tbuckley/cabot-search huggingface dataset:
Observations on Drug Prescribing in Rheumatoid Arthritis
Authors: P. Lee, S. J. Ahola, D. Grennan, P. Brooks, W. W. Buchanan
Journal: BMJ (1974)

A total of 125 patients with rheumatoid arthritis were investigated about their drug therapy before referral to a specialist centre. Most referrals were from general practitioners. Only 47 of the patients had received salicylates as the first drug and 18 had never had them at all. Soluble aspirin was the preparation of salicylates most frequently prescribed (for 63 patients). Only 60 patients had been given an adequate dose and only 62 an adequate course of treatment with salicylates. In 28 patients salicylates had been stopped on account of side effects. About one-third of the patients had been prescribed oral corticosteroids.The referral letters were poor in giving details of past and present drug therapy, and there were serious omissions in reporting of previous side effects.Seventy-five general practitioners were asked to rate several currently marketed antirheumatic drugs in terms of effectiveness. Though prednisolone 15 mg daily ranked higher than aspirin 4 g daily the difference was not significant. The study shows the inadequacies of drug prescribing for rheumatoid arthritis in the Glasgow area.
Is histological examination of tissue removed by general practitioners always necessary? Before and after comparison of detection rates of serious skin lesions
Authors: A. Lowy, D. Willis, K. Abrams
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To examine whether histological examination of all tissue removed by general practitioners in minor surgery increases the rate of detection of clinically important skin lesions, and to assess the impact of such a policy on pathologists9 workload. <b>Design:</b> Before and after comparison. <b>Setting:</b> Stratified random sample of 257 general practitioner partnerships from the catchment areas of 19 English pathology laboratories. <b>Subjects:</b> Tissue removed in minor surgery by general practitioners during the control period (September 1992 to February 1993) and intervention period (September 1993 to February 1994). <b>Intervention:</b> General practitioners referred to their local pathology laboratory all solid tissue removed in all minor surgery, irrespective of their previous policy. <b>Main outcome measures:</b> Numbers of specimens referred for histology by general practitioners during intervention and control periods; numbers of primary malignant melanomas, non-melanoma malignancies, premalignant lesions, and benign lesions. <b>Results:</b> 257/330 partnerships participated (response rate 78%). During the intervention period 5723 specimens were sent, compared with 4430 during the control period. The referral rate increased by an estimated 1.34 specimens per 1000 patient years (95% confidence interval 0.93 to 1.76, P&lt;0.001). General practitioners sent 204 specimens that were malignant (including 16 malignant melanomas) in the control period and 188 that were malignant (including 15 malignant melanomas) during the intervention period (change in total number of malignancies, -1.0 per 100 000 patient years (-5.9 to 3.8, non-significant). <b>Conclusions:</b> The intervention was associated with a substantial increase in laboratory workload, all of which was accounted for by increases in non-serious lesions. This observation should be taken into account when considering the merits of a policy requiring histological examination in every case. <h3>Key messages</h3> Requiring general practitioners to refer all tissue for histological examination resulted in a substantial increase in laboratory workload No corresponding increase was observed in detection of clinically important lesions As a means of increasing detection of serious skin pathology, requiring general practitioners to send a tissue specimen whenever they excise a lesion is unlikely to be cost effective
Relationship between Cigarette Smoking and Novel Risk Factors for Cardiovascular Disease in the United States
Authors: Lydia A. Bazzano, Jiang He, Paul Muntner, Suma Vupputuri, Paul K. Whelton
Journal: Annals of Internal Medicine (2003)

Background: Few studies have examined the relationship between cigarette smoking and novel risk factors for cardiovascular disease in a general population or have included a biochemical marker of current smoking. Objective: To examine the relationship between cigarette smoking and serum C-reactive protein, fibrinogen, and homocysteine levels. Design: Cross-sectional study. Setting: The U.S. general population. Patients: 4187 current smokers, 4791 former smokers, and 8375 never-smokers 18 years of age or older who participated in the Third National Health and Nutrition Examination Survey conducted between 1988 and 1994. Measurements: Serum C-reactive protein levels were categorized as detectable (2.2 to 9.9 mg/L) or clinically elevated ( 10 mg/L), and fibrinogen and homocysteine levels were defined as elevated if in the 85th percentile or greater (11.1 mol/L and 12.7 mmol/L, respectively). Results: After adjustment for traditional cardiovascular disease risk factors, cigarette smoking was related to elevated levels of C-reactive protein, fibrinogen, and homocysteine. Compared with never smoking cigarettes, self-reported current cigarette smoking was associated with a C-reactive protein level in the detectable (odds ratio, 1.66 [95% CI, 1.40 to 1.97]; P < 0.001) or clinically elevated (odds ratio, 1.98 [CI, 1.57 to 2.51]; P < 0.001) ranges, with elevated levels of fibrinogen (odds ratio, 2.15 [CI, 1.65 to 2.80]; P < 0.001) and homocysteine (odds ratio, 2.10 [CI, 1.62 to 2.74]; P < 0.001). There were positive and significant dose–response relationships between measures of cigarette smoking (cigarettes per day, pack-years, and serum cotinine levels) and elevated levels of novel risk factors. Conclusions: These findings suggest that inflammation and hyperhomocysteinemia may be important mechanisms by which smoking promotes atherosclerotic disease.
MODERN HOMEOPATHY AND MEDICAL SCIENCE.
Authors: HENRY BIXBY HEMENWAY
Journal: JAMA (1894)

Recent addresses by Mr. Ernest Hart of London, and Professors Roberts and Cohen of Philadelphia, together with the agitation relative to the revision of the Code of the American Medical Association, have caused considerable criticism in this country, pro and con, relative to homeopathy. It is not a question of taste or of fancy for the laity; nor is it simply an indication of bigotry, if a physician declines to consult with a homeopath. If homeopathy is right, a very large majority of physicians are mistaken. As a class they can have no possible object for opposing homeopathy except a firm belief that it is radically wrong. If homeopathy is wrong, thousands of our citizens are deluded and defrauded by this form of quackery. It is, therefore, a proper subject for careful consideration in secular as well as professional journals. When the writer decided to study medicine, the homeopathists were
CARCINOMA EPIBULBARE PLANUM.
Authors: B. MATYS
Journal: JAMA (1903)

Epibulbar tumors are those which arc localized on the margin of the cornea, where it joins the sclera (limbus corneæ), from which they spread over the cornea and conjunctiva, sometimes also in the sclera. They do not include secondary tumors occurring in the ciliary body, choroid or lids. Among the more frequent benign tumors occurring here are dermoid, fibroma and lipoma; the malignant forms being mainly sarcoma and carcinoma. The early diagnosis of these, especially the latter, is of the greatest importance, since by its timely removal the eye may be saved and, according to the testimony of medical literature, without any recurrences. The epibulbar tumor in our case was flat, peculiar in appearance and color, unusual in this respect among the malignant forms, but certainly belonging to the epibulbar tumors. Noyes had met with only three cases in seventy thousand patients. In the out-department of the Bohemian Eye
Quantitative measurement of delivery and gene silencing activities of siRNA polyplexes containing pyridylthiourea-grafted polyethylenimines
Authors: Sophie Pinel, Emmanuel Aman, Felix Erblang, Jonathan Dietrich, Benoit Frisch, Julien Sirman, Antoine Kichler, Annie-Paule Sibler, Monique Dontenwill, Florence Schaffner, Guy Zuber
Journal: Journal of Controlled Release (2014)
Therapeutic Trial of Sympathomimetics in Three Cases of Complete Heart Block in the Fetus
Authors: Alison M.M. Groves, Lindsey D. Allan, Eric Rosenthal
Journal: Circulation (1995)

Background A total of 36 fetuses with isolated congenital complete heart block and structurally normal hearts have been seen in the department of fetal echocardiography since 1980. Although the prognosis is good in the majority of cases, those who develop intrauterine cardiac failure have a high mortality. The aim of this study was to investigate the contribution to management of sympathomimetic therapy by comparing two possible agents administered to the mothers. Methods and Results The effect of two sympathomimetic agents, isoprenaline and salbutamol, was compared in three patients with isolated complete heart block. Fetal heart rate and indexes of cardiac function were monitored during therapy. Maternal cardiovascular status was also regularly assessed. Dosage of isoprenaline increased from 1 to 12 μg/min, and salbutamol increased from 4 to 64 μg/min during the trial. No significant change was detected with isoprenaline therapy, but all fetuses showed an increase in heart rate and improvement in ventricular function with salbutamol. Salbutamol was maintained until delivery in one case with evidence of cardiac failure, with resolution of fetal hydrops. All three delivered in good condition close to term. Two of three required pacing in the neonatal period. Conclusions We conclude that salbutamol can be effective in the treatment of fetal complete heart block and should be considered in patients with this condition where there is evidence of deteriorating cardiac function.
<i>Darpp-32</i>: a Novel Antiapoptotic Gene in Upper Gastrointestinal Carcinomas
Authors: Abbes Belkhiri, Alexander Zaika, Nataliya Pidkovka, Sakari Knuutila, Christopher Moskaluk, Wa'el El-Rifai
Journal: Cancer Research (2005)

Abstract We show the molecular mechanisms involved in Darpp-32 overexpression and its biological role in upper gastrointestinal adenocarcinomas (UGC). A tumor tissue array of 377 samples was developed and used to detect DARPP-32 DNA amplification and protein overexpression, which occurred in 32% and 60% of UGCs, respectively. Concomitant overexpression of mRNA for Darpp-32 and its truncated isoform t-Darpp was observed in 68% of tumors (P &amp;lt; 0.001). When Darpp-32 and t-Darpp were overexpressed in AGS and RKO gastrointestinal cells, up to a 4-fold reduction in the apoptosis rate was observed (terminal deoxynucleotidyl transferase–mediated nick-end labeling and Annexin V assays) in response to camptothecin, sodium butyrate, and ceramide. However, the introduction of mutations in phosphorylation sites abrogated this effect. Expression of Darpp-32 and t-Darpp preserved the mitochondrial transmembrane potential and was associated with increased levels of Bcl2 protein. A reversal of Bcl2 protein level was obtained using small interfering RNAs for Darpp-32 and t-Darpp. Luciferase assays using the p53 and p21 reporter plasmids and probing of immunoblots with antibodies specific for p53 transcriptional targets, such as Hdm2 and p21, indicated that neither Darpp-32 nor t-Darpp interfere with p53 function. Altogether, we show more frequent mRNA and protein overexpression of Darpp-32 than DNA amplification, suggesting that, in addition to amplification, transcriptional or posttranscriptional mechanisms may play an important role. The expression of Darpp-32 and t-Darpp is associated with a potent antiapoptotic advantage for cancer cells through a p53-independent mechanism that involves preservation of mitochondrial potential and increased Bcl2 levels.
Vitamin D Supplementation Enhances Antimycobacterial Immunity in London Tuberculosis Contacts
Authors: A.R. Martineau, S.M. Newton, B.M. Hall, K.A. Wilkinson, B. Kampmann, R.N. Davidson, G.E. Packe, Z. Maunsell, S. Rainbow, S. Eldridge, C.J. Griffiths, R.J. Wilkinson
Journal: Journal of Infection (2007)
Cancer of the Head and Neck
Authors: Philip Rubin
Journal: JAMA (1971)

The malignant gradient increases as the origin of cancers moves posteriorly in the oral cavity and reaches the oropharynx (Fig 1, Fig 2, Table 1). Thus, cancers of the base of the tongue tend to be more extensive (60% to 70% are T3 and T4) and more aggressive than cancers in the oral portion of the tongue.<sup>2</sup>The same is true of cancers of the tonsillar region as compared to those of the buccal mucosa or alveolar ridge. The incidence of metastatic neck disease is higher (more than 50% on admission). Bilateral and contralateral presentation increases in oropharyngeal primaries because of the richer network of lymphatics. The histological features are more aggressive; cancer in the oropharynx is undifferentiated and anaplastic in contrast to the more differentiated cancers of the mouth. Cure rates are very poor when one considers the more common incidence of this disease in older age groups,
MODIFIED "COUTARD" ROENTGEN THERAPY
Authors: JAMES M. MARTIN
Journal: JAMA (1935)

Roentgen rays have been used in the treatment of malignant tumors for thirty-four years, but the general acceptance of technics delivering efficient dosages has been a very slow process. Pusey1reported cases of proved carcinoma of the lip treated successfully with many times an erythema dose twenty-seven years ago, but most dermatologists are still unwilling to use such effective therapy through fear of injury to normal tissues. Experienced radiologists discovered long ago that the actual cure of carcinoma requires the administration of from 5 to 10 erythema doses of x-rays, and even more in some instances. However, the first well presented proof of this fact was brought forward by Martin and Quimby2in 1930, when they showed that the actual cure of adult squamous cell carcinoma requires from 7 to 10 erythema doses.  When considered in retrospect it now seems odd that the German so-called massive dose or
Maintenance of aerobic metabolism during global ischemia with perfluorocarbon cardioplegia improves myocardial preservation.
Authors: J T Flaherty, J H Jaffin, G J Magovern, K R Kanter, T J Gardner, M V Miceli, W E Jacobus
Journal: Circulation (1984)

We used phosphorus-31 nuclear magnetic resonance to test the ability of a perfluorocarbon blood substitute that has been shown in previous studies to improve oxygen delivery to hypothermic myocardium to maintain aerobic high-energy phosphate metabolism during total global ischemia. Twenty-three isolated perfused rabbit hearts were subjected to 180 min of hypothermic (23 degrees C) global ischemia followed by 45 min of normothermic reperfusion. Hearts received multiple doses of a cardioplegic solution that contained either oxygenated perfluorocarbon (Fluosol O2), nonoxygenated perfluorocarbon (Fluosol N2), or standard crystalloid hyperkalemic cardioplegic solution (STD-KCl) at 30 min intervals. Recovery of isovolumic left ventricular developed pressure (LVDP) was used to assess preservation of contractile function. Recovery of LVDP was 84 +/- 19% of preischemic control values with Fluosol O2, 68 +/- 16% with Fluosol N2, and 67 +/- 17% with STD-KCl (p = .058 vs Fluosol N2 and p = .056 vs STD-KCl). During 3 hr of ischemia intracellular pH (pHi) fell to 6.68 +/- 0.20 with STD-KCl and to 6.71 +/- 0.14 with Fluosol N2 but remained above 7.00 throughout the ischemic period with Fluosol O2 (p less than .0001 vs Fluosol N2 or STD-KCl). Myocardial ATP content was better preserved at 107 +/- 14% of control values with Fluosol O2 compared to 60 +/- 18% of control with Fluosol N2 and 75 +/- 21% of control with STD-KCl (p less than .001 vs Fluosol N2, p = .002 vs STD-KCl). Phosphocreatine (PCr) was also better preserved with Fluosol O2.(ABSTRACT TRUNCATED AT 250 WORDS)
Microvascular and tissue oxygen distribution
Authors: M. Intaglietta, P. C. Johnson, R. M. Winslow
Journal: Cardiovascular Research (1996)

Understanding of oxygen delivery by the microcirculation has been dominated by the unitary component analysis of Krogh and Erlangen focussed on oxygen transport mediated by single capillaries, oxygenation of tissue as a whole being extrapolated from findings on oxygen exchange in these vessels. This analysis is under revision since capillaries are not sole sources of oxygen. It is increasingly apparent that arterioles are a significant equivalent source, while venules may serve as sinks for capillary and arteriolar oxygen. As a consequence detailed descriptions of the architecture of the microcirculation based on the tissue cylinder conceptualization does not yield new information given the non-exclusive role of capillaries as purveyors of oxygen to tissue. In the present study we investigate how tissue is oxygenated directly from the arteriolar supply on the basis of current results with newly developed optical techniques for the measurement of local intra- and extravascular pO2 by phosphorescence decay. This methodology shows that tissue regions between arterioles and venules have essentially uniform tissue pO2. The only experimentally detectable gradients in pO2 are those present in the immediate vicinity of arterioles. Findings on vascular longitudinal gradients are used to devise a model that links convective and diffusive processes, showing how blood viscosity, blood oxygen-carrying capacity and the slope of the oxygen dissociation curve are linked in determining intravascular and tissue pO2. The integrated approach provides a numerical basis for interpreting consequences of alterations in transport properties of blood applicable to the field of blood substitutes.
Staphylococcus aureus and pseudomonas aeruginosa are principal pathogens of acute exacerbations following endoscopic sinus surgery
Authors: M.Y. Desrosiers, H. Al-Shemari, W. Abou-Hamad, A. Hussain, M. Poisson, M. Libman
Journal: Journal of Allergy and Clinical Immunology (2005)
Letter: Complication of Austin Moore prosthesis.
Authors: O N Vyas, A K Varshneya
Journal: BMJ (1974)

Background: Isolated facial tremor on smiling is a rare phenomenon. There are only two case reports in the English literature. Method: Case report Result: A 32 year old caucasian male presented with a 15-year history of a progressively worsening bilateral facial tremor that occured only when he changed facial expressions, in particular, when smiling. The tremor was non-responsive to propranolol and primidone. Patient also reported generalized muscle pain and stiffness. There is a family history of tremor in his grandmother but no details available. Physical exam showed tremor involving both cheeks upon smiling. No tremor or dystonia was seen in other parts of the body. He had mild parkinsonism including hypomimia, slight rigidity, bradykinesia and decreased arms swing. MRI brain w/wo contrast, DaT scan, serum ceruloplasmin, 24-hour urine copper, heavy metal screen, TSH, anti-GAD and CPK were normal. Discussion: Two cases of isolated tremor on smiling were previously reported. One was a 27 year-old woman with family history of similar symptom in her father. Her tremor responded to propranolol. Another case was a 61 year-old woman whose symptom developed after steroid treatment. Both patients refused botulinum toxin injection as a treatment. Schwingenschuh et al. reported one case in association with Parkinson’s disease (PD). PD’s symptoms responded to PD drugs but not the smiling tremor. Our patient also has mild parkinsonism, however, normal DaT scan argue against neurodegenerative parkinsonism as an etiology. Differential diagnosis include facial myoclonus, myokymia, dystonic tremor, hemifacial spasms, Meige’s syndrome, jaw tremor, tics, focal motor seizure and psychogenic tremor. Our patient is undergoing electrophysiology tests and awaiting botulinum toxin injection. Given the tremor that presents only upon activation of muscle that involving in smiling we would like to propose the term “risus tremulous”. It may represent another form of action tremor or task specific tremor. <b>Disclosure:</b> Dr. KALRA has nothing to disclose. Dr. Oravivattanakul has nothing to disclose.
Use of Remotely Sensed Data to Evaluate the Relationship between Living Environment and Blood Pressure
Authors: Maurice G. Estes, Mohammad Z. Al-Hamdan, William Crosson, Sue M. Estes, Dale Quattrochi, Shia Kent, Leslie Ain McClure
Journal: Environmental Health Perspectives (2009)

Urbanization has been correlated with hypertension (HTN) in developing countries undergoing rapid economic and environmental transitions.We examined the relationships among living environment (urban, suburban, and rural), day/night land surface temperatures (LST), and blood pressure in selected regions from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Also, the linking of data on blood pressure from REGARDS with National Aeronautics and Space Administration (NASA) science data is relevant to NASA's strategic goals and missions, particularly as a primary focus of the agency's Applied Sciences Program.REGARDS is a national cohort of 30,228 people from the 48 contiguous United States with self-reported and measured blood pressure levels. Four metropolitan regions (Philadelphia, PA; Atlanta, GA; Minneapolis, MN; and Chicago, IL) with varying geographic and health characteristics were selected for study. Satellite remotely sensed data were used to characterize the LST and land cover/land use (LCLU) environment for each area. We developed a method for characterizing participants as living in urban, suburban, or rural living environments, using the LCLU data. These data were compiled on a 1-km grid for each region and linked with the REGARDS data via an algorithm using geocoding information.REGARDS participants in urban areas have higher systolic and diastolic blood pressure than do those in suburban or rural areas, and also a higher incidence of HTN. In univariate models, living environment is associated with HTN, but after adjustment for known HTN risk factors, the relationship was no longer present.Further study regarding the relationship between HTN and living environment should focus on additional environmental characteristics, such as air pollution. The living environment classification method using remotely sensed data has the potential to facilitate additional research linking environmental variables to public health concerns.
THE PSYCHOSES OF HEART DISEASE.
Authors: WILLIAM HOUSE
Journal: JAMA (1905)

The task of classifying the psychoses caused or aggravated by disease of the heart is not easy. Eliminating organic disease of the brain, it is probable that disease of the heart is responsible for more cases of psychic disturbance than is disease of any other organ. It is notable that but brief attention is accorded to this etiologic phase of insanity and allied psychoses by textbook authors, probably for the reason that heart disease is in most instances regarded as a result or simple complication and not as a cause. A further explanation of the possible oversight rightly to place heart diseases in the etiology of mental disturbances is that, primarily, the psychic phenomena of the milder forms of heart trouble, such as palpitation, are usually insufficient to constitute insanity and are looked on as unimportant. Secondly, the severe forms of heart disease producing active mental disturbance, incapacitate the victim