tbuckley/cabot-search huggingface dataset:
Oral salt supplements to compensate for jejunostomy losses: comparison of sodium chloride capsules, glucose electrolyte solution, and glucose polymer electrolyte solution.
Authors: J M Nightingale, J E Lennard-Jones, E R Walker, M J Farthing
Journal: Gut (1992)

Six patients with jejunostomies and residual jejunal lengths of 105 to 250 cm took the same food and water each day for eight study days. In random order, three methods of salt replacement were tested, each over 48 hours, against a period without added salt. During the three test periods the patients took 120 mmol of sodium chloride daily, as salt in gelatine capsules, as an isotonic glucose electrolyte (280 mOsmol/kg; 30 kcal) solution, and as a glucose polymer (Maxijul) solution (280 mOsmol/kg; 200 kcal). The daily stomal output remained constant for each patient during the four test periods but varied between patients from 0.60 to 2.84 kg (daily intestinal fluid balance 0.74-2.61 kg). Without a salt supplement, three patients lost more sodium from the stoma than they took in by mouth (-25, -94, and -101 mmol/day) and the mean sodium balance for all six subjects was -16 mmol (range -101 to 79) daily. Extra salt was absorbed with each form of supplement (p less than 0.05); no patient with the glucose electrolyte solution (mean 96, range 0 to 226 mmol), but one patient with the glucose-polymer solution (mean 96, range -25 to 164 mmol) and two with the salt capsules (mean 66, range -8 to 145 mmol) were in negative balance. Two patients vomited with the salt capsules. There was only a small increase in energy absorption (mean 115 kcal) with the glucose polymer solution compared with the glucose electrolyte solution. A sipped glucose electrolyte solution seems to be the optimal mode of sodium replacement in patients with a high output jejunostomy.
Functional in vitro assays for the isolation of cell transformation effector and suppressor genes.
Authors: H Zarbl, C J Kho, M O Boylan, J Van Amsterdam, R C Sullivan, C D Hoemann, V L Afshani
Journal: Environmental Health Perspectives (1991)

Malignant transformation may be viewed as an imbalance between signals inducing cell growth and signals leading to growth inhibition, differentiation, or senescence. A basic understanding of how these counterbalancing forces interact to regulate normal cell growth is the prerequisite to comprehending the mechanisms of tumorigenesis. Identification and characterization of the gene products implicated in these regulatory pathways is the first step toward understanding the disease process. The studies outlined here provide the potential basis for isolating and molecularly characterizing transformation effector and suppressor genes, which must respectively function in the positive and negative regulation of normal cell growth. The general strategy used involves the isolation and molecular characterization of nontransformed variants (revertants) from populations of tumor cells. The selection of revertants is facilitated by the ability to separate normal from transformed cells by fluorescence-activated sorting. The basis for this separation is the differential retention of the fluorescent dye rhodamine 123 in the mitochondria of normal versus transformed cells. Using this approach, we have isolated revertants from a mutagenized population of v-fos-transformed Rat-1 fibroblasts. Characterization of these clones indicated that they had sustained causal mutations in transformation effector genes. The unmutated effector genes are being identified and molecularly cloned by isolating retransformed clones from revertant cell lines that have been transfected with DNA or cDNA from normal primary cells. The same selection protocol has also been used to isolate revertants from tumor cell lines that have been transfected with DNA or cDNA from primary cells. The putative tumor-suppressor genes present in these revertants are currently being analyzed.
Risk of tuberculosis among healthcare workers in an intermediate-burden country: A nationwide population study
Authors: Hsi Chu, Chia-Jen Shih, Yi-Jung Lee, Shu-Chen Kuo, Yen-Tao Hsu, Shuo-Ming Ou, Yu-Ning Shih, Der-Cherng Tarng, Szu-Yuan Li, Yung-Tai Chen, Ran-Chou Chen
Journal: Journal of Infection (2014)
Normal cardiovascular autonomic function in patients with systemic sclerosis (CREST variant).
Authors: M E Suarez-Almazor, E Bruera, A S Russell
Journal: Annals of the Rheumatic Diseases (1988)

Sixteen consecutive patients with systemic sclerosis (CREST variant (calcinosis, Raynaud9s phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia)) were included in this study. Standard non-invasive clinical and electrocardiographic procedures for the detection of cardiovascular autonomic insufficiency were performed in all patients and included heart rate (HR) response to deep breathing, Valsalva manoeuvre, and standing, and blood pressure (BP) response to hand grip and standing. None of the patients had overt cardiovascular disease or were receiving cardiovascular treatment at the time of testing. Results were compared with those obtained in 17 controls. A significant difference between patients and controls was observed only in the HR and BP response to standing (results of this last procedure were within the normal expected values in both patients and controls). We conclude that patients with systemic sclerosis and CREST syndrome may have an abnormal vascular response to standing; cardiovascular autonomic insufficiency, however, does not appear to be a significant feature in these patients.
Destruction of Case Records
Authors: P. A. Hill
Journal: BMJ (1971)

disquieting on this point.These classes pro- vide nursery facilities for all young handi- capped children from birth and in the presence of normal children and with simultaneous provision for mothers.Few of a sample of 18 classes felt they had a satis- factory relationship with local authorities and contact appears poorest where there is little or no provision.The need for a meaningful dialogue is urgent.-I am, etc.,
Conventional Dendritic Cells at the Crossroads Between Immunity and Cholesterol Homeostasis in Atherosclerosis
Authors: Emmanuel L. Gautier, Thierry Huby, Flora Saint-Charles, Betty Ouzilleau, John Pirault, Virginie Deswaerte, Florent Ginhoux, Elizabeth R. Miller, Joseph L. Witztum, M. John Chapman, Philippe Lesnik
Journal: Circulation (2009)

Background— Immunoinflammatory mechanisms are implicated in the atherogenic process. The polarization of the immune response and the nature of the immune cells involved, however, are major determinants of the net effect, which may be either proatherogenic or antiatherogenic. Dendritic cells (DCs) are central to the regulation of immunity, the polarization of the immune response, and the induction of tolerance to antigens. The potential role of DCs in atherosclerosis, however, remains to be defined. Methods and Results— We created a mouse model in which the lifespan and immunogenicity of conventional DCs are enhanced by specific overexpression of the antiapoptotic gene hBcl-2 under the control of the CD11c promoter. When studied in either low-density lipoprotein receptor–deficient or apolipoprotein E–deficient backgrounds, DC-hBcl2 mice exhibited an expanded DC population associated with enhanced T-cell activation, a T-helper 1 and T-helper 17 cytokine expression profile, and elevated production of T-helper 1–driven IgG2c autoantibodies directed against oxidation-specific epitopes. This proatherogenic signature, however, was not associated with acceleration of atherosclerotic plaque progression, because expansion of the DC population was unexpectedly associated with an atheroprotective decrease in plasma cholesterol levels. Conversely, depletion of DCs in hyperlipidemic CD11c–diphtheria toxin receptor/apolipoprotein E–deficient transgenic mice resulted in enhanced cholesterolemia, thereby arguing for a close relationship between the DC population and plasma cholesterol levels. Conclusions— Considered together, the present data reveal that conventional DCs are central to the atherosclerotic process, because they are directly implicated in both cholesterol homeostasis and the immune response.
Study backs tamoxifen for young women
Authors: H. Bower
Journal: BMJ (1998)

Results from the largest ever collection of randomised data on a cancer drug suggest tamoxifen should be given to all patients with breast cancer who have had surgery for hormone dependent tumours, regardless of age.

The new data decisively overturns accepted wisdom that tamoxifen has no benefit for younger women or those with breast only tumours. It also indicates that the drug has a substantial benefit on top of chemotherapy. Coordinators of the Early Breast Cancer Trialists' Collaborative Group based at Oxford University's Clinical Trial Service Unit say that acting on these results will prevent around 20000 more deaths from breast cancer a year worldwide, including …
Risk of Natalizumab-Associated Progressive Multifocal Leukoencephalopathy
Authors: Gary Bloomgren, Sandra Richman, Christophe Hotermans, Meena Subramanyam, Susan Goelz, Amy Natarajan, Sophia Lee, Tatiana Plavina, James V. Scanlon, Alfred Sandrock, Carmen Bozic
Journal: New England Journal of Medicine (2012)

Progressive multifocal leukoencephalopathy (PML) is associated with natalizumab treatment. We quantified the risk of PML in patients with multiple sclerosis, according to the presence or absence of three risk factors: positive status with respect to anti–JC virus antibodies, prior use of immunosuppressants, and increasing duration of natalizumab treatment.
Overdiagnosis in lung cancer: different perspectives, definitions, implications
Authors: P. B Bach
Journal: Thorax (2008)

Does lung cancer screening lead to overdiagnosis? Most lung cancer prevention experts think it does, but there is a contingent who believe that it does not. This latter group holds fast to a notion that essentially all histological foci of lung cancer pose an imminent threat to health, irrespective of how they are discovered. Enter Dr Reich’s interesting and thoughtful article,1 which provides a cohesive overview of the epidemiological data that would be explained by “overdiagnosis”, and therefore the case for its existence (see page 377) . Reich also considers the totality of studies that are oft cited as evidence that “overdiagnosis” does not exist. For these articles, he summarises their findings too, and raises his concerns about them. It is an important contribution, that clearly presents Reich’s view that overdiagnosis is a serious concern in lung cancer screening. Because it also incorporates opposing evidence, it is a worthy reference for anyone interested in understanding this confusing issue.

My interpretation of the data is much like Reich’s—I have little doubt that lung cancer screening, particularly with CT, uncovers vast numbers of lesions with relatively little malignant potential. I also harbour little doubt that surgical treatment of individuals who are overdiagnosed is potentially very harmful to them, given that surgery confers risks both short and long term. However, as a clinician, I find this epidemiologic concept hard to operationalise because current knowledge does not allow me to distinguish between those histological foci that pose a reduced threat compared with those that pose a very real and imminent threat. Therefore, faced with a positive biopsy at this point, it is essentially an instinctual response to recommend immediate and definitive treatment.

Perhaps this tension between epidemiological data and clinical instinct is what leads to different interpretations of the available data. This …
Abstract 2444: Targeting Epstein-Barr virus oncoprotein LMP1-mediated glycolysis sensitizes nasopharyngeal carcinoma to radiation therapy
Authors: Lanbo Xiao, Zhe-yu Hu, Ya Cao
Journal: Cancer Research (2014)

Abstract Our goal in this work was to illustrate the Epstein-Barr Virus (EBV)-modulated global biochemical profile and provide a novel metabolism-related target to improve the therapeutic regimen of nasopharyngeal carcinoma (NPC). We used a metabolomics approach to investigate EBV-modulated metabolic changes, and found that the exogenous overexpression of the EBV encoded latent membrane protein 1 (LMP1) significantly increased glycolysis. The deregulation of several glycolytic genes, including hexokinase 2 (HK2), was determined to be responsible for the reprogramming of LMP1-mediated glucose metabolism in NPC cells. The up-regulation of HK2 elevated aerobic glycolysis and facilitated proliferation by blocking apoptosis. More importantly, HK2 was positively correlated with LMP1 in NPC biopsies, and high HK2 levels were significantly associated with poor overall survival of NPC patients following radiation therapy. Knockdown of HK2 effectively enhanced the sensitivity of LMP1-overexpressing NPC cells to irradiation. Finally, c-Myc was demonstrated to be required for LMP1-induced up-regulation of HK2. The LMP1-mediated attenuation of the PI3-K/Akt-GSK3beta-FBW7 signaling axis resulted in the stabilization of c-Myc. These findings indicate a close relationship between EBV and glycolysis in NPC. Notably, LMP1 is the key regulator of the reprogramming of EBV-mediated glycolysis in NPC cells. Given the importance of EBV-mediated deregulation of glycolysis, anti-glycolytic therapy might represent a worthwhile avenue of exploration in the treatment of EBV-related cancers. Note: This abstract was not presented at the meeting. Citation Format: Lanbo Xiao, Zhe-yu Hu, Ya Cao. Targeting Epstein-Barr virus oncoprotein LMP1-mediated glycolysis sensitizes nasopharyngeal carcinoma to radiation therapy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2444. doi:10.1158/1538-7445.AM2014-2444
Orienting College Students to Careers in Medicine-Reply
Authors: Leonard J. Lyon
Journal: JAMA (1992)

<h3>In Reply.</h3> —I thank Dr Liang for his favorable comments on our recent Commentary describing Pascack Valley Hospital's premedical student orientation. We emphasized that we are a nonteaching community hospital so that similar institutions would be encouraged to try this sort of program. His suggestion that premedical student orientation should include exposure to the experiences of student and resident training as well as medical practice on the attending physician level is an interesting one but only feasible if the program is conducted in a teaching hospital. Nevertheless, Liang should be aware that all of our attending physicians were formerly residents, some as recently as last year, so that discussion of the rigors of medical training is included in the one-on-one sessions with the students. Finally, I suspect that those potential physicians who would be discouraged by the demands of medical school and residency lack the dedication to the profession that
Dynamic stiffness measured in central segment of excised rabbit papillary muscles during barium contracture.
Authors: T Shibata, W C Hunter, A Yang, K Sagawa
Journal: Circulation Research (1987)

The dynamic mechanical behavior of excised rabbit papillary muscles that had been tonically activated by replacing bathing Ca2+ with Ba2+ was studied. Steady activation was used to visualize the dynamic behavior of cardiac myofilaments more clearly than is possible during twitches, which are complicated by the kinetics of excitation-contraction coupling. To avoid artifacts due to damaged ends of the muscle, the length of a central segment, which was defined by 2 tungsten pins inserted through the muscle, was measured. To test the mechanical behavior of the contractured muscles (at 24 degrees C), the central segment length was sinusoidally oscillated (amplitude 1%) at 15 different frequencies (0.05-30 Hz). The dynamic stiffness of the central segment was calculated from the ratio of force response amplitude to length perturbation amplitude. At low frequencies (below 0.4 Hz), stiffness was approximately constant and reflected the force-length relation. However, in a localized range near 1 Hz, there was a distinct drop in the magnitude of dynamic stiffness to approximately half its low-frequency baseline. This range may reflect the dynamics of attachment and detachment of force generators. The frequency of minimum stiffness was consistent among all muscles (1.3 +/- 0.3 Hz). Moreover, no significant change in this frequency was found over the examined range of lengths (90-100% of the segment length that produced maximal developed force) and activation levels (Ba2+ concentration 0.3-1.0 mM). From 2 to 8 Hz, dynamic stiffness appeared to reflect force-velocity properties, but at higher frequencies, another elastic property emerged. At 30 Hz, stiffness was proportional to force, with an apparent series elasticity less than 1.8%. Even though the muscles had only moderate longitudinal inhomogeneity, quantitatively significant (35%) errors would have been introduced had the study relied on total muscle length instead of central segment length.
Asthma mortality in Birmingham 1975-7: 53 deaths.
Authors: L P Ormerod, D E Stableforth
Journal: BMJ (1980)

Out of 83 patients studied 72 were certified as dying from asthma, and 11 aged under 45 as dying from chronic bronchitis and pneumonia. Fifty-three deaths were thought to be due to asthma. There were avoidable factors associated with several of these deaths from asthma. Recent discharge from hospital (16%), non-availability of aerosol bronchodilators (45%), underuse of corticosteroids (66%), and lack of objective measurements of airflow obstruction (100%) were found in deaths outside hospital. Inadequate initial assessment including baseline spirometry and blood gases (50%), significant underusage of corticosteroids (93%) and intravenous and nebulised bronchodilators (100%), and failure to monitor treatment objectively (100%) were found in deaths in hospital. "False-positive" and "false-negative" certifications of asthma were studied, and the findings suggest that these may lead to appreciable inaccuracy in the reporting of deaths from asthma.
Abstract 3007: Annexin-A1 Mimetic Peptide and PPAR-alpha Agonist Attenuate Hyperglycemic Exacerbation of Myocardial Ischemia/Reperfusion Injury Following Cardioplegic Arrest in the Rat
Authors: Zhiquan Zhang, Qing Ma, Burkhard G Mackensen, Mihai Podgoreanu
Journal: Circulation (2009)
Insurance and the U.S. Health Care System
Authors: Barbara Starfield
Journal: New England Journal of Medicine (2005)

Nearly 15 percent of children in the United States are inadequately insured because they lack health insurance for all or part of the year. In this issue of the Journal, Olson and colleagues1 describe the potent effect of inadequate insurance coverage on several aspects of access to services. They also examine several other effects of inadequate insurance coverage. Olson et al. characterized insurance coverage as full-year, part-year, or none and as private or public. The manifestations of compromised access to services were delays in seeking care, unmet medical care needs, unfilled prescriptions, no visits to doctors' offices, the lack of . . .
CONTROL OF UTERINE HEMORRHAGE BY THE ROENTGEN RAY
Authors: WILLIAM S. NEWCOMET
Journal: JAMA (1925)

The sensibility of the organs of generation to irradiation has been proved by a number of experimenters, and, while exact figures may differ to some degree as to the amount of irradiation required and the results produced, the fact remains that generative cellular elements are the most susceptible of all the cells of the body. It may be safely stated that they undergo a retrograde change from the influence of about one half the amount of irradiation tolerated by other cells. These experimental facts are based on the normal cell and not on cells influenced by local inflammatory or general systemic changes that are usually observed in cases of metrorrhagia or menorrhagia. The question now arises as to what extent irradiation influences cellular elements under these altered conditions. In the last decade, radium has been employed by many operators for the control of hemorrhage in certain benign diseases of the
Physiopathology of Cushing's Disease
Authors: DOROTHY T. KRIEGER
Journal: Endocrine Reviews (1983)

HARVEY CUSHING first described a patient with the disease bearing his name in 1912 (1). The patient manifested rapidly acquired central obesity, hypertrichosis, amenorrhea, and muscle weakness; on physical examination, "her round face was dusky and cyanoid," supraclavicular and posterior cervical fat pads were present, and it was also noted that the skin was rough and dry, with considerable pigmentation, and with numerous ecchymoses and purplish striae. At that time, Cushing was uncertain as to whether the symptoms were attributable to pituitary "or adrenal, pineal, or ovarian influences," involvement of these regions having previously been reported in association with similar clinical findings. There was apparently an even earlier report of a similar clinical syndrome by Osier in 1899 (2), which was described, however, as "An acute myxoedematous condition, with tachycardia, glycosuria, melaena, mania, and death" (the latter occurring within 6 months of onset). Between 1923 and 1926, in addition to other case reports, there were three in which similar signs and symptoms were described in association with pituitary tumors, which the authors considered to be incidental findings (3–5).
Helicobacter pylori persistence: biology and disease
Authors: Martin J. Blaser, John C. Atherton
Journal: Journal of Clinical Investigation (2004)

Helicobacter pylori are bacteria that have coevolved with humans to be transmitted from person to person and to persistently colonize the stomach. Their population structure is a model for the ecology of the indigenous microbiota. A well-choreographed equilibrium between bacterial effectors and host responses permits microbial persistence and health of the host but confers risk of serious diseases, including peptic ulceration and gastric neoplasia.
Ireland seeks injunction to prevent opening of new fuel plant at Sellafield
Authors: Doug Payne
Journal: BMJ (2001)

The Irish government is intensifying its multipronged attack on the United Kingdom's plans to open a mixed-oxide (MOX) nuclear fuel production plant at Sellafield.

It moved to forge a wider alliance with its Nordic counterparts during a conference of Nordic environment ministers in Copenhagen earlier this week. The activity is a separate but parallel action to arbitration proceedings started in June under the OSPAR convention (the Oslo/Paris accord governing protection of marine environments in the north east Atlantic).

The proposed plant at Sellafield would reprocess “weapons-grade” plutonium and uranium into MOX fuels for use in nuclear power reactors. The separated material would come from spent fuel that is reprocessed mainly in BNFL's thermal oxide reprocessing plant (THORP), also located at the Sellafield site.

Last week the Irish government also launched an …
CERTAIN FACTORS IN DEVELOPMENT OF NEUROSYPHILITIC LESIONS IN LATE CONGENITAL SYPHILIS
Authors: EDWIN G. ZABRISKIE
Journal: JAMA (1923)

The late appearance of syphilitic lesions in the various organs of the body in so-called congenital syphilis has always aroused interest ever since it was first recognized that the disease may be implanted during intrauterine life and remain unrecognized until it manifests itself in late childhood or puberty, after emotional disturbances, infections and trauma. The protean features of syphilis are remarkably well illustrated in this department of the subject. Although the present communication deals chiefly with late manifestations of syphilis of the nervous system, in the literature may be found many instances of gumma and other tertiary lesions of the vascular apparatus, upper respiratory tract, eyes and abdominal viscera. In 1879, Augagneur pointed out that these lesions were always tertiary in character and never secondary, and he made the interesting observation that whenever he had an opportunity to investigate the stage of the disease in the parents at the time