tbuckley/cabot-search huggingface dataset:
Preliminary Study of the Efficacy of Insulin Aerosol Delivered by Oral Inhalation in Diabetic Patients
Authors: Beth L. Laube
Journal: JAMA (1993)

To maximize deposition of an aerosolized dose of insulin (mean +/- SD = 0.99 +/- 0.06 U/kg of body weight) in the lungs of subjects with non-insulin-dependent diabetes mellitus (NIDDM), and investigate its efficacy in normalizing plasma glucose levels during the fasting state.Nonrandomized, placebo-controlled trial.A primary care facility.Six nonobese, nonsmoking volunteers with NIDDM. No subjects withdrew from the study.Aerosolized insulin was administered by oral inhalation after a 12-hour period of fasting. Aerosol was generated by a raindrop nebulizer from regular 500 U/mL pork insulin. During inhalation, inspiratory flow was regulated at 17 L/min. Plasma samples were collected after inhalation and analyzed for insulin and glucose levels.Plasma insulin and glucose levels.Deposition of the aerosol was maximized within the lungs, with 79% +/- 17% of the inhaled dose depositing below the larynx. Geometric mean fasting plasma insulin level was 71 pmol/L (11.8 microU/mL), rising to 269 pmol/L (44.8 microU/mL) after insulin inhalation. Average time to peak insulin level was 40 +/- 34 minutes. The mean fasting plasma glucose level (12.63 +/- 2.59 mmol/L [225.5 +/- 46.3 mg/dL]) was reduced to within the normal range in five subjects and was almost normal in the sixth subject (5.52 +/- 0.89 mmol/L [98.6 +/- 15.9 mg/dL]). Average maximum decrease in plasma glucose from baseline was 55% +/- 10% (n = 6) vs 13% +/- 9% after placebo aerosol inhalation (n = 3). No side effects were reported following insulin or placebo aerosol inhalation.These preliminary results indicate that a dose of approximately 1.0 U of aerosolized insulin per kilogram of body weight, delivered by oral inhalation and deposited predominantly within the lungs, is well tolerated and can effectively normalize plasma glucose levels in patients with NIDDM.
Anthony Johnston Fairrie
Authors: Nicholas Fairrie
Journal: BMJ (2006)

Multifocal motor neuropathy (MMN) and some lower motor neuron syndromes are immune-mediated and treatable. These motor syndromes produce weakness that is typically distal and asymmetric, involves the arms early in the course of disease, and progresses slowly. Electrophysiologic abnormalities often include evidence of demyelination, especially focal conduction block, selectively on motor axons. High titers of serum IgM binding to GM<sub>1</sub> ganglioside, alone or in a membrane environment, occur in 80-90% of patients with MMN. Treatments for MMN that commonly produce increased strength include IV human immune globulin (HIG) and cyclophosphamide. After an initial treatment with 2 g/kg of HIG, up to 80% of patients with MMN show short-term improvement. Long-term HIG treatment is useful in 60% of MMN patients and has few side effects but is costly. Intravenous cyclophosphamide treatment is effective in 70% of MMN patients but has significant toxicity, and is reserved for patients who have severe disease and do not respond adequately to HIG.
Conflicting Remedies for the National Institutes of Health
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1979)

The political doctors attending the biomedical research enterprise agree that much is wrong and that something should be done, but though all profess affection and concern for the object of their attention, their diagnoses and remedies differ on many important points.The latest to prescribe is a long-time observer and enthusiast of biomedical research, Senator Edward M. Kennedy (D-Mass.), who, on April 23, introduced the Health Science Promotion Act of 1979 (S. 988), which, among other things, is aimed at many of the most frequently cited problems of the National Institutes of Health and its researcher clients: politically inspired, abrupt . . .
Pathogenesis of neonatal hyperbilirubinaemia after induction of labour with oxytocin.
Authors: P C Buchan
Journal: BMJ (1979)

To determine the pathogenesis of neonatal hyperbilirubinaemia after oxytocin-induced labour venous cord blood from 95 healthy newborn infants was examined. Of these, 15 were delivered by elective caesarean section, 40 after spontaneous labour, and 40 after oxytocin-induced labour. There was no significant difference in any haematological or biochemical variable between the first two groups. Infants born after oxytocin-induced labour, however, showed clear evidence of increased haemolysis associated with significantly decreased erythrocyte deformability (P less than 0.001). In-vitro studies showed a time- and dose-related reduction in erythrocyte deformability in response to oxytocin. The findings suggest that the vasopressin-like action of oxytocin causes osmotic swelling of erythrocytes leading to decreased deformability and hence more rapid destruction with resultant hyperbilirubinaemia in the neonate.
Positional cloning of a novel gene influencing asthma from Chromosome 2q14
Authors: Maxine Allen, Andrea Heinzmann, Emiko Noguchi, Gonçalo Abecasis, John Broxholme, Chris P Ponting, Sumit Bhattacharyya, Jon Tinsley, Youming Zhang, Richard Holt, E Yvonne Jones, Nick Lench, Alisoun Carey, Helene Jones, Nicholas J Dickens, Claire Dimon, Rosie Nicholls, Crystal Baker, Luzheng Xue, Elizabeth Townsend, Michael Kabesch, Stephan K Weiland, David Carr, Erika von Mutius, Ian M Adcock, Peter J Barnes, G Mark Lathrop, Mark Edwards, Miriam F Moffatt, William O C M Cookson
Journal: Nature Genetics (2003)
Potential Pitfall in Bone Scanning by Transcutaneous Nitroglycerin
Authors: CHIARA GALLINI, CONCETTA DE CICCO, MASSIMO LEGNAIOLI, ALESSANDRO CAVACIOCCHI
Journal: Clinical Nuclear Medicine (1990)

An unusual case of soft tissue uptake of Tc-99m MDP in the anterior left hemithorax is presented. The patient had local hyperemia associated with transcutaneous nitroglycerin. The possibility of local cutaneous increased blood flow causing intense anterior chest uptake should be considered in the interpretation of scans in patients being treated with transcutaneous vasodilator drugs.
Clash of Symbols—The AMA Stone in the Washington Monument: Hippocratectomy or Hippocratoplasty?
Authors: Howard S. Rubenstein
Journal: JAMA (1989)

To the Editor.—  It is fitting for the American Medical Association (AMA) to launch a fund to create a symbol of American medicine to be displayed by the National Park Service. But its choice of the same inappropriate symbol it selected over 100 years ago is disappointing. 1   The original symbol was a sculpture of Hippocrates refusing to give medical aid to an enemy of his homeland. The 19th-century American physician considered patriotic the attitude that the physician was the servant of the state before being the servant of humanity. (Perhaps this attitude contributed to the imprisonment of Dr Mudd because he gave medical aid to President Lincoln's assassin.) Today, however, I think most American physicians would consider the old attitude chauvinistic, unethical, uncharitable, and mean.  The original sculpture by Beck, whom posterity has judged to have been without talent and imagination, was a translation into stone of a painting
Melanoma Antigen A4 Is Expressed in Non–Small Cell Lung Cancers and Promotes Apoptosis
Authors: Tobias Peikert, Ulrich Specks, Carol Farver, Serpil C. Erzurum, Suzy A.A. Comhair
Journal: Cancer Research (2006)

Abstract A variety of melanoma antigen A (MAGE-A) genes are commonly detected in non–small cell lung cancers. Their biological function is not well characterized but may involve the regulation of apoptosis and cell cycle progression. We hypothesized that MAGE-A4 is involved in the regulation of apoptosis. To investigate this, expression of MAGE-A was evaluated. MAGE-A4 was expressed in 48% of non–small cell lung carcinomas. Ninety percent of lung carcinomas expressing MAGE-A4 were classified as squamous cell carcinomas and 10% were adenocarcinomas. Tumor-free surrounding lung tissue was negative for MAGE-A4. A molecular clone of MAGE-A4 derived from human lung cancer was stably expressed in human embryonic kidney cells (293 cells) to evaluate effects on cell death. Overexpression of MAGE-A4 increased apoptosis as measured by the apoptotic index (P &amp;lt; 0.0001) and caspase-3 activity (P &amp;lt; 0.002). Exposure to 25 μmol/L etoposide, a chemotherapeutic agent, increased the apoptotic effect (P &amp;lt; 0.0001). Furthermore, we show that MAGE-A4 silencing using a small interfering RNA approach results in decreased caspase-3 activity in the squamous cell lung cancer cell line H1703 by 58% (P = 0.0027) and by 24% (P = 0.028) in 293/MAGE-A4 cells. These findings suggest that MAGE-A4 expression may promote tumor cell death, sensitize malignancies to apoptotic stimuli, such as chemotherapeutic agents, and therefore may represent a tumor suppressor protein. (Cancer Res 2006; 66(9): 4693-700)
Palestinian territories face huge burden of disability
Authors: A. Ferriman
Journal: BMJ (2002)

Doctors in the Palestinian territories are deeply concerned at the level of disability that will result from the present conflict with Israel and the restricted facilities that are available to deal with it.

Research carried out by the Institute of Community and Public Health at Birzeit University, near Ramallah, shows that about 13% of the injuries sustained by Palestinians during the conflict so far are likely to result in permanent disability. A total of 33 000 injuries have …
THE POOR RISK FOR SURGERY OF THE PELVIC ORGANS
Authors: JOHN G. CLARK
Journal: JAMA (1925)

[Editorial Note.—This paper together with the papers of Drs. Walters and Mayo, and Lahey, which follow it, conclude the symposium on the Poor Surgical Risk. In our last issue we published the papers of Drs. Thalhimer, Jones, McKittrick and Root, and Orr and Haden.]  Within the last decade there has been a radical change in the point of view concerning surgical contraindications because of the incalculable improvement in the choice and methods of administering various anesthetics. Formerly the selection lay between chloroform and ether. The first, because of its subtle and catastrophic dangers, was gradually eliminated as a routine drug, for, in addition to the immediate risks attending its use, laboratory investigations have revealed the frequency of toxic lesions occurring in the liver and kidneys, ranging from minor to major issues, indeed to as lethal an event as acute yellow atrophy of the liver.  Chloroform has therefore lost its
Joining forces for children's health.
Authors: K S Brown
Journal: Environmental Health Perspectives (1998)

From airborne particulatesto pesticide-laden fruit, children probably encounter more pollutants than adults. Because their bodies are rapidly developing, children may react more strongly to these toxins, too. The NIEHS hopes to learn more about how several hazardous agents specifically affect kids. Together, the NIEHS and the EPA are spending $10 million to establish up to six Centers for Children's Environmental Health and Disease Prevention Research. The CDC, a third partner,will later help apply center research to public health.
Effectiveness of Extended-Duration Transdermal Nicotine Therapy
Authors: Robert A. Schnoll
Journal: Annals of Internal Medicine (2010)

Background: Tobacco dependence is a chronic, relapsing condition that may require extended treatment. Objective: To assess whether extended-duration transdermal nicotine therapy increases abstinence from tobacco more than standard-duration therapy in adult smokers. Design: Parallel randomized, placebo-controlled trial from September 2004 to February 2008. Participants and all research personnel except the database manager were blinded to randomization. (ClinicalTrials.gov registration number: NCT00364156) Setting: Academic center. Participants: 568 adult smokers. Intervention: In an unstratified small block–randomization scheme, participants were randomly assigned to standard therapy (Nicoderm CQ [GlaxoSmithKline, Research Triangle Park, North Carolina], 21 mg, for 8 weeks and placebo for 16 weeks) or extended therapy (Nicoderm CQ, 21 mg, for 24 weeks). Measurements: The primary outcome was biochemically confirmed point-prevalence abstinence at weeks 24 and 52. Secondary outcomes were continuous and prolonged abstinence, lapse and recovery events, cost per additional quitter, and side effects and adherence. Results: At week 24, extended therapy produced higher rates of point-prevalence abstinence (31.6% vs. 20.3%; odds ratio, 1.81 [95% CI, 1.23 to 2.66]; P = 0.002), prolonged abstinence (41.5% vs. 26.9%; odds ratio, 1.97 [CI, 1.38 to 2.82]; P = 0.001), and continuous abstinence (19.2% vs. 12.6%; odds ratio, 1.64 [CI, 1.04 to 2.60]; P = 0.032) versus standard therapy. Extended therapy reduced the risk for lapse (hazard ratio, 0.77 [CI, 0.63 to 0.95]; P = 0.013) and increased the chances of recovery from lapses (hazard ratio, 1.47 [CI, 1.17 to 1.84]; P = 0.001). Time to relapse was slower with extended versus standard therapy (hazard ratio, 0.50 [CI, 0.35 to 0.73]; P < 0.001). At week 52, extended therapy produced higher quit rates for prolonged abstinence only (P = 0.027). No differences in side effects and adverse events between groups were found at the extended-treatment assessment. Limitation: The generalizability of the findings may be limited because participants were smokers without medical comorbid conditions who were seeking treatment, and differences in adherence across treatment groups were detected. Conclusion: Transdermal nicotine for 24 weeks increased biochemically confirmed point-prevalence abstinence and continuous abstinence at week 24, reduced the risk for smoking lapses, and increased the likelihood of recovery to abstinence after a lapse compared with 8 weeks of transdermal nicotine therapy. Primary Funding Source: National Institutes of Health.
Statistical analysis of pacemaker follow-up data. Rate stability and reliability.
Authors: G L Grunkemeier, J L Dobbs, A Starr
Journal: Circulation (1976)

In a rate-stable pacemaker, pacemaker rate reflects battery voltage level and should remain constant or be slightly depleted with time in a linear fashion until failure occurs. Linear regression techniques are therefore particularly suited to the analysis of pacemaker rate data. Data on model 8114/8114A Starr-Edwards pacemakers followed at the University of Oregon Health Sciences Center were studied. For a given pacemaker both the slope of the regression line and the standard deviation about the regression line are proportional to the original rate. Natural indices of rate depletion and rate stability for each pacemaker can therefore be calculated by dividing the slope and the standard deviation, respectively, by the inpercept of the corresponding regression line. This model pacemaker has a small average standard deviation so that significant variations from the line of regression, indicating impending pulse generator failure, can be detected in spite of random fluctuations. Emergency and prophylactic replacements can therefore be kept to a minimum so that pulse generator lifetime is maximized. Success in extending pulse generator longevity can be measured by actuarial techniques, which show this pacemaker to have a median battery depletion time of 38 months and a median replacement time of 35 months.
Sex Differences in Severe Pulmonary Emphysema
Authors: Fernando J. Martinez, Jeffrey L. Curtis, Frank Sciurba, Jeanette Mumford, Nicholas D. Giardino, Gail Weinmann, Ella Kazerooni, Susan Murray, Gerard J. Criner, Donald D. Sin, James Hogg, Andrew L. Ries, MeiLan Han, Alfred P. Fishman, Barry Make, Eric A. Hoffman, Zab Mohsenifar, Robert Wise
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Limited data on sex differences in advanced COPD are available.To compare male and female emphysema patients with severe disease.One thousand fifty-three patients (38.8% female) evaluated for lung volume reduction surgery as part of the National Emphysema Treatment Trial were analyzed.Detailed clinical, physiological, and radiological assessment, including quantitation of emphysema severity and distribution from helical chest computed tomography, was completed. In a subgroup (n = 101), airway size and thickness was determined by histological analyses of resected tissue. Women were younger and exhibited a lower body mass index (BMI), shorter smoking history, less severe airflow obstruction, lower Dl(co) and arterial Po(2), higher arterial Pco(2), shorter six-minute walk distance, and lower maximal wattage during oxygen-supplemented cycle ergometry. For a given FEV(1)% predicted, age, number of pack-years, and proportion of emphysema, women experienced greater dyspnea, higher modified BODE, more depression, lower SF-36 mental component score, and lower quality of well-being. Overall emphysema was less severe in women, with the difference from men most evident in the outer peel of the lung. Females had thicker small airway walls relative to luminal perimeters.In patients with severe COPD, women, relative to men, exhibit anatomically smaller airway lumens with disproportionately thicker airway walls, and emphysema that is less extensive and characterized by smaller hole size and less peripheral involvement.
Perception of Severity of Disease and Health Locus of Control in Compliant and Noncompliant Diabetic Patients
Authors: Maria Alogna
Journal: Diabetes Care (1980)

Compliant and noncompliant obese, non-insulin-dependent diabetic subjects were assessed using a variety of demographic variables, the health locus of control scale (HLC), and the perception of severity of disease index based on the health belief model. The complaint subjects were significantly older and viewed their illness as significantly more severe than the noncompliant patients. Additionally, they tended to exhibit more of an internal locus of control that the noncompliant patients.
Prostaglandin E2 promotes colorectal adenoma growth via transactivation of the nuclear peroxisome proliferator-activated receptor δ
Authors: Dingzhi Wang, Haibin Wang, Qiong Shi, Sharada Katkuri, Walter Walhi, Beatrice Desvergne, Sanjoy K. Das, Sudhansu K. Dey, Raymond N. DuBois
Journal: Cancer Cell (2004)
The current single exhalation method of measuring exhaled nitric oxide is affected by airway calibre
Authors: L.P. Ho, F.t Wood, A Robson, J.a Innes, A.p Greening
Journal: European Respiratory Journal (2000)

The authors have observed that some patients with acute exacerbations of asthma do not have substantially higher levels of exhaled nitric oxide (NO). The study examined whether this could be explained by the effect of airway calibre on exhaled NO. Exhaled NO, height and forced expiratory volume in one second (FEV1) were measured in 12 steroid-naive asthmatics and 17 normal subjects. For comparison, another group of patients with airways disease (34 cystic fibrosis patients) were also studied. In 20 asthmatics (on various doses of inhaled steroids, 0-3,200 microg x day-1), exhaled NO was measured before and after histamine challenge (immediately after reaching the provocative concentration causing a 20% fall in FEV1) and in 12 of these patients, also after nebulized salbutamol to restore FEV1 to baseline. Studies were also conducted to examine possible confounding effects of repeated spirometry (as would occur in histamine challenge) and nebulized salbutamol alone in exhaled NO levels. Exhaled NO was measured using a single exhalation method with a chemiluminescence analyser at a constant flow rate and mouth pressure. There was a significant correlation between FEV1 and exhaled NO in steroid naive asthmatics (r=0.9, p&lt;0.001) and cystic fibrosis patients (r=-0.48, p&lt;0.05) but not in normal subjects (r=-0.13, p=0.61). Exhaled NO decreased significantly after histamine challenge and returned to baseline after bronchodilation by nebulized salbutamol (mean+/-SEM: 23.6+/-3.6 parts per billion (ppb) (prehistamine), 18.2+/-2.7 ppb (posthistamine) and 23.6+/-3.8 ppb (postsalbutamol) p=0.001). Repeated spirometry and nebulized salbutamol did not affect exhaled NO measurements significantly. Exhaled nitric oxide levels appear to be lower in circumstances of smaller airway diameter. Hence, within a subject nitric oxide levels may be artefactually decreased during bronchoconstriction. This may be caused by increased airflow velocity in constricted airways when the exhalation rate is kept constant.
Rates of Disease Progression by Baseline CD4 Cell Count and Viral Load After Initiating Triple-Drug Therapy
Authors: Robert S. Hogg
Journal: JAMA (2001)

ContextCurrent recommendations for initiation of antiretroviral therapy in patients infected with human immunodeficiency virus type 1 (HIV) are based on CD4 T-lymphocyte cell counts and plasma HIV RNA levels. The relative prognostic value of each marker following initiation of therapy has not been fully characterized.ObjectiveTo describe rates of disease progression to death and AIDS or death among patients starting triple-drug antiretroviral therapy, stratified by baseline CD4 cell count and HIV RNA levels.Design, Setting, and ParticipantsPopulation-based analysis of 1219 antiretroviral therapy–naive HIV-positive men and women aged 18 years or older in British Columbia who initiated triple-drug therapy between August 1, 1996, and September 30, 1999.Main Outcome MeasureCumulative mortality rates from the initiation of triple-drug antiretroviral therapy to September 30, 2000, determined using various CD4 cell and plasma HIV RNA thresholds.ResultsAs of September 30, 2000, 82 patients had died of AIDS-related causes, for a crude AIDS-related mortality rate of 6.7%. The product limit estimate (SE) of the cumulative mortality rate at 12 months was 2.9% (0.5%). In univariate analyses, a prior diagnosis of acquired immunodeficiency syndrome (AIDS), CD4 cell count, use of protease inhibitors, and HIV RNA level were associated with mortality. There was no difference in mortality by age or sex. Only CD4 cell count remained statistically significant in the multivariate analysis. After controlling for AIDS, protease inhibitor use, and plasma HIV RNA level at baseline, patients with CD4 cell counts of less than 50/µL were 6.67 (95% confidence interval [CI], 3.61-12.34) times and those with counts of 50/µL to 199/µL were 3.41 (95% CI, 1.93-6.03) times more likely to die than those with counts of at least 200/µL.ConclusionOur data demonstrate uniformly low rates of disease progression to death and AIDS or death among patients starting antiretroviral therapy with CD4 cell counts of at least 200/µL. In our study, disease progression to death and AIDS or death was clustered among patients starting therapy with CD4 cell counts less than 200/µL.