tbuckley/cabot-search huggingface dataset:
On the Admission and Retention of Foreign Matters in the Lungs
Authors: C. Elam
Journal: BMJ (1876)

which I can assign no other cause but the action of the lead.She was, until the last I saw of her, blind and paralysed.1Her friends took her with them from the town, and I have no doubt that ere this she is dead or the inmate of the Chronic Paupers' Home, probably the latter ; for, as I have said, this disease is slow to mercifully kill, but leaves a destroyed body to crawl through poverty and life with all the unhappy reflections such a condition of helplessness entails on the poor.*These two cases, abstracted from many, serve strongly to show why this disease should interest us, and in their instruction give us zest to turn from their depressing details and look upon what we may more callously consider the pathology and treatment of the disease.I am aware that time will not permit me fully to discuss its pathology.I will then briefly lay before you what is known concerning it.
Access to Care in Medically Underserved Areas
Authors: Gerald H. Mandell
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Dr Petersdorf's Editorial<sup>1</sup>is simplistic in its approach to resolving the problems of patient access to care and availability of primary care by advocating a 2-year conscription of medical graduates to be placed in underserved areas. The idea that all graduates need to be involved in a program of medical school loan forgiveness is overreaching and raises significant questions about the federal funding for medical schools, the number of students to be trained, and potential interference and control by the government of medical education. The idea that the federal government is the best arbiter to decide which areas of the country are medically underserved ignores the role that politics plays in such decisions. The provision of 17 500 new graduates into underserved areas without adequate support services (ie, inner-city and rural locations) does not solve the problem of providing quality care in regions where access is
Modulation of tolerance to the transgene product in a nonhuman primate model of AAV-mediated gene transfer to liver
Authors: Federico Mingozzi, Nicole C. Hasbrouck, Etiena Basner-Tschakarjan, Shyrie A. Edmonson, Daniel J. Hui, Denise E. Sabatino, Shangzhen Zhou, J. Fraser Wright, Haiyan Jiang, Glenn F. Pierce, Valder R. Arruda, Katherine A. High
Journal: Blood (2007)
Idiosyncratic Reaction to 25-Hydroxylated Vitamin D_3
Authors: Charles G. Gegick, T.S. Danowski, Hector F. De Luca, Michael F. Holick
Journal: Annals of Internal Medicine (1974)

Letters1 March 1974Idiosyncratic Reaction to 25-Hydroxylated Vitamin D3CHARLES G. GEGICK, M.D., T.S. DANOWSKI, M.D., F.A.C.P., HECTOR F. DE LUCA, M.D., MICHAEL F. HOLICK, M.D.CHARLES G. GEGICK, M.D.Search for more papers by this author, T.S. DANOWSKI, M.D., F.A.C.P.Search for more papers by this author, HECTOR F. DE LUCA, M.D.Search for more papers by this author, MICHAEL F. HOLICK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-80-3-416 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We have administered hydroxylated derivatives of cholecalciferol or vitamin D3 (25(OH)-cholecalciferol, 1,25 dihydroxycholecalciferol, and 1-alpha hydroxycholecalciferol) to a 47-year-old woman with postthyroidectomy hypothyroidism, controlled with desiccated thyroid, and hypoparathyroidism and pruritus resistant to large dosages of calcium lactate and vitamin D2 (Table 1).In the dosages tested, each of the three hydroxylated derivatives was equally effective in controlling the severe pruritis, even though increases in serum calcium levels, if any, were slight, and the serum inorganic phosphorus remained high. Headache, nausea, vomiting, diarrhea, and fever occurred, however, in the last 4 weeks of the initial 5-month course...References1. FRASERKOOHKIND DSH: Pathogenesis of hereditary vitamin-D-dependent rickets. An inborn error of vitamin D metabolism involving defective conversion of 25-hydroxyvitamin D to 1-alpha, 25-dihydroxyvitamin D. N Engl J Med 289:817-882, 1973 CrossrefMedlineGoogle Scholar2. CHALMERSDAVIEHUNTER TMJ: 1-alpha-hydroxycholecalciferol as a substitute for the kidney hormone 1, 25-dihydroxycholecalciferol in chronic renal failure. Lancet 2:696-699, 1973 CrossrefMedlineGoogle Scholar3. DENTGARRETTS CM: Skin changes in hypocalcemia. Lancet 1:142-146, 1960 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByVitamin D analoguesVitamin D analoguesKnochenumbau und Calciumphosphat-StoffwechselThe therapeutic approach to hypoparathyroidism 1 March 1974Volume 80, Issue 3Page: 416-417KeywordsCalciumHeadachesHypoparathyroidismHypothyroidismLactatesNauseaPhosphorusPruritusThyroidVomiting Issue Published: 1 March 1974 PDF DownloadLoading ...
The Fellowship Application Process
Authors: Stuart E. Lind
Journal: JAMA (1984)

FELLOWSHIP training is the final stage of formal medical education for a substantial number of physicians. Its influence, however, extends beyond those who undergo its rigors and is felt by the profession as a whole and the society it serves. The National Study of Internal Medicine Manpower<sup>1,2</sup>has studied the process by which physicians become fellows. Their reports are quite detailed and thoughtful but are unlikely to be of help to those wrestling with individual career decisions. The remarks that follow are intended to promote thought and discussion among fellowship candidates and the faculty members who train them. While based on observations of trainees in internal medicine training programs, these remarks may also be of interest to those in other fields who are forced to consider similar problems. My basic premise is that it is to the advantage of the applicant, the training program, the profession, and the patients
Effect of intensive exercise on patients with active RA
Authors: S EDMONDS
Journal: Annals of the Rheumatic Diseases (2001)

EVect of intensive exercise on patients with active RAThe eVect of intensive exercise on disease activity in rheumatoid arthritis (RA) is an interesting one. 1 Although we would not dispute that such exercise does indeed have a beneficial eVect on parameters of disease activity, we wish to propose an alternative hypothesis as to its mechanism.In particular, we would argue that the eVect of raised intraarticular pressure on synovial blood flow during exercise is not as the authors suggest.The intra-articular pressure in chronically inflamed joints undoubtedly rises during exercise, and exceeds capillary perfusion pressure within the synovium. 2 3This pressure rise occurs in joints with and without eVusions.It is clearly diYcult to measure intra-articular pressure during dynamic exercise, but we would speculate that the pressure rises which occur during dynamic exercise are similar to those occurring during static exercise.The study that is quoted by the authors suggests that synovial blood flow increases during dynamic exercise such as walking and cycling and was only measured in joints with eVusions. 4 We would argue that raised intra-articular pressure during any form of exercise not only compromises synovial blood flow, resulting in synovial hypoxia, but is the initiating step in reperfusion injury. 5 Hypoxia-reperfusion injury is one of the mechanisms by which reactive oxygen species (ROS) are produced, including the highly toxic hydroxyl radical. 6 Damage by such ROS to biomolecules and tissues within the rheumatoid joint is well documented. 7 8Oxidative damage to fine nociceptor nerve endings within the synovium renders the joint relatively anaesthetic 9 and perhaps allows the patient to exercise the joint more vigorously.We propose therefore that intensive exercise brings about an "auto-synovectomy", eVectively reducing the amount of inflammation within the joint and thereby reducing the disease activity score.
Adenosine Challenge and Boost Protocols
Authors: ROBERT HURWITZ, KENNETH LYONS, RICHARD TAKETA
Journal: Clinical Nuclear Medicine (1999)

The validity of pharmacologic stress testing and subsequent myocardial perfusion imaging is uncertain in those patients who may have taken caffeine within the 24 hours before testing. For such patients, two new challenge tests have been developed. An intravenous bolus dose of adenosine is given at a dose of 6 mg in a period of 1 or 2 seconds. A physiologic response qualifies the patient to proceed with the scheduled stress test. In the occasional patient who exhibits no pharmacologic symptoms during an infusion test, a similar bolus dose of 6 mg adenosine can validate perfusion tests. These two applications are successful regardless of whether adenosine or dipyridamole infusions are performed. Based on this multicenter experience over 4 years, the authors estimate that 5% to 10% of patients undergoing pharmacologic testing are appropriate candidates for a challenge test.
Preexisting Insulin Autoantibodies Predict Efficacy of Otelixizumab in Preserving Residual β-Cell Function in Recent-Onset Type 1 Diabetes
Authors: Simke Demeester, Bart Keymeulen, Leonard Kaufman, Annelien Van Dalem, Eric V. Balti, Ursule Van de Velde, Patrick Goubert, Katrijn Verhaeghen, Howard W. Davidson, Janet M. Wenzlau, Ilse Weets, Daniel G. Pipeleers, Frans K. Gorus
Journal: Diabetes Care (2015)

OBJECTIVE Immune intervention trials in recent-onset type 1 diabetes would benefit from biomarkers associated with good therapeutic response. In the previously reported randomized placebo-controlled anti-CD3 study (otelixizumab; GlaxoSmithKline), we tested the hypothesis that specific diabetes autoantibodies might serve this purpose. RESEARCH DESIGN AND METHODS In the included patients (n = 40 otelixizumab, n = 40 placebo), β-cell function was assessed as area under the curve (AUC) C-peptide release during a hyperglycemic glucose clamp at baseline (median duration of insulin treatment: 6 days) and every 6 months until 18 months after randomization. (Auto)antibodies against insulin (I[A]A), GAD (GADA), IA-2 (IA-2A), and ZnT8 (ZnT8A) were determined on stored sera by liquid-phase radiobinding assay. RESULTS At baseline, only better preserved AUC C-peptide release and higher levels of IAA were associated with better preservation of β-cell function and lower insulin needs under anti-CD3 treatment. In multivariate analysis, IAA (P = 0.022) or the interaction of IAA and C-peptide (P = 0.013) independently predicted outcome together with treatment. During follow-up, good responders to anti-CD3 treatment (i.e., IAA+ participants with relatively preserved β-cell function [≥25% of healthy control subjects]) experienced a less pronounced insulin-induced rise in I(A)A and lower insulin needs. GADA, IA-2A, and ZnT8A levels were not influenced by anti-CD3 treatment, and their changes showed no relation to functional outcome. CONCLUSIONS There is important specificity of IAA among other diabetes autoantibodies to predict good therapeutic response of recent-onset type 1 diabetic patients to anti-CD3 treatment. If confirmed, future immune intervention trials in type 1 diabetes should consider both relatively preserved functional β-cell mass and presence of IAA as inclusion criteria.
Effects of mitochondrial KATP modulators on cardioprotection induced by chronic high altitude hypoxia in rats
Authors: J Neckár
Journal: Cardiovascular Research (2002)

Adaptation of rats to intermittent high altitude hypoxia increases the tolerance of their hearts to acute ischemia/reperfusion injury. Our aim was to examine the role of mitochondrial ATP-sensitive potassium channels (K(ATP)) in this form of protection.Adult male Wistar rats were exposed to hypoxia of 5000 m in a barochamber for 8 h/day, 5 days a week; the total number of exposures was 24-32. A control group was kept under normoxic conditions (200 m). Infarct size (tetrazolium staining) was measured in anesthetized open-chest animals subjected to 20-min regional ischemia (coronary artery occlusion) and 4-h reperfusion. Isolated perfused hearts were used to assess the recovery of contractile function following 20-min global ischemia and 40-min reperfusion. In the open-chest study, a selective mitochondrial K(ATP) blocker, 5-hydroxydecanoate (5 mg/kg), or openers, diazoxide (10 mg/kg) or BMS-191095 (10 mg/kg), were administered into the jugular vein 5 and 10 min before occlusion, respectively. In the isolated heart study, 5-hydroxydecanoate (250 micromol/l) or diazoxide (50 micromol/l) were added to the perfusion medium 5 or 10 min before ischemia, respectively.In the control normoxic group, infarct size occupied 62.2+/-2.0% of the area at risk as compared with 52.7+/-2.5% in the chronically hypoxic group (P<0.05). Post-ischemic recovery of contractile function (dP/dt) reached 60.0+/-3.9% of the pre-ischemic value and it was improved to 72.4+/-1.2% by adaptation to hypoxia (P<0.05). While 5-hydroxydecanoate completely abolished these protective effects of chronic hypoxia, it had no appreciable influence in normoxic groups. In contrast, diazoxide significantly increased the recovery of contractile function and reduced infarct size in normoxic groups only. The later effect was also observed following treatment with BMS-191095.The results suggest that opening of mitochondrial K(ATP) channels is involved in the cardioprotective mechanism conferred by long-term adaptation to intermittent high altitude hypoxia.
A PEST sequence in ABCA1 regulates degradation by calpain protease and stabilization of ABCA1 by apoA-I
Authors: Nan Wang, Wengen Chen, Patrick Linsel-Nitschke, Laurent O. Martinez, Birgit Agerholm-Larsen, David L. Silver, Alan R. Tall
Journal: Journal of Clinical Investigation (2003)

Cholesterol-loaded macrophage foam cells are a central component of atherosclerotic lesions. ABCA1, the defective molecule in Tangier disease, mediates the efflux of phospholipids and cholesterol from cells to apoA-I, reversing foam cell formation. In ABCA1, we identified a sequence rich in proline, glutamic acid, serine, and threonine (PEST sequence) that enhances the degradation of ABCA1 by calpain protease and thereby controls the cell surface concentration and cholesterol efflux activity of ABCA1. In an apparent positive feedback loop, apoA-I binds ABCA1, promotes lipid efflux, inhibits calpain degradation, and leads to increased levels of ABCA1. ApoA-I infusion also increases ABCA1 in vivo. These studies reveal a novel mode of regulation of ABCA1 by PEST sequence-mediated calpain proteolysis that appears to be reversed by apolipoprotein-mediated phospholipid efflux. Inhibition of ABCA1 degradation by calpain could represent a novel therapeutic approach to increasing macrophage cholesterol efflux and decreasing atherosclerosis.
Multicenter clinical trial of recombinant human insulin-like growth factor I in patients with acute renal failure
Authors: Raimund Hirschberg, Joel Kopple, Pamela Lipsett, Ernest Benjamin, Joseph Minei, Timothy Albertson, Mark Munger, Michael Metzler, Gary Zaloga, Michael Murray, Stephen Lowry, John Conger, Wade Mckeown, Michael O'Shea, Robert Baughman, Kenneth Wood, Marilyn Haupt, Roger Kaiser, Hank Simms, David Warnock, Warren Summer, Raymond Hintz, Brian Myers, Kathrine Haenftling, William Capra, Marilyn Pike, Hans-Peter Guler
Journal: Kidney International (1999)

Patients with acute renal failure (ARF) have high morbidity and mortality rates, particularly if they have serious comorbid conditions. Several studies indicate that in rats with ARF caused by ischemia or certain nephrotoxins, insulin-like growth factor-I (IGF-I) enhances the recovery of renal function and suppresses protein catabolism.Our objective was to determine whether injections of recombinant human IGF-I (rhIGF-I) would enhance the recovery of renal function and is safe in patients with ARF. The study was designed as a randomized, double-blind, placebo-controlled trial in intensive care units in 20 teaching hospitals. Seventy-two patients with ARF were randomized to receive rhIGF-I (35 patients) or placebo (37 patients). The most common causes of ARF in the rhIGF-I and placebo groups were, respectively, sepsis (37 and 35% of patients) and hypotension or hemodynamic shock (42 and 27% of patients). At baseline, the mean (+/- SD) APACHE II scores in the rhIGF-I and placebo-treated groups were 24 +/- 5 and 25 +/- 8, respectively. In the rhIGF-I and placebo groups, the mean (median) urine volume and urinary iothalamate clearances (glomerular filtration rate) were 1116 +/- 1037 (887) and 1402 +/- 1183 (1430) ml/24 hr and 6.4 +/- 5.9 (4.3) and 8.7 +/- 7.2 (4.4) ml/min and did not differ between the two groups. Patients were injected subcutaneously every 12 hours with rhIGF-I, 100 microgram/kg desirable body weight, or placebo for up to 14 days. Injections were started within six days of the onset of ARF. The primary end-point was a change in glomerular filtration rate from baseline. Other end points included changes from baseline in urine volume, creatinine clearance and serum urea, creatinine, albumin and transferrin, frequency of hemodialysis or ultrafiltration, and mortality rate.During the treatment period, which averaged 10.7 +/- 4.1 and 10.6 +/- 4.5 days in the rhIGF-I and placebo groups, there were no differences in the changes from baseline values of the glomerular filtration rate, creatinine clearance, daily urine volume, or serum urea nitrogen, creatinine, albumin or transferrin. In patients who did not receive renal replacement therapy, there was also no significant difference in serum creatinine and urea between the two groups. Twenty patients in the rhIGF-I group and 17 placebo-treated patients underwent dialysis or ultrafiltration. Twelve rhIGF-I-treated patients and 12 placebo-treated patients died during the 28 days after the onset of treatment.rhIGF-I does not accelerate the recovery of renal function in ARF patients with substantial comorbidity.
Mutations in filamin 1 Prevent Migration of Cerebral Cortical Neurons in Human Periventricular Heterotopia
Authors: Jeremy W Fox, Edward D Lamperti, Yaman Z Ekşioğlu, Susan E Hong, Yuanyi Feng, Donna A Graham, Ingrid E Scheffer, William B Dobyns, Betsy A Hirsch, Rodney A Radtke, Samuel F Berkovic, Peter R Huttenlocher, Christopher A Walsh
Journal: Neuron (1998)
Salbutamol: tablets, inhalational powder, or nebuliser?
Authors: K Grimwood, J J Johnson-Barrett, B Taylor
Journal: BMJ (1981)

A study was carried out to ascertain the most effective method of giving salbutamol. Seventeen children with severe asthma received active salbutamol (4 mg via a nebuliser, 400 micrograms as an inhalational powder, or a 4 mg tablet) together with complementary placebos on a double-blind, triple-dummy randomly allocated basis. The bronchodilatation effect was assessed by measuring the peak expiratory flow rate. The bronchodilatation effect was greatest when patients received nebulised salbutamol (p less than 0.05) but lasted longest when they received the tablet (p less than 0.0001); the onset of the effect was rapid with all forms of administration. These results indicate that nebulised salbutamol gives the best relief in severe asthma; in less severe cases, however, a regimen combining the inhalational powder and tablets is sufficient and more convenient.
Medical Care of Prisoners and Detainees
Authors: Bernard L. Diamond
Journal: JAMA (1974)

The Ciba symposia, held in London, bring together small groups of distinguished authorities on a wide variety of specialized topics of medical and scientific interest. This symposium included 21 of the world's foremost authorities concerned with the medical and psychiatric care of prisoners. However, there were no representatives from "iron-curtain" countries. Each participant presents a short formal paper, followed by extensive, free discussion. Both the papers and the discussions are presented in full in this volume (with the exception of a "Medical Psychiatric Survey in Alabama State Prison" which, for some unstated reason, had to be censored from the volume). Many critical issues, of increasing concern to physicians who engage in prison work or are concerned about prison and correctional problems, are discussed here in a very direct and provocatively informal manner. Reading this volume is almost as good as attending the symposium. Many of the papers and much of
POSTURAL HYPOTENSION WITH SYNCOPE
Authors: CLIFFORD R. WEIS
Journal: Annals of Internal Medicine (1935)

Article1 February 1935POSTURAL HYPOTENSION WITH SYNCOPEREPORT OF A CASE CURED WITH EPHEDRINE SULPHATE*CLIFFORD R. WEIS, M.D., F.A.C.P.CLIFFORD R. WEIS, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-8-8-920 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe diagnosis of postural hypotension, as first described by Bradbury and Eggleston,1is predicated upon the following phenomena: (1) syncopal attacks on change of posture with a drop of the systolic blood pressure to the shock levels; (2) anhidrosis; (3) increased distress during the heat of the summer months; (4) slow and unchanging pulse rate with marked variation in the blood pressure; (5) slight decrease in the basal metabolic rate; (6) signs of slight and indefinite changes in the central nervous system; (7) blood urea at the upper normal level. Other relevant signs or symptoms in one or more of...References1. BRADBURYEGGLESTON SC: Postural hypotension, Am. Heart Jr., 1925, i, 73-86. CrossrefGoogle Scholar2. GHRISTBROWN DGGE: Postural hypotension with syncope; its successful treatment with ephedrine, Am. Jr. Med. Sci., 1928, clxxv, 336-349. CrossrefGoogle Scholar3. MAHAN VC: Private communication. Google Scholar4. VAUGHN WT: Clinical study of hypotension, Va. Med. Month., 1928, liv, 757-760. Google Scholar5. SANDERS AO: Postural hypotension; case report, Am. Jr. Med. Sci., 1931, clxxxii, 217-221. CrossrefGoogle Scholar6. RIECKERUPJOHN HHEG: Postural hypotension; case report, Am. Heart Jr., 1930, vi, 225-229. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Dayton, Ohio*Received for publication April 9, 1934.From the Medical Service, St. Elizabeth Hospital, Dayton, Ohio. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByVegetative Herz- und KreislaufstörungenZur Patho-Physiologie und Klinik der orthostatischen KreislaufstörungenOrthostatic Hypotension, Anhidrosis, and ImpotenceORTHOSTATIC HYPOTENSION: REPORT OF A CASE REFRACTORY TO VASOCONSTRICTOR DRUGS; WITH OBSERVATIONS ON USE OF DESOXYCORTICOSTERONE, LNOREPINEPHRINE, ACTH AND VASOPRESSOR POTENTIATING SUBSTANCES*EDWIN A. CROST, M.D., HERZL FRIEDLANDER, M.D.STUDIES ON THE CIRCULATION WITH THE AID OF TAGGED ERYTHROCYTES IN A CASE OF ORTHOSTATIC HYPOTENSION (ASYMPATHICOTONIC HYPOTENSION)*G. NYLIN, M. LEVANDERHYPOTENSION AND FLYINGORTHOSTATIC HYPOTENSION; REPORT OF A CASE*WANN LANGSTON, M.D., F.A.C.P. 1 February 1935Volume 8, Issue 8Page: 920-922KeywordsBlood pressureHeart rateHypotensionMedical servicesPostural controlShockSigns and symptomsSyncopeSystolic pressureUrea Issue Published: 1 February 1935 PDF DownloadLoading ...