tbuckley/cabot-search huggingface dataset:
Calcium Channel Blockers and the Risk of Cancer
Authors: Lynn Rosenberg
Journal: JAMA (1998)

Context.—Recent epidemiologic studies have raised the concern that calcium channel blocker use may increase the risk of cancer overall and of several specific cancers.Objective.—To assess whether calcium channel blocker use increases the risk of cancer overall and of specific cancers.Design.—Case-control drug surveillance study based on data collected from 1983 to 1996.Setting.—Hospitals in Baltimore, Md, New York, NY, and Philadelphia, Pa.Patients.—A total of 9513 patients aged 40 to 69 years with incident cancer of various sites and 6492 controls aged 40 to 69 years admitted for nonmalignant conditions.Main Outcome Measures.—Incident cancer overall and 23 specific cancers.Results.—Calcium channel blocker use was unrelated to the risk of cancer overall (relative risk [RR], 1.1; 95% confidence interval [CI], 0.9-1.3). Use was not significantly associated with increased risks of individual cancers, including those previously implicated, except cancer of the kidney (RR, 1.8; 95% CI, 1.1-2.7). Recent use, use for 5 or more years, and use of individual calcium channel blocker drugs were also not associated with cancer incidence. Use of β-blockers and angiotensin-converting enzyme inhibitors was generally unrelated to cancer overall or individual cancers, but both were associated with kidney cancer (RR, 1.8; 95% CI, 1.3-2.5; and RR, 1.9; 95% CI, 1.2-3.0, respectively).Conclusions.—The present study suggests that the use of calcium channel blockers is unrelated to an increase in the overall risk of cancer or of individual cancers, except kidney cancer, which has been associated with hypertension or drugs to treat hypertension in previous studies.
When Is Termination of Pregnancy during the Third Trimester Morally Justifiable?
Authors: Frank A. Chervenak, Margaret A. Farley, LeRoy Walters, John C. Hobbins, Maurice J. Mahoney
Journal: New England Journal of Medicine (1984)

The question whether to terminate pregnancy during the third trimester involves a moral conflict. We argue that such termination is morally justifiable if two conditions are fulfilled: first, that the fetus is afflicted with a condition that is either incompatible with postnatal survival for more than a few weeks or characterized by the total or virtual absence of cognitive function; and second, that highly reliable diagnostic procedures are available for determining prenatally that the fetus fulfills either of the two parts of the first condition. At present, one entity, anencephaly, clearly fulfills both conditions. We studied 10 cases involving fetuses with sonographically diagnosed anencephaly that were aborted during the third trimester. We also examined other fetal disorders and conclude that they do not clearly fulfill our two conditions for the justifiable termination of pregnancy in the third trimester.The question whether to terminate the pregnancy during 3rd trimester involves a moral conflict. The authors argue that such termination is morally justifiable if 2 conditions are fulfilled: 1st, that the fetus is afflicted with a condition that is either incompatible with postnatal survival for more than a few weeks or characterized by the total or virtual absence of cognitive function; and 2nd, that highly reliable diagnostic procedures are available for determining prenatally that the fetus fulfills either of the 2 parts of the 1st condition. At present, 1 entity, anencephaly, clearly fulfills both conditions. We studied 10 cases involving fetuses with sonographically diagnosed anencephaly that were aborted during the 3rd trimester. The authors also examined other fetal disorders and concluded that they do not clearly fulfill the 2 conditions for the justifiable termination of 3rd trimester pregnancy.
Increased Small Low-Density Lipoprotein Particle Number
Authors: Sekar Kathiresan, James D. Otvos, Lisa M. Sullivan, Michelle J. Keyes, Ernst J. Schaefer, Peter W.F. Wilson, Ralph B. D’Agostino, Ramachandran S. Vasan, Sander J. Robins
Journal: Circulation (2005)

Background— Levels of LDL cholesterol (LDL-C) are frequently not elevated in individuals with the metabolic syndrome (MetSyn). However, the atherogenic potential of LDL may depend on the number and size of LDL particles in addition to the cholesterol content of LDL. Methods and Results— We examined the sex-specific cross-sectional relations of small LDL particle number (determined by nuclear magnetic resonance spectroscopy) to the presence of MetSyn and its components in 2993 Framingham Heart Study participants (mean age, 51 years; 53% women) without cardiovascular disease (CVD) and the relations of small LDL particle number to CVD incidence in people with MetSyn. The MetSyn (≥3 of 5 traits as defined by the National Cholesterol Education Adult Treatment Panel III) was present in 27% of men and 17% of women. In both sexes, small LDL particle number increased from 0 to 5 MetSyn traits, a pattern partly accounted for by strong correlations between small LDL particle number and serum triglycerides ( r =0.61, P &lt;0.0001) and HDL-C ( r =−0.55, P &lt;0.0001). Compared with participants without the MetSyn, those with the MetSyn had a higher CVD event rate. However, among participants with the MetSyn, CVD rates were similar for groups with an elevated versus a lower number of small LDL particles (defined by the sex-specific median). Conclusions— Small LDL particle number is elevated in the MetSyn, increases with the number of MetSyn components, and most prominently is correlated with triglycerides and HDL-C. Whereas increased small LDL particle number identified the MetSyn with high sensitivity, a higher small LDL particle number was not associated with greater CVD event rates in people with the MetSyn.
Variability in ciliary beat frequency in normal subjects and in patients with bronchiectasis.
Authors: D Veale, A D Rodgers, C J Griffiths, T Ashcroft, G J Gibson
Journal: Thorax (1993)

BACKGROUND--There is a wide variation in tracheobronchial clearance of inhaled aerosol in normal subjects and in patients with bronchiectasis, but little information is available on the variability in ciliary beat frequency (CBF). METHODS--The variability in CBF was measured in 10 nasal mucosal samples from each of 19 normal controls and 23 stable bronchiectatic subjects. RESULTS--The CBF varied at different mucosal sites in both normal subjects and bronchiectatic patients. Although the CBF of the fastest beating cilia was similar in both groups, the CBF of the slowest beating cilia was, on average, lower and showed greater within subject variation in bronchiectatic than in normal subjects. CONCLUSIONS--There is a wide variation in CBF in nasal mucosal samples and this is significantly wider in bronchiectatic subjects with some cilia beating slowly. This may be a consequence of chronic inflammation or infection.
Opposing roles of gp130-mediated STAT-3 and ERK-1/2 signaling in liver progenitor cell migration and proliferation
Authors: George C. T. Yeoh, Matthias Ernst, Stefan Rose-John, Barbara Akhurst, Christine Payne, Sarah Long, Warren Alexander, Ben Croker, Dianne Grail, Vance B. Matthews
Journal: Hepatology (2007)

Gp130-mediated IL-6 signaling may play a role in oval cell proliferation in vivo. Levels of IL-6 are elevated in livers of mice treated with a choline-deficient ethionine-supplemented (CDE) diet that induces oval cells, and there is a reduction of oval cells in IL-6 knockout mice. The CDE diet recapitulates characteristics of chronic liver injury in humans. In this study, we determined the impact of IL-6 signaling on oval cell-mediated liver regeneration in vivo. Signaling pathways downstream of gp130 activation were also dissected. Numbers of A6(+ve) liver progenitor oval cells (LPCs) in CDE-treated murine liver were detected by immunohistochemistry and quantified. Levels of oval cell migration and proliferation were compared in CDE-treated mouse strains that depict models of gp130-mediated hyperactive ERK-1/2 signaling (gp130(deltaSTAT)), hyperactive STAT-3 signaling (gp130(Y757F) and Socs-3(-/deltaAlb)) or active ERK-1/2 as well as active STAT-3 signaling (wild-type). The A6(+ve) LPC numbers were increased with IL-6 treatment in vivo. The gp130(Y757F) mice displayed increased A6(+ve) LPCs numbers compared with wild-type and gp130(deltaSTAT) mice. Numbers of A6(+ve) LPCs were also increased in the livers of CDE treated Socs-3(-/deltaAlb) mice compared with their control counterparts. Lastly, inhibition of ERK-1/2 activation in cultured oval cells increased hyper IL-6-induced cell growth. For the first time, we have dissected the gp130-mediated signaling pathways, which influence liver progenitor oval cell proliferation.Hyperactive STAT-3 signaling results in enhanced oval cell numbers, whereas ERK-1/2 activation suppresses oval cell proliferation.
[327] RAS/MEK/ERK AND TGF-BETA/CTGF PATHWAYS AS POSSIBLE DETERMINANTS OF RESISTANCE TO RAPAMYCIN TREATMENT IN BDL-INDUCED LIVER FIBROSIS. RESULTS OF A GENE ARRAY ANALYSIS
Authors: L. Idrissova, M. Ledermann, H. Saegesser, V. Schneider, A. Kuhn, S. Shaw, J. Reichen, M. Neef
Journal: Journal of Hepatology (2007)
Should women who elect to have caesarean sections pay for them?
Authors: I Z MacKenzie
Journal: BMJ (1999)

EDITOR—The issue of whether doctors should perform elective caesarean sections on request confronts obstetricians almost daily.1 Neither the original articles in the BMJ on elective caesarean section nor the correspondence that followed quantified the problem in the United Kingdom. 1 2

The table illustrates the primary indications for 978 caesarean sections performed before labour in 1976, 1986, and 1996 at the John Radcliffe Hospital in Oxford. The information …
TOR Signaling and Rapamycin Influence Longevity by Regulating SKN-1/Nrf and DAF-16/FoxO
Authors: Stacey Robida-Stubbs, Kira Glover-Cutter, Dudley W. Lamming, Masaki Mizunuma, Sri Devi Narasimhan, Elke Neumann-Haefelin, David M. Sabatini, T. Keith Blackwell
Journal: Cell Metabolism (2012)
Asthma and atopy – the price of affluence?
Authors: L. C. Von Hertzen, T. Haahtela
Journal: Allergy (2004)

Irrespective of improved knowledge of many aspects of atopic diseases, the unfavorable trends in their prevalence particularly among children could not have been reversed. A growing body of evidence suggests that something may lack from our societal affluence that has the capacity to provide protection against the development of atopic diseases. Much attention during the last years has been devoted to the hygiene hypothesis. This review outlines the impact of environment and lifestyle, particularly from the perspective of the East–West gradient, on the development of atopic diseases, with a special emphasis on the hygiene hypothesis in its broadest sense.
RECENT PROGRESS IN THE TREATMENT OF PLUMBISM
Authors: IRVING GRAY
Journal: JAMA (1935)

The opportunity for studying a group of patients with lead poisoning was afforded because of the contentious situation that arose in the adjudication of their disability. In one group of individuals a diagnosis of chronic lead poisoning had been made from six months to two years prior to coming under my observation. The problem that arose was to determine whether or not protracted subjective symptoms were due to chronic lead poisoning and, if so, to institute a method of treatment. There were nine patients in this group. In a second group, more recently exposed to either the ingestion or the inhalation of lead, a diagnosis of subacute lead poisoning had been made. The problem here was to determine the best type of treatment to bring about recovery. There were four patients in this group. In a third group (two patients) it was alleged that subjective symptoms of recent origin were
Economic burden of inadequate management of allergic diseases in the European Union: a GA<sup>2</sup>LEN review
Authors: T. Zuberbier, J. Lötvall, S. Simoens, S. V. Subramanian, M. K. Church
Journal: Allergy (2014)

In the European Union (EU), between 44 and 76 million individuals of the 217 million EU employees suffer from allergic disease of the airways or the skin. Up to 90% of these persons are untreated or insufficiently treated. This has major socio-economic consequences such as absence from work (absenteeism), particularly reduced productivity at work (presenteeism).We used published literature and online statistical information from Eurostat and Eurofound to assess the costs of allergic disease to society.Allergies have an impact on direct, indirect, intangible and opportunity costs. Most importantly, for the EU, avoidable indirect costs per patient insufficiently treated for allergy range between €55 and €151 billion per annum due to absenteeism and presenteeism, that is, €2405 per untreated patient per year. On the other hand, appropriate therapy for allergic diseases is available at comparatively low costs at an average of €125 per patient annually, equalling only 5% of the costs of untreated disease, allowing potential savings of up to €142 billion.A better care for allergies based on guideline-based treatment would allow Europe's economy substantial savings. In addition, allergies have an impact on learning and performance at school and university, leading to opportunity costs for society. This cannot be calculated moneywise but will have an impact in a modern knowledge-based society. Still allergies are trivialized in society, noting that the costs of therapy are paid by patients and healthcare services, whereas economic savings are made by employers and society. A change of this mindset is urgently needed.
Protein Digestion and Absorption
Authors: Howard L. Bleich, Emily S. Boro, Marvin H. Sleisenger, Young S. Kim
Journal: New England Journal of Medicine (1979)

ALTHOUGH protein accounts for only about 11 to 14 per cent of the total calories that Americans ingest each day, this food substance is essential for nutritional homeostasis. The bulk of protein, which maintains nitrogen balance, is from exogenous sources, but endogenous protein is also important for nitrogen balance; from 25 to 200 g per day are presented to the small intestine in the form of enzymes, secreted proteins, secreted glycoproteins and desquamated epithelial cells. Only 2 to 5 per cent of the protein in contact with the absorbing surface of the small bowel escapes transport. Thus, the processes of . . .
Coupling calcium in mammalian ventricle: its source and factors regulating its quantity
Authors: G. A. Langer
Journal: Cardiovascular Research (1971)

Coupling calcium in mammalian ventricle: its source and factors regulating its quantity Get access G. A. Langer G. A. Langer From the Departments of Physiology and Medicine and the Los Angeles County Cordiovascular Research Laboratory, University of California at Los Angeles, Center for Health Sciences, Los Angeles, California, U.S.A. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 5, Issue supp1, July 1971, Pages 71–75, https://doi.org/10.1093/cvr/5.supp1.71 Published: 01 July 1971
The Social and Economic Costs of End-Stage Renal Disease
Authors: James D. Campbell, Anne R. Campbell
Journal: New England Journal of Medicine (1978)

Abstract The social and economic effects of end-stage renal disease are enormous. This case history of our experience with dialysis and transplantation details our life with these two modes of treatment. Despite the common notion that Medicare covers most of the expenses, the detailed records of our financial experience show that Medicare paid only 53 per cent of our total costs; the remainder came from a mixture of private and public sources. In seeking alternative financial support, we encountered many problems, including complex and constraining requirements for aid, invasion of privacy, high insurance and bank-interest rates and termination of employment. Even those in middle-income brackets find it difficult to maintain their independence under such circumstances. New legislation extending Medicare coverage of home dialysis and transplantation should help to alleviate these problems in the future. (N Engl J Med 299:386–392, 1978)
Polycythemia Rubra Vera Progressing to Ph^1-Positive Chronic Myelogenous Leukemia
Authors: EDWARD C. HOPPIN
Journal: Annals of Internal Medicine (1975)

Polycythemia rubra vera and chronic myelogenous leukemia are both myeloproliferative disorders and, as such, share certain clinical features. Although some myeloproliferative disorders may transform into others, conversion of polycythemia rubra vera to chronic myelogenous leukemia has been denied. We report here an elderly man with polycythemia rubra vera and a normal leukocyte alkaline phosphatase who developed chronic myelogenous leukemia with a low leukocyte alkaline phosphatase and a marrow karyotype of 45, X, Ph1-positive. In addition, we have collected evidence of two similar cases and thus conclude that, although uncommon, polycythemia rubra vera may on occasion progress to chronic myelogenous leukemia.
Computers in Electrocardiography
Authors: L. H. Anderson
Journal: JAMA (1971)

An introduction to computer analysis of the electrocardiogram, this book attempts to cover the subject comprehensively in a compact and easy-to-read form. This objective has been accomplished quite well. It is a mixture of basic instruction for the beginner and complex reference data for the expert. The first 56 pages are a review of electrocardiography and vectorcardiography, addressed primarily to mathematicians. The remaining pages are intended for both mathematicians and physicians and deal with computer processing. Formulas and techniques in common usage, as well as from the author's own laboratory, are described in detail. A fairly broad bibliography is included at the end of each of the six chapters.  Although the ECG review receives a rather laborious mathematical treatment, the illustrations are clear, and there are useful medical reference sources in such topics as constructing unipolar, bipolar, and orthogonal leads; relating 12-lead and X-Y-Z-lead systems; diagrams and tables of the
The Mark of a Cane
Authors: Michael Joel Pottash
Journal: Annals of Internal Medicine (2013)

On Being a DoctorDecember 3, 2013The Mark of a CaneMichael Joel Pottash, MD, MPHMichael Joel Pottash, MD, MPHFrom Jacobi Medical Center, Bronx, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-11-201312030-00018 Audio Reading - “The Mark of a Cane” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Mark of a Cane," by M.J. Pottash. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “The tragedy of old age,” as Oscar Wilde writes in The Picture of Dorian Gray, “is not that one is old, but that one is young.” We inevitably age and become ill while continuing to regard ourselves as young and healthy.In medicine, overlooking this wisdom can be a key barrier to patient care. As physicians, we know our sick patients as sick and our old patients as old, but patients tend to view themselves as vigorous and youthful.Patients seek us out when they are sick, vulnerable, and exposed. We meet them already stripped of their individuality: lying flat ... Author, Article, and Disclosure InformationAffiliations: From Jacobi Medical Center, Bronx, New York.Corresponding Author: Michael Pottash MD, MPH, Jacobi Medical Center, Department of Medicine, Building 1, Room 3N21, 1400 Pelham Parkway South, Bronx, NY, 10461; e-mail, [email protected]. PreviousarticleNextarticle Advertisement Audio Reading - “The Mark of a Cane” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Mark of a Cane," by M.J. Pottash. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics December 3, 2013Volume 159, Issue 11Page: 792KeywordsCaregiversDeceptionElderlyEpileptic seizuresFallsMyocardial infarctionPatientsPhysiciansStrokeWalking ePublished: 3 December 2013 Issue Published: December 3, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Reviews and Notes: A Way of Thinking: A Primer on the Art of Being a Doctor. Essays by Eugene A. Stead, Jr
Authors: Andrew L. Epstein
Journal: Annals of Internal Medicine (1996)

Literature of Medicine15 August 1996Reviews and Notes: A Way of Thinking: A Primer on the Art of Being a Doctor. Essays by Eugene A. Stead, JrAndrew L. Epstein, MDAndrew L. Epstein, MDHarvard Pilgrim Health Care, Cambridge, MA 02138Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-4-199608150-00035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail BF Haynes; ed. 181 pages. Durham, NC: Carolina Academic Pr; 1995. $24.95. ISBN 0-89089-753-0. Order phone 919-489-7486.Why do so many great physicians write books at the end of their careers about the essence of doctoring rather than about their achievements in science? This question recurred as I read this collection of essays by Eugene A. Stead, Jr., who was Chairman of Medicine at Duke University from 1947 to 1967. The collection was edited by Barton F. Haynes, the current Chairman.Many current observers attribute the loss of traditional values of doctoring to the restrictions of managed care, but Dr. ... Author, Article, and Disclosure InformationAffiliations: Harvard Pilgrim Health Care, Cambridge, MA 02138 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byReflecting on pain management for patients with osteoarthritis and other rheumatic disorders: there's more to pain management than managing pain 15 August 1996Volume 125, Issue 4Page: 351KeywordsBehaviorBrainFearForecastingHealth careHealth care providersMedical educationMotivationPatientsProgressive diseases Issue Published: 15 August 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
FGF19 action in the brain induces insulin-independent glucose lowering
Authors: Gregory J. Morton, Miles E. Matsen, Deanna P. Bracy, Thomas H. Meek, Hong T. Nguyen, Darko Stefanovski, Richard N. Bergman, David H. Wasserman, Michael W. Schwartz
Journal: Journal of Clinical Investigation (2013)

Insulin-independent glucose disposal (referred to as glucose effectiveness [GE]) is crucial for glucose homeostasis and, until recently, was thought to be invariable. However, GE is reduced in type 2 diabetes and markedly decreased in leptin-deficient ob/ob mice. Strategies aimed at increasing GE should therefore be capable of improving glucose tolerance in these animals. The gut-derived hormone FGF19 has previously been shown to exert potent antidiabetic effects in ob/ob mice. In ob/ob mice, we found that systemic FGF19 administration improved glucose tolerance through its action in the brain and that a single, low-dose i.c.v. injection of FGF19 dramatically improved glucose intolerance within 2 hours. Minimal model analysis of glucose and insulin data obtained during a frequently sampled i.v. glucose tolerance test showed that the antidiabetic effect of i.c.v. FGF19 was solely due to increased GE and not to changes of either insulin secretion or insulin sensitivity. The mechanism underlying this effect appears to involve increased metabolism of glucose to lactate. Together, these findings implicate the brain in the antidiabetic action of systemic FGF19 and establish the brain’s capacity to rapidly, potently, and selectively increase insulin-independent glucose disposal.