tbuckley/cabot-search huggingface dataset:
Blood Pressure Biofeedback Treatment, Organ Damage and Sympathetic Activity in Mild Hypertension
Authors: Mutsuhiro Nakao, Shinobu Nomura, Tatsuo Shimosawa, Toshiro Fujita, Tomifusa Kuboki
Journal: Psychotherapy and Psychosomatics (1999)

Although biofeedback treatment is reported to be useful for patients with mild hypertension as an adjunct to medication, it is not certain whether the presence of organ damage affects its efficacy. The aim of this study is to clarify the clinical effects of biofeedback on mild hypertension in the absence and presence of organ damage.Eleven mildly hypertensive outpatients without damage to the heart, brain, retina or kidney (4 men and 7 women), aged 40-65 years, and 11 mildly hypertensive outpatients with target organ damage and matching variables for age, sex and medication were included in this study. They underwent biofeedback treatment once a week for a total of four sessions.As a result of these sessions, mean blood pressures (MBP) in the organ-damage-negative (-) group and in the organ-damage-positive (+) group were significantly reduced by 12 +/- 11 and 12 +/- 8, respectively. The decrease was still significant 3 months after the treatment in the organ-damage (-) group, whereas no significant change was found 1 or 3 months after the treatment in the organ-damage (+) group. Throughout these sessions, the ratio of low frequency to high frequency of heart rate variance as well as systolic and MBP gradually decreased in each group (p < 0.01); this ratio of heart rate variance was smaller, and the alpha-wave amplitude on the electroencephalogram was larger in the organ-damage (-) group (p < 0.05).These results suggested that biofeedback intervention may be effective in mild hypertension, especially when the patient is organ damage (-). Sympathetic activity seems to play an important role in the differentiated response.
Economics of Medical Education
Authors: John T. Flynn
Journal: JAMA (1979)

<h3>To the Editor.—</h3> Despite his earnestly presented COMMENTARY (240:831, 1978), Dr Alexis' concern about minority enrollment in medical schools is more likely to be frustrated by the rising cost of medical education than by direct effects of the Bakke decision. Today, even medical students from financially comfortable families require tuition loans and subsidies, while the schools themselves vie for increasing federal dollars. Tomorrow, the new graduate physician will be the indentured servant of his government, while his school will struggle against progressive bureaucratic control. Despite our zeitgeist on minority needs, the economics of the situation will strike hardest at the least financially favored student during the ensuing clash of social and academic needs.
Postlipopolysaccharide Oxidative Damage of Mitochondrial DNA
Authors: Hagir B. Suliman, Martha S. Carraway, Claude A. Piantadosi
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Selected structural and functional alterations of mitochondria induced by bacterial lipopolysaccharide (LPS) were investigated on the basis of the hypothesis that LPS initiates hepatic mitochondrial DNA (mtDNA) damage by oxidative mechanisms. After a single intraperitoneal injection of Escherichia coli LPS, liver mtDNA copy number decreased, as determined by Southern analysis, within 24 hours relative to nuclear 18S rRNA (p < 0.05). LPS induced a novel oxidant-dependent 3.8-kb mtDNA deletion in the region encoding NADH dehydrogenase subunits 1 and 2 and cytochrome c oxidase subunit I, which correlated with mitochondrial glutathione depletion. Expression of mitochondrial mRNA and transcription of mitochondrial RNA were suppressed, whereas mRNA expression increased for selected nuclear-encoded mitochondrial proteins. Resolution of mtDNA damage was mediated by importation of mitochondrial transcription factor A protein, a central regulator of mtDNA copy number, accompanied by binding of mitochondrial protein extract to the mitochondrial transcription factor A DNA-binding site. Hence, mtDNA integrity and transcriptional capacity after LPS administration appeared to be reinstated by mitochondrial biogenesis. These data provide the first link between LPS-mediated hepatic injury and a specific oxidative mtDNA deletion, which inhibits mitochondrial transcription and is restored by activation of mechanisms that lead to biogenesis.
Australia's swine flu vaccination plans come under fire
Authors: M. Sweet
Journal: BMJ (2009)

The Australian government’s impending programme of vaccination against H1N1 flu has been criticised by some professional groups that have raised concerns about potential risks.

The Australian Infection Control Association this week warned the government against proceeding with the programme, saying that the planned use of multidose vials (used to vaccinate several people) posed a “significant potential risk to patient safety.”

The association’s president, Claire Boardman, said that use of multidose vials would contravene national infection control guidelines (www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/02A94EEE98D72244CA25740F00251B98/$File/NationalInfectionControlGuidelines.pdf) and that numerous adverse events related to their use had been well documented.

Ms Boardman said there was no justification for using multidose vials, as “the occurrence and distribution of H1N1 in 2009 within Australia does not constitute an emergency.”

She added, “We advise strongly against the use of multidose vials and do not support this mechanism for dissemination of the …
Gonadotrophin deficiency and adrenocortical insufficiency in children: a new syndrome.
Authors: W F Kelly, G F Joplin, G W Pearson
Journal: BMJ (1977)

Gonadotrophin deficiency and adrenocortical insufficiency in children: a new syndromeIn 1962 this patient was described' by one of us (GWP) as a rare case of Addison's disease in a 6-year-old child.At the age of 23, the patient, it is now apparent, has an even rarer condition-namely, the associa- tion of hypogonadotrophic hypogonadism with congenital adrenal hypoplasia.
ALTERNATING PERSONALITIES; THEIR ORIGIN AND MEDICO-LEGAL ASPECT.
Authors: R. OSGOOD MASON
Journal: JAMA (1896)

The condition of double personality has, in a way, always been recognized, but no special importance has generally been attached to it by the profession. Cases of protracted somnambulism or an occasional instance of catalepsy or trance, either with or without remembered visions or voices, were referred to as curiosities, but without any just analysis of the condition or attempt at classification; in fact, they have been looked upon as belonging to no system of recognized psychic phenomena, and in general, like many other variations from the usual personality—the recognized, reasoning, knowledge acquiring personality —they have been looked upon simply as<i>abnormal</i>, and been thrown into the category of either hysteria or insanity. Of late, however, the subject has received more definite treatment; many cases of the condition have been carefully observed, their peculiarities studied, and their relations to other psychic states have been considered. Ribot, Janet, Richet, Kraft-Ebing
Total energy expenditure and the level of physical activity correlate with plasma leptin concentrations in five-year-old children.
Authors: A D Salbe, M Nicolson, E Ravussin
Journal: Journal of Clinical Investigation (1997)

Leptin, the product of the ob gene, is a hormone secreted by adipocytes that is known to decrease food intake and increase energy expenditure in ob/ob mice. In humans, variants in the OB gene have not been detected and very little is known about the action of leptin on food intake and energy expenditure, although circulating leptin concentrations are positively correlated to body fat stores. The purpose of this study was to assess the relationship between fasting plasma leptin concentrations and energy expenditure in 123 5-yr-old Pima Indian children (67 males/76 females). Body composition was assessed by isotopic water dilution (18O) whereas total energy expenditure (TEE) and resting metabolic rate (RMR) were measured using doubly labeled water and indirect calorimetry, respectively. The physical activity level was calculated as the ratio of TEE:RMR. Plasma leptin concentrations were positively correlated to percent body fat (r = 0.84, P < 0.0001), but were similar in boys and girls after adjusting for percent body fat. Most importantly, we found that, independent of the percentage of body fat, plasma leptin concentrations correlated with TEE (in absolute values, r = 0.37, P < 0.0001, or adjusted for body size r = 0.42; P < 0.0001) and with physical activity level (r = 0.26, P < 0.01), but not RMR. These results suggest that, as in animal models, leptin plays a role in energy expenditure in humans.
NECESSITY FOR REVISING THE COMMON CONCEPTION OF FOCAL INFECTION
Authors: MYER SOLIS-COHEN
Journal: JAMA (1934)

A focus of infecion has been defined as a circumscribed area of tissue infected with pathogenic organisms. 1 General recognition that it can cause systemic or general disease makes its elimination an important part of the treatment of such disease.  COMMON MISCONCEPTION OF FOCAL INFECTION  In the common conception of focal infection, attention seems to be concentrated on the infected tissue rather than on the infecting bacteria. When a physician speaks of eliminating the focus of infection, what he really means is the removal of infected tissue, such as tonsils and teeth, or the opening and draining, or the cleaning out, of an infected cavity, such as a nasal accessory sinus. He apparently fails to realize that, in the upper air passages, at least, infecting bacteria seldom are confined to a circumscribed area of diseased tissue but are present also on adjacent tissues. The germs infecting the tonsil, for instance,
Membrane Topology of the C. elegans SEL-12 Presenilin
Authors: Xiajun Li, Iva Greenwald
Journal: Neuron (1996)

Mutant presenilins cause Alzheimer's disease. Presenilins have multiple hydrophobic regions that could theoretically span a membrane, and a knowledge of the membrane topology is crucial for deducing the mechanism of presenilin function. By analyzing the activity of beta-galactosidase hybrid proteins expressed in C. elegans, we show that the C. elegans SEL-12 presenilin has eight transmembrane domains and that there is a cleavage site after the sixth transmembrane domain. We examine the presenilin sequence in view of the predicted topology and discuss possible mechanisms for presenilin function.
Should geriatric medicine remain a specialty? Yes
Authors: L. Flicker
Journal: BMJ (2008)

The development of geriatricshas greatly improved care for older people.<b> Leon Flicker </b>believesspecialist care remains important for this vulnerable group,but<b>C P Denaro</b> and <b>A Mudge </b>(doi: 10.1136/bmj.39533.696076.AD) argue that age divisions are no longer relevant
Haemophilus influenzae Type b Disease
Authors: Charles M. Ginsburg, George H. McCracken, Sharon Rae, James C. Parke
Journal: JAMA (1977)

<i>Haemophilus influenzae</i>type b (HIB) disease was observed during a 14-month period in seven of 48 infants attending a day-care center. Surveillance studies showed that 28 (58%) infants had positive nasopharyngeal cultures for HIB; four infants were colonized with HIB for nine to 12 months. Ampicillin trihydrate prophylaxis failed to reduce the HIB carrier rate.<i>Haemophilus influenzae</i>type b polysaccharide vaccine was administered to 34 of the children. Sera obtained prior to immunization showed detectable antibody in all infants. Only nine (26%) infants had twofold or greater rises in serum HIB antibody titers after vaccination. Antibody response was independent of age, preimmunization antibody concentration, and HIB carrier status. In one infant, HIB meningitis developed four months after she received polysaccharide vaccine. This outbreak emphasizes that HIB is highly contagious in closed populations of young, susceptible infants. (<i>JAMA</i>238:604-607, 1977)
Ambulation Problems in Very Young Children
Authors: Ernest W. Johnson
Journal: JAMA (1961)

Delayed ambulation in young children presents a difficult problem to both parents and physician. It may be caused by neuromuscular disease. A child who is not walking by 18 to 20 months is considered to be delayed in ambulation. Assistance should be given in preambulation activities (e.g., sitting, crawling, creeping, standing) when such delay is anticipated. Balance and support are two requirements for independent walking. The use of aids, such as the tilt board, stand-up table, and parallel bars, sometimes supplies the necessary balance and support. These can be constructed inexpensively by the parents. Minimal bracing, crutches, and canes are additional ambulation aids. Disabled children usually exceed our expectations but may fall short of their parents' hopes.
Oxygen Transport during Erythropoietic Response to Moderate Blood Loss
Authors: Miles J. Edwards, Belle Canon
Journal: New England Journal of Medicine (1972)

Abstract The removal of 250 to 750 ml of blood over one to three weeks' time from nine normal nonsmoking males produced, one to three weeks later, slightly decreased hemoglobin concentrations (mean, 16.2 to 15.0 g per 100 ml). Oxygen pressure at 50 per cent hemoglobin saturation with oxygen (P50) increased from 27.9 to 29.8 torr (mean values) and was significantly correlated (p less than 0.005) with an average increase of erythrocyte glutamic oxalacetic transaminase activity from 4.4 to 5.4 U per gram of hemoglobin, indicating increased numbers of young erythrocytes. 2,3-diphosphoglycerate did not change (mean, 13.1 to 13.0 μmoles per gram of hemoglobin). The improved oxygen unloading afforded by the increased P50 thus seems to have more than compensated for the reduced hemoglobin concentration so that cardiac output could decrease and still maintain an unchanged normal mixed venous oxygen pressure.
Impact of Internal Mammary Artery Conduit on Long-term Outcomes After Percutaneous Intervention of Saphenous Vein Graft
Authors: Rajendra H. Mehta, Emily Honeycutt, Eric D. Peterson, Christopher B. Granger, Abdul R. Halabi, Linda K. Shaw, Peter K. Smith, Robert M. Califf, Robert A. Harrington, Michael H. Sketch
Journal: Circulation (2006)

The influence of an internal mammary artery (IMA) graft on long-term outcomes after percutaneous saphenous vein graft (SVG) intervention is currently unknown.To examine the impact of IMA on outcomes in patients undergoing SVG interventions, we analyzed 2119 patients from the Duke Cardiovascular Disease Database (1986-2003) with prior coronary artery bypass surgery undergoing cardiac catheterization who had at least 1 SVG graft. Patients were categorized into 4 groups: group I, SVG intervention and patent IMA; group II, no SVG intervention and patent IMA; group III, SVG intervention without patent IMA; and group IV, no SVG intervention without patent IMA. At a median follow-up of 4.8 years (interquartile range, 2.1 to 8.8 years), adjusted survival rates in groups I, II, III, and IV were 72.8%, 72.3%, 64.5%, and 58.9%, respectively. Multivariate Cox proportional hazards modeling showed similar survival for groups I and II (P=0.63) and for groups III and IV (P=0.33). The presence of IMA graft was related to lower long-term mortality (adjusted hazard ratio [HR], 0.69; 95% CI, 0.58 to 0.82), whereas SVG intervention was not associated with long-term mortality (adjusted HR, 0.94; 95% CI, 0.81 to 1.10). In contrast, the adjusted event-free rates for nonfatal myocardial infarction were lower in the SVG intervention groups (groups I and III) than in the non-SVG intervention groups (groups II and IV) (HR for SVG intervention versus no SVG intervention, 3.19; 95% CI, 2.18 to 4.66), with the presence of patent IMA conferring no significant benefit on this outcome (HR, 1.37; 95% CI, 0.91 to 2.08).In patients undergoing SVG interventions, survival, but not nonfatal myocardial infarction, is favorably influenced by the presence of patent IMA. In contrast, SVG intervention had no measurable survival benefit but was associated with an increased risk of nonfatal myocardial infarction.
Stedman's Medical Dictionary
Authors: Lester S. King
Journal: JAMA (1972)

Congratulations to the editors and publishers who have brought out this new edition of<i>Stedman's Medical Dictionary!</i>The improvement over the preceding edition is enormous. The book has a splendid format: some 300 pages<i>shorter</i>than its predecessor, fully three quarters of an inch thinner, and about two pounds lighter, the new volume fits the hand nicely. The typography is superb— small but remarkably clear type, easy to read, with headings in boldface of appropriate and pleasing weight. The arrangement of entries is excellent. As to the content, the editors tell us that there are more than 7,000 new entries and more than 24,000 "significant editorial revisions." Random sampling indicates that definitions tend to be simpler and more precise than formerly, closer to real definitions without any tendency to spill over into a micro-mini-textbook. The philosopher can ponder the "real" nature of a definition. In so doing he can point
Emergency transport for neonates after home deliveries: Expectations of flying squads are too high
Authors: J Wyllie, S Richmond, A Ryall, R A Cocks, R Cocks
Journal: BMJ (1994)

EDITOR, - Northern region has had a centralised neonatal flying squad for many years, but we agree with Carol Sullivan and colleagues that the title is misleading.1 It causes confusion and results in an instant response being expected. Such a response has become impossible with the reduction in junior doctors' hours and has always been problematic if the squad is already attending a call.

Community midwives may well have the expectations outlined by the authors,1 and these should be dispelled. A neonatal flying squad could never, however, react sufficiently quickly to fulfil a primary role in neonatal resuscitation. Northumbria ambulance authority has one of the best response times but would not be able to move a squad from hospital to a patient at home in less than 15 minutes from receipt of a call. In the few cases in which …
Higher prevalence of human herpesvirus 8 DNA sequence and specific IgG antibodies in patients with pemphigus in China
Authors: Guan-Qing Wang, Honghui Xu, Ya-Kun Wang, Xing-Hua Gao, Yuming Zhao, Chundi He, Naoki Inoue, Hong-Duo Chen
Journal: Journal of the American Academy of Dermatology (2005)
Deletion of the Activated Protein-1 Transcription Factor JunD Induces Oxidative Stress and Accelerates Age-Related Endothelial Dysfunction
Authors: Francesco Paneni, Elena Osto, Sarah Costantino, Bogdan Mateescu, Sylvie Briand, Giuseppe Coppolino, Enrico Perna, Pavani Mocharla, Alexander Akhmedov, Ruslan Kubant, Lucia Rohrer, Tadeusz Malinski, Giovanni G. Camici, Christian M. Matter, Fatima Mechta-Grigoriou, Massimo Volpe, Thomas F. Lüscher, Francesco Cosentino
Journal: Circulation (2013)

Reactive oxygen species are major determinants of vascular aging. JunD, a member of the activated protein-1 family of transcription factors, is emerging as a major gatekeeper against oxidative stress. However, its contribution to reactive oxygen species homeostasis in the vasculature remains unknown.Endothelium-dependent vasorelaxation was impaired in young and old JunD(-/-) mice (6 and 22 months old) compared with age-matched wild-type mice. JunD(-/-) mice displayed an age-independent decline in endothelial nitric oxide release and endothelial nitric oxide synthase activity and increased mitochondrial superoxide formation and peroxynitrite levels. Furthermore, vascular expression and activity of the free radical scavengers manganese and extracellular superoxide dismutase and aldehyde dehydrogenase 2 were reduced, whereas the NADPH oxidase subunits p47phox, Nox2, and Nox4 were upregulated. These redox changes were associated with premature vascular aging, as shown by reduced telomerase activity, increased β-galactosidase-positive cells, upregulation of the senescence markers p16(INK4a) and p53, and mitochondrial disruption. Interestingly, old wild-type mice showed a reduction in JunD expression and transcriptional activity resulting from promoter hypermethylation and binding with tumor suppressor menin, respectively. In contrast, JunD overexpression blunted age-induced endothelial dysfunction. In human endothelial cells, JunD knockdown exerted a similar impairment of the O2(-)/nitric oxide balance that was prevented by concomitant NADPH inhibition. In parallel, JunD expression was reduced in monocytes from old versus young healthy subjects and correlated with mRNA levels of scavenging and oxidant enzymes.JunD provides protection in aging-induced endothelial dysfunction and may represent a novel target to prevent reactive oxygen species-driven vascular aging.
Response to Letter Regarding Article, “Pathological Correlates of Late Drug-Eluting Stent Thrombosis: Strut Coverage as a Marker of Endothelialization”
Authors: Aloke V. Finn, Mike C. John, Herman K. Gold, John Newell, Gaku Nakazawa, Michael Joner, Frank D. Kolodgie, Renu Virmani
Journal: Circulation (2007)
Training facilities in gastrointestinal endoscopy: an animal model as an aid to learning endoscopic ultrasound
Authors: M. Bhutani, R. Wong, B. Hoffman
Journal: Endoscopy (2006)

Apart from dedicated fellowships, endoscopic ultrasound (EUS) training comprises "informal" methods, including EUS courses and the use of animal models. We have tried to determine the usefulness of a "hands-on" experience with a live animal model as a teaching strategy for EUS training. In 1997 and 2000 the American Society for Gastrointestinal Endoscopy (ASGE) sponsored hands-on EUS workshops using a live porcine model and participants in these courses were asked to complete a questionnaire about the course (2 years after the 1997 workshop and immediately after the 2000 workshop). The main outcome measurements were the usefulness and quality of the overall course and of the hands-on component in particular, and the effect on EUS practice patterns. Twenty of 38 attendees (53 %) responded to the survey administered 2 years after the 1997 course: 95 % thought the overall course was useful and 85 % valued the hands-on portion; 60 % of respondents had either started performing EUS or, if already experienced in EUS, had increased the number of EUS examinations and/or the complexity of EUS procedures they performed. Of the 34 participants who were at the 2000 ASGE course, over 90 % thought that the course enhanced their EUS skills and 88 % believed that they would be likely to perform EUS in the future. The study was limited in that it did not account for other methods of EUS training that could affect EUS practice patterns and also by the fact that not all the 1997 course participants responded to the questionnaire. In conclusion, live animal models may be a useful adjuctive method for learning EUS skills for the novice or the less experienced endosonographer.
Preparing to prevent severe acute respiratory syndrome and other respiratory infections
Authors: Mei-Shang Ho, Ih-Jen Su
Journal: The Lancet Infectious Diseases (2004)

Globalisation and its effect on human development has rendered an environment that is conducive for the rapid international spread of severe acute respiratory syndrome (SARS), and other new infectious diseases yet to emerge. After the unprecedented multi-country outbreak of avian influenza with human cases in the winter of 2003-2004, an influenza pandemic is a current threat. A critical review of problems and solutions encountered during the 2003-2004 SARS epidemics will serve as the basis for considering national preparedness steps that can be taken to facilitate the early detection of avian influenza, and a rapid response to an influenza pandemic should it occur.