Role of Endoscopic Ultrasonography in Gastric Carcinoma
Authors: H. J. Dittler, J. R. Siewert
Journal: Endoscopy (1993)

Two hundred and fifty four consecutive patients with gastric adenocarcinoma who underwent surgery were preoperatively evaluated with endoscopic ultrasonography (EUS). The results were compared with the post-operative histo-pathological staging. EUS was correct in determining the T and N stage in 83% and 66%, respectively. Although EUS was accurate in determining the absence of lymph node metastases (accuracy in stage N0: 93%), it was not reliable in determining stages N1 and N2 (64% and 52%, respectively). Since 88% of all T3 and T4 tumors had lymph node metastases, the concomitant T stage may be an important criterion for assessing the nature of endosonographically visualized lymph nodes. The actual R0-resection rate (78%) was almost identical to the rate predicted preoperatively by EUS (81%). We therefore consider EUS a valuable pretherapeutic procedure in patients with gastric carcinoma.
Black Raspberry Extracts Inhibit Benzo(<i>a</i>)Pyrene Diol-Epoxide–Induced Activator Protein 1 Activation and VEGF Transcription by Targeting the Phosphotidylinositol 3-Kinase/Akt Pathway
Authors: Chuanshu Huang, Jingxia Li, Lun Song, Dongyun Zhang, Qiangsong Tong, Min Ding, Linda Bowman, Robeena Aziz, Gary D. Stoner
Journal: Cancer Research (2006)

Abstract Previous studies have shown that freeze-dried black raspberry extract fractions inhibit benzo(a)pyrene [B(a)P]–induced transformation of Syrian hamster embryo cells and benzo(a)pyrene diol-epoxide [B(a)PDE]–induced activator protein-1 (AP-1) activity in mouse epidermal Cl 41 cells. The phosphotidylinositol 3-kinase (PI-3K)/Akt pathway is critical for B(a)PDE-induced AP-1 activation in mouse epidermal Cl 41 cells. In the present study, we determined the potential involvement of PI-3K and its downstream kinases on the inhibition of AP-1 activation by black raspberry fractions, RO-FOO3, RO-FOO4, RO-ME, and RO-DM. In addition, we investigated the effects of these fractions on the expression of the AP-1 target genes, vascular endothelial growth factor (VEGF) and inducible nitric oxide synthase (iNOS). Pretreatment of Cl 41 cells with fractions RO-F003 and RO-ME reduced activation of AP-1 and the expression of VEGF, but not iNOS. In contrast, fractions RO-F004 and RO-DM had no effect on AP-1 activation or the expression of either VEGF or iNOS. Consistent with inhibition of AP-1 activation, the RO-ME fraction markedly inhibited activation of PI-3K, Akt, and p70 S6 kinase (p70S6k). In addition, overexpression of the dominant negative PI-3K mutant Δp85 reduced the induction of VEGF by B(a)PDE. It is likely that the inhibitory effects of fractions RO-FOO3 and RO-ME on B(a)PDE-induced AP-1 activation and VEGF expression are mediated by inhibition of the PI-3K/Akt pathway. In view of the important roles of AP-1 and VEGF in tumor development, one mechanism for the chemopreventive activity of black raspberries may be inhibition of the PI-3K/Akt/AP-1/VEGF pathway. (Cancer Res 2006; 66(1): 581-7)
Red Cross seeks to boost medical support in Afghanistan to ease plight of civilians
Authors: John Zarocostas
Journal: BMJ (2007)

The International Committee of the Red Cross is increasing its surgical support and other medical services in Afghanistan to help ease the plight of large numbers of civilians, many in isolated rural areas, caught up in the spreading of hostilities across more than half the country.

“The civilian population is paying a high price, and we are seeing a lot casualties in ICRC [International Committee of the Red Cross] supported hospitals such as Mirwais in Kandahar,” said Reto Stocker, head of the committee's delegation in Afghanistan.

During the first six months of this year hospitals assisted by the Red Cross performed about 9000 operations and provided medical services to 17 700 inpatients and 86 000 outpatients.

Mr Stocker said that because of the deteriorating situation and greater need …
THE CLINICIAN OF THE FUTURE
Authors: JAMES B. HERRICK
Journal: JAMA (1926)

By the word clinician I mean the physician who comes in contact with the patient, in his bed κλ[unk]νη in the hospital, at his home, in the dispensary or in the private office. We ordinarily think of the clinician as opposed to the nonpracticing laboratory man, who may not be a graduate in medicine and who is not immediately concerned with the living patient—the anatomist. chemist, pathologist, physiologist or pharmacologist. My theme, therefore, is the doctor of the future who is the practitioner, who sees, examines, advises and treats patients, rather than the investigator or teacher along lines of so-called pure science. I have no special thesis to defend. I do not presume to settle definitely the many problems involved. My address, therefore, will lack the "punch" that comes from advocating ideas that seem final and unequivocally right. It will lose force because of inconclusiveness. But I cannot speak otherwise,
Book: Bent not Broken
Authors: R. Little
Journal: BMJ (2002)

Lauren Roche Zymurgy Publishing, £6.99, pp 267 ISBN 1 903506 02 6 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> Most doctors I know entered medical school straight from school or after undergraduate study. New Zealander Lauren Roche had an unconventional path to become a doctor, which included stints as a stowaway, stripper, prostitute, and drug misuser. She describes this journey in her courageous autobiography, Bent not Broken. Roche begins her narrative with snippets and stories from her childhood. These reveal instability, poverty, and abuse. Her parents' marriage ended in … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Characterization of pancreatic NMDA receptors as possible drug targets for diabetes treatment
Authors: Jan Marquard, Silke Otter, Alena Welters, Alin Stirban, Annelie Fischer, Jan Eglinger, Diran Herebian, Olaf Kletke, Maša Skelin Klemen, Andraž Stožer, Stephan Wnendt, Lorenzo Piemonti, Martin Köhler, Jorge Ferrer, Bernard Thorens, Freimut Schliess, Marjan Slak Rupnik, Tim Heise, Per-Olof Berggren, Nikolaj Klöcker, Thomas Meissner, Ertan Mayatepek, Daniel Eberhard, Martin Kragl, Eckhard Lammert
Journal: Nature Medicine (2015)
Life Expectancy and Colorectal Cancer Screening
Authors: Robert C. Burack
Journal: Annals of Internal Medicine (2007)

Letters15 May 2007Life Expectancy and Colorectal Cancer ScreeningRobert C. Burack, MD, MPHRobert C. Burack, MD, MPHFrom Wayne State University, Detroit, MI 48202.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-10-200705150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Gross and colleagues (1) provide important information demonstrating the expected reduction in life expectancy that accompanies advancing age and higher burden of comorbid conditions among patients with newly diagnosed colorectal cancer. While their observations may be particularly informative when considering treatment options after diagnosis of colorectal cancer, the direct relevance of their observations to decision making about screening is somewhat more complex. If the benefit of endoscopic screening for colorectal cancer derives from an earlier diagnosis of cancer, then life expectancy at the time of diagnosis is particularly relevant. However, to the extent that the endoscopy offers ...References1. Gross CP, McAvay GJ, Krumholz HM, Paltiel AD, Bhasin D, Tinetti ME. The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening. Ann Intern Med. 2006;145:646-53. [PMID: 17088577] LinkGoogle Scholar2. Lin OS, Kozarek RA, Schembre DB, Ayub K, Gluck M, Drennan F, et al. Screening colonoscopy in very elderly patients: prevalence of neoplasia and estimated impact on life expectancy. JAMA. 2006;295:2357-65. [PMID: 16720821] CrossrefMedlineGoogle Scholar3. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285:2750-6. [PMID: 11386931] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert C. Burack, MD, MPHAffiliations: From Wayne State University, Detroit, MI 48202.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Effect of Age and Chronic Illness on Life Expectancy after a Diagnosis of Colorectal Cancer: Implications for Screening Cary P. Gross , Gail J. McAvay , Harlan M. Krumholz , A. David Paltiel , Devina Bhasin , and Mary E. Tinetti Life Expectancy and Colorectal Cancer Screening Cary P. Gross , Gail J. McAvay , and Mary E. Tinetti Metrics 15 May 2007Volume 146, Issue 10Page: 758KeywordsCancer screeningCancer treatmentColorectal cancerColorectal cancer screeningConflicts of interestDecision makingEndoscopyLife expectancy ePublished: 15 May 2007 Issue Published: 15 May 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Development and use of a quality scale for assessing studies that analyze the diagnostic capacity of capsule endoscopy
Authors: L. Varela-Lema, A. Ruano-Ravina
Journal: Endoscopy (2006)

Background and study aims: The aim of this study was to develop a scale for assessing the quality of published studies on capsule endoscopy, and to apply it to research papers retrieved by a systematic review. Methods: The scale was based on the evidence-based quality assessment tools used in diagnostic accuracy studies, and was adapted by the inclusion of additional aspects considered to be relevant for the assessment of capsule endoscopy. The scale that was developed used a score range of 0 - 100 and was divided into two sections: validity, with six criteria and a weight of 80 %; and applicability, with two criteria and a weight of 20 %. Two investigators applied the scale independently to the studies retrieved in a systematic review.
Spironolactone and canrenoate: Different antialdosteronic diuretic agents
Authors: Jorge J. Gumucio, Paolo Gentilini
Journal: Hepatology (1991)

Plasma levels of canrenone and androgen receptoractive materials (ARM) were determined during long-term oral K-canrenoate or spironolactone therapy in cirrhotics with chronic recurrent ascites. Mean plasma canrenone level was approximately 3 times higher under K-canrenoate than under spironolactone treatment; moreover, the levels were not dose related. Either type of treatment did not affect plasma aldosterone and testosterone concentrations. Plasma ARM during K-canrenoate treatment did not change, whereas in the spironolactone group a 3-fold increase of ARM occurred (p &lt;0.05). No dose-related effect was evident with the latter treatment. The lower incidence of gynecomastia in the K-canrenoate group was not correlated with values of plasma canrenone or ARM (p &gt; 0.05). Our study questions the traditional view that the mode of action of spironolactone is via its metabolite canrenone. The two antialdosterone drugs, although equally effective in clearing ascites from cirrhotics, appear to act through partially different metabolites. The lower incidence of antiandrogenic or estrogen-like side effects during K-canrenoate seems to be related to metabolites other than canrenone itself.