tbuckley/cabot-search huggingface dataset:
Velocity profile in the main pulmonary artery in a canine model
Authors: G. W HENRY, T. A JOHNSON, J. I FERREIRO, H. S HSIAO, C. L LUCAS, B. A KEAGY, M. E LORES, B. R WILCOX
Journal: Cardiovascular Research (1984)

The velocity profile of the main pulmonary artery was determined in nine adult, open-chested, mechanically ventilated mongrel dogs using an intraluminal, needle-mounted, range-gated, pulsed Doppler technique. Mean phasic point velocities were determined at 2 mm intervals across the lumen of the vessel, 2 cm above the pulmonary valve, by recording the Doppler shift of an activated 20 MHz piezoelectric crystal, range-gated 3.5 mm in the direction of the pulmonary valve. Mean Reynolds numbers from the main pulmonary artery ranged from 275 to 1140. Radially normalised intraluminal distance versus mean phasic point velocity plots were constructed which demonstrated a curved profile in all 9 dogs. First order regression analysis demonstrted a poor fit (r: 0.05-0.68). Second order (r:0.61-0.97) and third order (r:0.72-0.99) regression analyses markedly improved the fit, confirming the non-linear nature of the velocity profile. Step-wise third order regression analysis to determine the importance of the entry sequence demonstrated that the most important term for determining the regression coefficient was the X2 term in six dogs. In addition, the velocity profile was noted to be shifted, with the highest velocities recorded between the centre of the vessel and the anterior wall in eight of nine dogs (location of highest velocity: +0.26 radius ± 0.25 (mean ± SD).
THE EARLY SYMPTOMS AND DIAGNOSIS OF TUBERCULAR JOINT DISEASE.Read in the Section on Surgery and Anatomy at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: A. J. STEELE
Journal: JAMA (1894)

No more important division of our subject could have been given me for consideration than this; for while the aim of our calling is to cure disease, yet preceding the therapeutics comes the definite recognition—the diagnosis. And it is just here the physician most frequently errs. Four-fifths of the cases of joint and spinal disease that come under my observation have previously been wrongly diagnosed by medical men. It is in the matter of diagnosis that we need to more thoroughly enlighten the profession— how to early and unerringly recognize these joint troubles. To those of us who have given years of study to this subject, it seems simple and trite, and so while to some I may be amenable to the charge of being commonplace, yet in accordance with the duty assigned me, I will briefly outline the symptoms of the tubercular joint affections. The earliest symptom, and one
UNIVERSAL CURES, ANCIENT AND MODERN
Authors: A. J. Clark
Journal: BMJ (1924)

ANY general disctussion of quackker-y is far too big a subject for a single paper.This papere is conifineed to cer-taini universeal cuires, broughit forward by meii of considerable mit edical knowledge, whio nevertheless appear to have geniniiiely beleieed that they had discovered a uniiver sal cure forl disease.Most of the cures discussed appear tohlave some ineal or supposed conexiol with electrical phenomiena.
Diabetes, cognitive impairment, and dementia
Authors: Mark W J Strachan, Jacqueline F Price, Brian M Frier
Journal: BMJ (2008)

Are strongly linked, but the precise mechanisms are unclear

The Dementia UK report, published earlier this year on behalf of the Alzheimer’s Society, predicts that by 2050, 34 million people worldwide will have dementia, and 71% of these people will live in developing countries.1 Currently, nearly 700 000 people have dementia in the United Kingdom, and worldwide this figure approaches 18 million. Dementia costs the UK economy around £17bn (€24bn; $35bn) each year, but the human cost to patients, their families, and their friends is incalculable.

Over the past 15 years, several studies have indicated that diabetes mellitus, particularly type 2 diabetes, is associated with an increased risk of cognitive impairment and dementia.234 If these studies are correct, then the future burden of dementia may be even greater than estimated as the prevalence of type 2 diabetes continues to rise.

Early data that linked type 2 diabetes with cognitive impairment came from cross sectional cohort studies that were generally of poor methodological quality.4 However, a recent systematic review of prospective observational studies identified 25 articles that assessed the …
Thoracic Kyphosis Results in Photopenia in the Upper Thoracic and Lumbar Spine
Authors: WEI-JEN SHIH, SYLVIA MAGOUN
Journal: Clinical Nuclear Medicine (2000)

A man with dorsal kyphosis and a lung mass from large-cell carcinoma underwent bone scintigraphy. The bone images showed abruptly decreased uptake in the upper thoracic and lumbar spine. These findings mimic the results seen after irradiation of lung cancer, resulting in decreased uptake in the upper thoracic spine, and after irradiation of renal cancer, resulting in photopenia in the lumber spine.
Sexual Dysfunction and Ocular Timolol
Authors: Irving M. Katz
Journal: JAMA (1986)

<h3>To the Editor.—</h3> The letter from Dr F. T. Fraunfelder and S. Martha Meyer<sup>1</sup>states that the National Registry of Drug Induced Ocular Side Effects has received reports of 28 complaints of various sexual dysfunctions in 25 patients following usual doses of topical ocular timolol. Impotence was reported in 18 patients, decreased libido in nine patients, and decreased ejaculate volume in one patient. In a subsequent issue of<i>JAMA</i>, Curb et al<sup>2</sup>reviewed the results of the Hypertension Detection and Followup Program clinical trial in a cohort of 5,485 patients. According to the authors, this is the largest cohort to date from which detailed data on antihypertensive drug surveillance are available. Sexually related side effects of oral antihypertensive drugs are often a major concern, and in the Hypertension Detection and Follow-up Program study, discontinuation of oral antihypertensive drug treatment in 8.3% of the male patients resulted from these side
Intron Splicing–mediated Expression of AAV Rep and Cap Genes and Production of AAV Vectors in Insect Cells
Authors: Haifeng Chen
Journal: Molecular Therapy (2008)

An artificial intron containing the insect cell polyhedrin (polh) promoter was designed, constructed, and inserted into the adeno-associated virus (AAV) Rep and Cap coding sequences to express the Rep and Cap proteins, respectively. The artificial intron was spliced out and full-length Rep78 or VP1 proteins were expressed from the insect promoters located upstream of their respective AUG start codons. The polh promoter located inside the artificial intron was functional, expressed the Rep52 or VP2/VP3 proteins located downstream of the artificial intron, and overlapped with the Rep78 or VP1 proteins. This is the first report that an artificial intron containing an insect cell promoter can be inserted into a coding sequence to express genes with overlapping open-reading frames (ORFs). A method was also established for AAV vector production in insect cells with these intron-containing Rep and Cap coding sequences, and the vectors produced thereby were infectious. These intron-containing AAV Rep and Cap coding sequences were very stable in recombinant baculoviruses and showed no apparent loss of protein expression even after five consecutive amplifications of the plaque-purified recombinant baculoviruses. This newly established AAV production method should prove to be a useful tool for large-scale AAV vector production.
Arsenic Upsets Heartbeat: Possible Early Warning for Cardiovascular Risk
Authors: Kris Freeman
Journal: Environmental Health Perspectives (2007)

Arsenic Upsets HeartbeatPossible Early Warning for Cardiovascular Risk Acute arsenic exposure can cause severe heartbeat abnormalities, and chronic exposure has been linked to coronary disease and cancer.Now researchers from Inner Mongolia, China, and the United States have begun to analyze the effects of chronic exposure on the electrical signals that regulate heartbeat [EHP 115:690-694; Mumford et al.].They found a correlation between exposure via drinking well water and signal changes associated with arrhythmia and death.Tens of millions of people worldwide drink groundwater contaminated with naturally occurring arsenic.Through metabolism, the inorganic arsenic found in drinking water is converted to more toxic methylated compounds.The research team focused on the QTc interval, a specific portion of the cardiac signal that corresponds to the active pumping (systole) phase of the heartbeat.QTc intervals of 0.45 second or longer are associated with cardiac risk.The team used electrocardiography to measure the QTc interval of 168 men and 145 women from four villages in Ba Men, an area of Inner Mongolia where the drilling of artesian wells in 1980 exposed residents to arsenic.Arsenic exposure was determined through analysis of toenail samples from participants and water samples from their wells.Arsenic exposure was categorized as low (21 µg/L or less), medium (100-300 µg/L), or high (430-609 µg/L).As exposure to arsenic increased, so did the occurrence of prolonged QTc interval, which was seen in 3.9% of the low exposure group, 11.1% of the medium exposure group, and 20.6% of the high exposure group.Women-who typically have a longer QTc interval than men-were more susceptible to this effect than men.Age, smoking, and pesticide exposure did not affect the association.The authors suggest that arsenic may affect QTc interval by altering the flow of potassium ions that are involved in cardiac signaling.They write that measurement of QTc interval may be useful in the early detection of cardiovascular risk among individuals exposed to arsenic, as well as in the identification of populations where such risk is high.The team is currently conducting a large follow-up study in the same population.Meanwhile, the Chinese government is helping to install water systems in the Ba Men area that will decrease arsenic exposure.-Kris Freeman
Cardiovascular and endocrine effects of endothelin-1 at pathophysiological and pharmacological plasma concentrations in conscious dogs.
Authors: J E Donckier, C Hanet, A Berbinschi, L Galanti, A Robert, H Van Mechelen, H Pouleur, J M Ketelslegers
Journal: Circulation (1991)

BACKGROUND Increased plasma concentrations of endothelin-1, a potent vasoconstrictor produced by the endothelium, have been reported in various pathological conditions. This study was conducted to evaluate effects of endothelin-1 at pathophysiological and pharmacological plasma concentrations. METHODS AND RESULTS Endothelin-1 was infused at increasing doses (2.5, 5, 10, and 20 ng/kg.min for 1 hour each) in nine conscious dogs. During endothelin-1 infusion, plasma endothelin-1 rose from a basal value of 1.8 +/- 0.4 pmol/l to 5.8 +/- 1.1 (pathophysiological), 20.8 +/- 3.9 (pathophysiological), 85.4 +/- 18.9 (pharmacological), and 311.4 +/- 55.7 (pharmacological) pmol/l at each dose, respectively. Heart rate increased at 2.5 ng/kg.min (from 129 +/- 7 to 146 +/- 12 beats/min) but decreased at 20 ng/kg.min (97 +/- 7 beats/min) (p less than 0.001). Such a biphasic response was also observed for peak (+)dP/dt and (dP/dt)/DP40 (p less than 0.005). Left ventricular systolic pressures, mean aortic pressure, and left atrial pressure increased over time (p less than 0.05, p less than 0.005, and p less than 0.001, respectively). The time constant of early isovolumic relaxation rose progressively (p less than 0.001). The percent systolic shortening decreased at 10 and 20 ng/kg.min (p less than 0.005). Pressure-segment length loops showed a reduction in systolic shortening associated with an increase in left ventricular systolic pressure at 20 ng/kg.min. Atrial natriuretic factor rose after 5 ng/kg.min from 28.5 +/- 6.5 to 92.0 +/- 18.2 pmol/l (p less than 0.005). Angiotensin II and catecholamines did not change significantly. Serum urea and creatinine rose progressively (p less than 0.05), whereas glucose decreased (p less than 0.05). The above results differed significantly from measurements obtained in a time-control group of six dogs. CONCLUSIONS A fourfold increase of plasma endothelin-1 obtained after doubling the infusion rate suggests a reduction in endothelin-1 clearance or endothelin-1 endogenous production. The biphasic response of heart rate is consistent with baroreflex-mediated effects resulting from vasodilation at the pathophysiological level and vasoconstriction at the pharmacological level. Hemodynamic data suggest an increase followed by a decrease in contractility at both levels, respectively. Finally, endothelin-1 is a stimulator of atrial natriuretic factor.
Treatment of Ischemic Heart Disease-Reply
Authors: Larry Scherwitz
Journal: JAMA (1983)

<h3>In Reply.—</h3> Dr Davidson suggests that the improvements we measured in cardiovascular status might be explained by dissimilarity of the intervention and control groups, as reflected by apparent preintervention differences in plasma triglyceride and HDL levels. To reply: 1. The triglyceride levels at preintervention were<i>not</i>significantly different between the groups (<i>P</i>&gt;.05). 2. As Dr Davidson points out, the plasma HDL levels were significantly higher in the experimental group at preintervention. However, we do not think that the extent of coronary artery disease was less severe in the experimental group. As we stated in our article, there were no significant preintervention differences between the two groups in extent of coronary disease as measured by coronary arteriography, previous myocardial infarction, previous coronary artery bypass surgery, or exercise radionuclide ventriculography. Similarly, there were no significant preintervention differences in cigarette smoking, physical activity, or ethanol use. Also, the preintervention differences in HDL
Enrollee Appeals of Preservice Coverage Denials at 2 Health Maintenance Organizations
Authors: David M. Studdert, Carole Roan Gresenz
Journal: JAMA (2003)

Context Congress and state legislatures are considering patient bills of rights that seek to strengthen opportunities for patients to have denials of coverage reconsidered by their health plans. Little is publicly known about such appeals systems. Objective To improve understanding of the sources, types, and outcomes of conflicts between patients and managed care organizations over coverage of services. Design and Setting Descriptive study of information abstracted from 1774 preservice appeals out of a larger stratified random sample of 3519 appeals lodged between January 1998 and June 2000 at 2 large US health maintenance organizations. Main Outcome Measures Classification of preservice appeals according to whether they contested access to out-of-network care, the contractual limits of coverage, or the medical necessity of services; analysis of contractual coverage and medical necessity appeals by the services in dispute and out-of-network appeals by enrollees' reasons for seeking care; and comparison of the proportions of appeals won by enrollees across types of appeals and services. Results Approximately one third (36.9%) of preservice appeals involved medical necessity determinations, another third (36.6%) centered on the scope of contractually covered benefits, and most of the remainder (19.7%) involved out-of-network care. Enrollee wins were significantly more frequent among medical necessity appeals than out-of-network or contractual coverage appeals (52.2% vs 35.4% and 33.2%, respectively; P &amp;amp;lt;.001). Appeals were concentrated among relatively few services and among therapies that are generally regarded as nonessential. Conclusions A majority of preservice appeals disputed choice of provider or contractual coverage issues, rather than medical necessity. Medical necessity disputes proliferate not around life-saving treatments but in areas of societal uncertainty about the legitimate boundaries of insurance coverage. Greater transparency about the coverage status of specific services, through more precise contractual language and consumer education about benefits limitations, may help to avoid a large proportion of disputes in managed care.
Chemokines Indicate Allergic Bronchopulmonary Aspergillosis in Patients with Cystic Fibrosis
Authors: Dominik Hartl, Philipp Latzin, Gernot Zissel, Markus Krane, Susanne Krauss-Etschmann, Matthias Griese
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Allergic bronchopulmonary aspergillosis (ABPA) is characterized by a Th2 immune response. Mouse models suggest a critical role for the Th2 chemokines thymus- and activation-regulated chemokine (TARC) and macrophage-derived chemokine (MDC) in ABPA.Objectives: To determine whether serum levels of TARC and MDC characterize ABPA in patients with cystic fibrosis (CF) and to examine longitudinally if levels of TARC and MDC indicate ABPA exacerbations in patients with CF.Methods: Levels of TARC and MDC and levels of Th1 (IL-12 and IFN-γ) and Th2 (IL-4, IL-5, and IL-13) cytokines were analyzed in serum of 16 patients with CF with ABPA, six non-CF patients with asthma with ABPA, 13 patients with CF colonized with Aspergillus fumigatus, six patients with CF sensitized to A. fumigatus, 12 atopic patients with CF, and 13 non-CF atopic control subjects by ELISA. The longitudinal course of TARC, MDC, and IgE levels was assessed during ABPA episodes.Results: Patients with ABPA had significantly higher serum levels of TARC compared with the other patient groups. Cytokine levels did not differ among the patient groups. Longitudinally, levels of TARC indicated ABPA exacerbations in patients with CF more clearly than IgE levels. In patients with CF and ABPA, levels of TARC correlated positively with specific IgE to A. fumigatus and rAsp f4.Conclusions: Serum levels of TARC differentiate patients with CF or patients with asthma with ABPA from patients with CF colonized with or sensitized to A. fumigatus, atopic patients with CF, and atopic control subjects. Longitudinally, levels of TARC indicate ABPA exacerbations, suggesting TARC as a marker for identification and monitoring of ABPA in patients with CF.
Reproducibility of a four-point clinical severity score for glabellar frown lines
Authors: P. Honeck, C. Weiss, W. Sterry, B. Rzany
Journal: British Journal of Dermatology (2003)

Summary Background Focal injections of botulinum toxin A are used successfully for the treatment of hyperkinetic facial wrinkles. Efficacy can be measured by several methods. However, so far none has been investigated for its reproducibility. Objectives To investigate the reproducibility of a clinical 0–3 score for glabellar frown lines. Methods In the first part of the study, a standardized photographic documentation of glabellar frown lines was produced. Based on the results of this phase, a consensus atlas of glabellar frown lines was developed and participants were trained using this atlas. In the main study, 50 standardized photographs were shown on two consecutive days to 28 dermatologists. The reproducibility of the score was investigated by conventional kappa statistics. Results In the main study, we found an unweighted kappa according to Fleiss of 0·62 for interobserver reproducibility. Intraobserver reproducibility showed an unweighted kappa according to Cohen of between 0·57 and 0·91 for each observer, and a weighted kappa according to Cicchetti and Allison of between 0·68 and 0·94. Conclusions The clinical 0–3 score for glabellar frown lines shows a good inter- and intraobserver reproducibility.
Hospitals have no excuse for cutting services, says Nuffield Trust
Authors: J. Wise
Journal: BMJ (2012)

A new report from the health policy think tank the Nuffield Trust says that cuts in services to patients in England are difficult to justify when many opportunities exist to improve hospitals’ efficiency.

The report points out that efficiency varies widely among hospitals in England across a range of measures, including length of hospital stay, proportion of day cases, and use of information technology. It says that bringing the worst performers up to the level of the best should be a priority.

Other areas where important savings can be made include the procurement of consumable goods and the organisation of back office functions such as finance, human resources, and estates management. The report says at least £600m (€730m; $930m) could be saved …
Ouabain Plasma Level Kinetics and Removal by Dialysis in Chronic Renal Failure
Authors: RICHARD SELDEN
Journal: Annals of Internal Medicine (1975)

Ouabain plasma level kinetics and removal by dialysis were studied in 14 dialysis-dependent patients with chronic renal failure. Each received one 400-µg intravenous dose of unlabeled ouabain (9 patients also received 83 µCi of 3H-ouabain) at the onset of a routine 4-hour hemodialysis. Plasma concentration fell rapidly the first few hours, and after 5 to 10 hours declined exponentially with a mean half-life of 50 ± 19 (SD) hours. Ouabain recovery in dialysis bath was 11.5% ± 2.2% the first 2 hours and only 3.4% ± 0.5% the next 2 hours after an intravenous dose, due to rapid removal of ouabain from the extracellular fluid compartment by tissue uptake. Hence, hemodialysis is relatively ineffective for reducing ouabain body stores. Ouabain elimination in patients with chronic renal failure is significantly slower than in normal subjects (P < 0.01), but significantly more rapid than that reported for digoxin (P < 0.01) and digitoxin (P < 0.01) in patients with chronic renal failure, a potentially useful characteristic in treating acute cardiac problems among such patients.
COURSE AND OUTCOME OF SCHIZOPHRENIA
Authors: F. A. FREYHAN
Journal: American Journal of Psychiatry (1955)

1. Long-span observations of 2 samples of schizophrenic patients, 20 years apart, in a setting of comparative uniformity disclose duplication of hospital separations since 1940. 2. Modern clinical management accounts for this significant improvement. 3. The beneficial impact of specific therapies appears inseparable from compensatory capacities possessed by favorably responding patients. 4. The malignant pattern of chronicity could not be reliably predicted on grounds of onset or personality nor averted by therapeutic efforts. 5. The summing-up of continuous observations and the analyses of factual developments are indispensable to our knowledge of schizophrenia and to an ascertainment of progress with therapies.
Hepatitis C virus related cirrhosis: time to occurrence of hepatocellular carcinoma and death
Authors: F Degos
Journal: Gut (2000)

<h3>BACKGROUND</h3> In patients with hepatitis C virus (HCV) infection and cirrhosis, long term outcome and the incidence of hepatocellular carcinoma (HCC) are still debated. <h3>DESIGN</h3> From January 1987 to January 1997, 416 patients (240 male, median age 57 years) with uncomplicated Child-Pugh A HCV related cirrhosis were followed in two Paris area centres from diagnosis of cirrhosis until death or reference date (1 June 1998). The analysis used a three state disability model generalising the Cox model. <h3>RESULTS</h3> Of the 416 patients, 60 developed HCC with a five year rate of 13.4% (95% confidence interval (CI) 9.0–17.8%) and 83 died (including 34 with HCC), with a five year death rate of 15.3% (95% CI 12.6–18.0%). By multivariable analysis, time to HCC relied on age (hazard ratio (HR) 1.05 per year; p=0.0005), male sex (HR 2.13; p=0.01), oesophageal varices (HR 2.36; p= 0.008), decreased platelet count (HR 0.99; p=0.03), and bilirubin level (HR 1.01; p=0.003), while death after HCC was mainly related to tobacco consumption (HR 1.04; p=0.0006). In contrast, death free of HCC was dependent on age (HR 1.04; p=0.01), oesophageal varices (HR 2.75; p=0.001), low platelet count (HR 0.99; p=0.006), and albumin level (HR 0.90; p=0.0001). <h3>CONCLUSION</h3> The incidence of HCC and mortality should be higher in these patients than previously stated, and prognostic factors of HCC and death are closely related age and symptoms of portal hypertension.