tbuckley/cabot-search huggingface dataset:
Patent Ductus Arteriosus
Authors: Richard Warren
Journal: JAMA (1984)

<h3>THE PROFESSIONAL SETTING</h3> August 1938! Few physicians of today can be fully aware of the forces at play on a surgeon contemplating a new procedure in that year. Even those of us still alive who were active then find it difficult to recreate the setting. I will try to recall some conditions and events. <h3>Anesthesia</h3> Intratracheal positive pressure anesthesia had developed to formal acceptance only six years before as the safest way to facilitate intrathoracic procedures. The story of the emergence of that technique paralleled and controlled that of intrathoracic surgery. Rehn's<sup>1</sup>semielective repair of a 1.5-cm stab wound of the right ventricle in 1896, usually cited as the first successful operation on the heart, had been done rapidly while the patient was under ether without positive pressure. The left lung collapsed but the patient survived, the lung presumably expanding satisfactorily postoperatively. A few emergency intrathoracic procedures, such as
The roles of insulin and glucagon in the regulation of hepatic glycogen synthesis and turnover in humans.
Authors: M Roden, G Perseghin, K F Petersen, J H Hwang, G W Cline, K Gerow, D L Rothman, G I Shulman
Journal: Journal of Clinical Investigation (1996)

To determine the respective roles of insulin and glucagon for hepatic glycogen synthesis and turnover, hyperglycemic clamps were performed with somatostatin [0.1 micrograms/(kg.min)] in healthy young men under conditions of: (I) basal fasting) portal vein insulinemia-hypoglucagonemia, (II) basal portal vein insulinemia-basal glucagonemia, and (III) basal peripheral insulinemia-hypoglucagonemia. Synthetic rates, pathway (direct versus indirect) contributions, and percent turnover of hepatic glycogen were assessed by in vivo 13C nuclear magnetic resonance spectroscopy during [1-13C]glucose infusion followed by a natural abundance glucose chase in conjunction with acetaminophen to noninvasively sample the hepatic UDP-glucose pool. In the presence of hyperglycemia (10.4 +/- 0.1 mM) and basal portal vein insulinemia (192 +/- 6 pM), suppression of glucagon secretion (plasma glucagon, I:31 +/- 4, II: 63 +/- 8 pg/ml) doubled the hepatic accumulation of glycogen (Vsyn) compared with conditions of basal glucagonemia [I: 0.40 +/- 0.06, II: 0.19 +/- 0.03 mumol/(liter.min): P < 0.0025]. Glycogen turnover was markedly reduced (I: 19 +/- 7%, II: 69 +/- 12%; P < 0.005), so that net rate of glycogen synthesis increased approximately fivefold (P < 0.001) by inhibition of glucagon secretion. The relative contribution of gluconeogenesis (indirect pathway) to glycogen synthesis was lower during hypoglucagonemia (42 +/- 6%) than during basal glucagonemia (54 +/- 5%; P < 0.005). Under conditions of basal peripheral insulinemia (54 +/- 2 pM) and hypoglucagonemia (III) there was negligible hepatic glycogen synthesis and turnover. In conclusion, small changes in portal vein concentrations of insulin and glucagon independently affect hepatic glycogen synthesis and turnover. Inhibition of glucagon secretion under conditions of hyperglycemia and basal concentrations of insulin results in: (a) twofold increase in rate of hepatic glycogen synthesis, (b) reduction of glycogen turnover by approximately 73%, and (c) augmented percent contribution of the direct pathway to glycogen synthesis compared with conditions of basal glucagonemia.
Cotinine Excretion as a Predictor of Peak Flow Variability
Authors: JOACHIM KUEHR, THOMAS FRISCHER, WILFRIED KARMAUS, ROLF MEINERT, THOMAS PRACHT, WILLI LEHNERT
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Environmental tobacco smoke (ETS) is suspected to be an important risk factor for bronchial hyperresponsiveness. In order to test the effect of ETS, we measured expiratory flow rates and urine cotinine excretion (UCE) within a narrow time window in two consecutive years. Maternal smoking habits and medical history were ascertained by standardized questionnaires. The percentage ratio of the amplitude over the mean (AVAM) of the diurnal peak flow rates of children (complete values from at least five consecutive days) was calculated as an indicator of bronchial responsiveness. The association of UCE and log10AVAM was analyzed by multiple linear regression. Complete data were available for a sample of 417 children. The median of UCE in children of parents who smoked (3.2 ng/mg and 2.9 ng/mg creatinine, Surveys 1 and 2, respectively) was higher than the median in children of nonsmoking parents (0 ng/mg in both surveys). With increasing UCE the log10AVAM rose in the first and second surveys, as well as in the longitudinal analysis (p = 0.003). This association, however, showed up only in boys (p = 0.0001) and not in girls (p = 0.31). Our data suggest that there is a need both for further analysis of the gender difference and for more support of strategies against passive smoking as far as children are concerned, since airway hyperresponsiveness is a risk factor for chronic airway impairment.
Starting inhaled corticosteroids in asthma: when, how high, and how long
Authors: T. van der Molen, H.A.M. Kerstjens
Journal: European Respiratory Journal (2000)

In the past 10 years many intervention studies have triedto define the optimal dose of inhaled corticosteroids in thetreatment of patients with mild or moderate asthma. In allbut the largest studies it has been very difficult to show adose related effect on common outcome parameters suchas symptoms and lung function. Relevant differences notonly in end-parameters but also in study designs, andpatient selections have made it difficult to compare indi-vidual study results. Despite the confusions, guidelinecommittees and leading scientists have tried to adviseclinicians about the dosage of inhaled corticosteroids thatthey should prescribe to their patients. It is not surprisingthat these advices still differ or are rather vague [1–3]. Forthe clinician many important questions remain: 1) whento start with an inhaled corticosteroid in patients withasthmatic symptoms; 2) is starting high and then steppingdown with inhaled corticosteroids more efficacious thanthe step up method; 3) is there a real requirement for themonitoring of symptoms, lung function, or inflammationin order the maintain the best results in the treatment ofpatients?; and 4) once therapy is started, how long shouldit continue?In this issue of the European Respiratory Journal (ERJ)two of these questions come closer to an answer: is aninitial high dose (step down treatment) of an inhaledcorticosteroid beneficial for patients with mild or moderateasthma; and, do clinicians have to start earlier with inhaledcorticosteroids, i.e. at the moment that bronchial inflam-mation causes airway responsiveness without asthma likesymptoms.G
A Prospective Study of Cigarette Smoking and Risk of Age-Related Macular Degeneration in Men
Authors: William G. Christen
Journal: JAMA (1996)

To examine the association between cigarette smoking and the incidence of age-related macular degeneration (AMD) in men.Prospective cohort study with average person-years of follow-up for AMD of 12.2 years.A total of 21 157 US male physicians participating in the Physicians' Health Study who did not have a diagnosis of AMD at baseline, were followed for at least 7 years, and had known levels of baseline smoking. Based on information reported at baseline, 11% were current smokers, 39% were past smokers, and 50% were never smokers.Incident AMD, defined as a self-report that was confirmed by medical record, review, first diagnosed after randomization, and responsible for vision loss to 20/30 or worse.A total of 268 incident cases of AMD with vision loss were confirmed. In multivariate analysis, current smokers of 20 or more cigarettes per day, compared with never smokers, had an increased risk of AMD (relative risk [RR], 2.46; 95% confidence interval [CI], 1.60-3.79). Past smokers had a modest elevation in risk of AMD (RR, 1.30; 95% CI, 0.99-1.70). For current smokers of fewer than 20 cigarettes per day, there was a nonsignificant 26% increased risk of AMD (RR, 1.26; 95% CI, 0.61-2.59).These prospective data provide support for the hypothesis that cigarette smoking increases the risk of developing AMD.
Nonrandom Distribution of Alu Elements in Genes of Various Functional Categories: Insight from Analysis of Human Chromosomes 21 and 22
Authors: D. Grover
Journal: Molecular Biology and Evolution (2003)

The first draft of the human genome has revealed enormous variability in the global distribution of Alu repeat elements. There are regions such as the four homeobox gene clusters, which are nearly devoid of these repeats that contrast with repeat dense regions in other transcriptionally active regions of the genome. Our analysis of the completely sequenced chromosomes 21 and 22 revealed a striking bias in Alu distribution. These elements are more clustered in genes which are involved in metabolism, transport, and signaling processes. In contrast, they are significantly fewer in genes coding for information pathway components as well as structural proteins. This bias in Alu distribution is independent of the effect of Alu density of the flanking genomic region and is also not affected by the GC content of the gene and its upstream and downstream regions. The relative proportions of Alu subfamilies (Alu J, Alu S, and Alu Y) are not significantly different in genes with high Alu density belonging to the functional categories of transport, metabolism, and signaling. However, in the structural proteins and information genes, these proportions are lower than the other three categories. We suggest that Alu elements might be involved in regulatory mechanisms and are therefore differentially selected in primate genomes.
Acceptable Sex Selection
Authors: Rosamond Rhodes
Journal: The American Journal of Bioethics (2001)

John Robertson presents a persuasive argument against government prohibition of preconception sex selection (PSS) as long as there is no actual evidence of significant social harm from allowing the technology to be freely available. I am convinced by what he says about PSS and have argued along similar lines in my own work (Rhodes 1995). In these comments, I will press Robertson's conclusion in several directions to show what more he might have said in its defense.
Europe in transition: Summary of webchat
Authors: Birte Twisselmann
Journal: BMJ (2005)

Time to wake up to cancer's tollEditor-As exemplified by your theme issue on Africa of 1 October, cancer has remained comparatively neglected in Africa although increasingly prevalent: 70% of people with cancer live in the economically developing world, where by 2020 the annual death toll is predicted to reach 20 million. 1 In sub-Saharan Africa measures to prevent cancer emphasised in the developed world-such as smoking cessation and screening-are not nationally adopted.One third of African cancers are preventable, but the influence of tobacco companies with mass media advertising and high crop payments is real.Traditional cancers, such as gastric and hepatocellular carcinoma, and newer cancers, such as lung cancer, breast cancer, and AIDS related Kaposi's sarcoma, are increasing in incidence. 2 3 Patients' expectations for oncological treatment are low in Africa.Lack of money, or a concern not to place their family in debt, prevents many from seeking medical help. 4 Lack of awareness of predisposing factors, warning symptoms or signs of cancer, or treatment options mean that patients present late.Cost and difficulty of travel over rough terrain also discourage service use.After diagnosis patients may tend to look for peace of mind and spiritual comfort rather than a physical cure.In Africa disease modifying cancer treatment and basic control of symptoms are largely absent.Even when analgesia is available, patients with cancer may experience severe and inadequately managed pain, as health professionals underprescribe strong analgesics, fearing drug dependency. 5 Individual sub-Saharan countries cannot tackle the challenges of cancer in isolation.A new, cooperative approach and research base are being advocated for preventing, treating, and palliating cancer to bridge the gap between developed and developing nations.
Noninvasive Monitoring of Oxidative Stress in Transplanted Mesenchymal Stromal Cells
Authors: Peter J. Psaltis, Karen M. Peterson, Rende Xu, Federico Franchi, Tyra Witt, Ian Y. Chen, Amir Lerman, Robert D. Simari, Sanjiv S. Gambhir, Martin Rodriguez-Porcel
Journal: JACC. Cardiovascular imaging (2013)
Greenfield's Neuropathology
Authors: Orville T. Bailey
Journal: JAMA (1964)

The first edition of this book brilliantly filled a long-recognized need for a treatise in neuropathology more complete than student textbooks but still manageable in size. It proved invaluable for resident training in all branches of the neurological sciences and served as an authoritative reference. With its companion volume on tumors of the nervous system by Russell and Rubinstein, it provided remarkably complete coverage of the field. But neuropathology is one of the most rapidly changing specialties in medicine and is going in new directions, largely as the result of technical developments. The prospect of a second edition incorporating the advances of the last five years has excited international interest. A thorough revision has been achieved without significant increase in length. Several of the chapters written by the late editor, Dr. J. Godwin Greenfield, have only been brought up to date, but others, notably that on demyelinating diseases, have been
Review: Fidaxomicin is better than vancomycin for Clostridium difficile recurrence
Authors: David A. Pegues
Journal: Annals of Internal Medicine (2012)

ACP Journal Club17 April 2012Review: Fidaxomicin is better than vancomycin for Clostridium difficile recurrenceDavid A. Pegues, MDDavid A. Pegues, MDHospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA (D.A.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-8-201204170-02009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationDrekonja DM, Butler M, MacDonald R, et al. Comparative effectiveness of Clostridium difficile treatments: a systematic review. Ann Intern Med. 2011;155:839-47. https://pubmed.ncbi.nlm.nih.gov/22184691Clinical Impact RatingsHospitalists: Gastroenterology: Infectious Disease: References1 McDonald LC, Killgore GE, Thompson A, et al. An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med. 2005;353:2433-41. [PMID: 16322603] Google Scholar2 Zar FA, Bakkanagari SR, Moorthi KM, Davis MB. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007;45:302-7. [PMID: 17599306] Google Scholar3 Cohen SH, Gerding DN, Johnson S, et al; Society for Healthcare Epidemiology of America; Infectious Diseases Society of America. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31:431-55. [PMID: 20307191] Google Scholar Author, Article, and Disclosure InformationAffiliations: Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA (D.A.P.)This article was published at Annals.org on 3 April 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 April 2012Volume 156, Issue 8Page: JC4-9KeywordsAntibioticsHealth careHealth services researchInfectious disease epidemiologyResearch quality assessmentSystematic reviewsVancomycin ePublished: 17 April 2012 Issue Published: 17 April 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Author's reply to Cameron, Chater and colleagues, Majeed, Munro, and Thornton
Authors: R. Wakeford
Journal: BMJ (2014)

Cameron states that the Medical Schools Council “values medical schools’ autonomy over student selection, curriculums, and staffing.”1 2 Of course. Just as the Country Landowners Association values foxhunting. Since Brotherston’s 1967 recommendations it has been accepted that, for undergraduate medical education, “identity lies not in the path, but in the goal.”3 Doubtless the proposed National Licensing Examination will clarify the goal for medical schools and widen the path.

The problem’s nub is that arrangements for undergraduate and postgraduate medical education …
Corticosteroid-Induced Changes in Phospholipid Membranes as Mediators of Their Action*
Authors: DON H. NELSON
Journal: Endocrine Reviews (1980)

THIS SHORT review will describe mechanisms by which corticosteroid modification of cellular phospholipids and particularly the phospholipid- structure of a variety of membranes can produce some of the effects of the corticosteroids. In addition to these effects, many studies have demonstrated effects of other hormones to alter specific phospholipids, phospholipases, or for phospholipase action on cells to mimic hormone action. All actions of the corticosteroids are not thought to be produced by these lipid alterations, but such changes are capable of producing widespread effects on receptor activity, RNA and protein synthesis, enzymatic activity, and transport through membranes. The availability of new data indicating that phospholipids are altered considerably by corticosteroids in a number of tissues makes a review of this subject of interest at this time. Corticosteroids are secreted in response to a variety of "stresses" that represent alterations in the cellular environment that might result in death or injury to the exposed cells if proper adaptation did not occur. Thus, these hormones are increased in response to anoxia, very low or very high temperature, or hypoglycemia. Through mechanisms that have not been clearly understood the cell is protected by the increased hormones against potentially harmful alterations in its environment.
Seasonal and pandemic (A/H1N1 2009) MF-59–adjuvanted influenza vaccines in complete remission non-Hodgkin lymphoma patients previously treated with rituximab containing regimens
Authors: Davide Bedognetti, Filippo Ansaldi, Elisa Zanardi, Paolo Durando, Mario Roberto Sertoli, Carlotta Massucco, Enrico Balleari, Omar Racchi, Gabriele Zoppoli, Andrea Orsi, Cristiano Alicino, Giancarlo Icardi, Francesco M. Marincola, Simonetta Zupo, Manlio Ferrarini, Andrea De Maria
Journal: Blood (2012)
Action of Long-Chain Polymers on Kidney Juxtaglomerular Cells and Connective Tissue Mast Cells
Authors: ALDO N. CORBASCIO
Journal: Circulation Research (1960)

The histochemical nature and the biologic characteristics of the specific cytoplasmic granulations of the juxtaglomerular (J-G) cells of the kidney have been reinvestigated. In the rat, it appears that these cells are mesenchymal in origin and capable of reacting as part of the reticuloendothelial system when exposed to the action of long-chain polymers like dextran or ovomucoid. The substance contained in the granules is probably constituted by a mixture of polysaccharide sulfate esters and lipoids, accounting for their staining properties with metachromatic dyes. Hyaluronic acid is not responsible for the latter reaction. The J-G granules respond in a manner strikingly similar to that of mast-cell granules after treatment with dextran or ovomucoid. The attempt to quantitate the amount of histamine liberated by degranulation of J-G cells has been less successful than with degranulated connective tissue mast cells, owing to the low J-G cell/parenchyma ratio in the kidney. The presence of mast-cell-like elements at the vascular pole of the kidney glomerulus is stressed in view of their possible role in the functional activity of the nephron, owing to the fact that degranulation of these cells is capable of releasing anticoagulant and vasoactive substances like heparin, histamine, and serotonin proximal to 1 of the most important circulatory districts of the body. The finding of elements with analogous characteristics in the subintimal layer of arterioles in other organs raises the question as to whether J-G cells play a less specialized role in the kidney than hitherto supposed.
THE PASTEURIZATION OF THE MILK SUPPLY
Authors: S. G. Moore
Journal: BMJ (1921)

94X-~~~~~~~~~~~~~~~~~~~~~~~~~~EIA On admission the legs and abdomen were swollen; he com- plained of weakness and shortness of breath.As regards the urine, specific gravity was 1020, the reaction was neutral, and it was full of albumin.The patient was treated during September and October on medical lines--jalap, diuretics of varying sorts, citrate anid acetate of potash, diuretin, etc.Later lie was given hot-air baths, pilocarpiin in i-graini doses.He had a vegetable and salt-free diet.Flaid was cut down to two pnts and subsequently less daily.The urine varied between iJ to 45 ounces.With reference to the albumin, 3, 7, and 12 parts per 1,000 Esbach, with lesser variations, were recorded.In November his condition was such that he could not lie down.His legs were enormously distenided, his abdominal wall was oedematous, he had ascites and oedema of the lungs.Oni November 10th Southey's tubes were put into the right leg and 46 oz. were drained away; on November 13th tubes were put into the left leg and 147 oz.draine(d.On the 14th, 17th, and 20th other Southey's tubes were introduced anid further drainage resulLed.As a result he improved.On November 22nd the note is:"Lunig conidition relieved, but dropsy still obstinate.Urine about50oz.,albumin12partsEsbach per 1,000, but has been down to one-half part per 1,000.In December, 1920, he was given hot-air baths daily, and at intervals dry cupping to the loins.The diet was milk and vegetables.The urine had increq,sed to from 40 oz. to 60 oz.On December 14th, 15th, and 16th the albumin was, 8 parts per 1,000 Esbach, but has been down to oine half part per 1,C00.DuringJanuiarythis treatmeint was continued and varying drugs were tried without any result.
Patient-Centered Cardiac Care for the Elderly
Authors: Eric D. Peterson
Journal: JAMA (2003)

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