tbuckley/cabot-search huggingface dataset:
<i>N</i>-acetylcysteine for acetaminophen overdose: When enough is enough
Authors: Neeral L. Shah, Fredric D. Gordon, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2007)

STUDY OBJECTIVE: Treatment with a shortened duration of oral N-acetylcysteine (20 to 48 hours) after acute acetaminophen poisoning is effective in the prevention of subsequent hepatic failure and death when administered to individuals meeting appropriate laboratory criteria. METHODS: Individuals with a potentially toxic acetaminophen ingestion according to serum acetaminophen levels were identified prospectively using a large statewide poison control system database throughout a 12-month period. N-acetylcysteine was administered for a minimum of 6 doses (20 hours), after which laboratory studies were obtained. Discontinuation of N-acetylcysteine was recommended by the poison center when 2 criteria were met: serum acetaminophen was undetectable (<10 μg/mL) and liver test results were normal (serum aminotransferase, international normalized ratio). A follow-up questionnaire was administered to individuals treated with N-acetylcysteine for 48 hours or less to ascertain the presence of symptoms consistent with progressive hepatotoxicity. RESULTS: Of 205 acutely poisoned individuals treated with N-acetylcysteine for 48 hours or less, 195 were successfully contacted after discharge, and 187 of 195 (95.9%) reported no symptoms consistent with hepatic failure. Eight individuals (4.1%) reported abdominal pain or vomiting; however, none received further N-acetylcysteine treatment or additional hospitalization. CONCLUSION: A shortened duration of treatment with N-acetylcysteine (20 to 48 hours) may be an effective treatment option in individuals considered to be at no further risk of developing liver toxicity according to the fulfillment of appropriate laboratory criteria before N-acetylcysteine discontinuation.
Epstein-Barr Virus Oncoprotein Super-enhancers Control B Cell Growth
Authors: Hufeng Zhou, Stefanie C.S. Schmidt, Sizun Jiang, Bradford Willox, Katharina Bernhardt, Jun Liang, Eric C. Johannsen, Peter Kharchenko, Benjamin E. Gewurz, Elliott Kieff, Bo Zhao
Journal: Cell Host & Microbe (2015)
Effect of anabolic steroid, IGF-1 and loading on expression of genes involved in collagen metabolism in bovine extensor tendon
Authors: Sukhbir Bhullar, Kirsten Legerlotz
Journal: British Journal of Sports Medicine (2011)

<h3>Background</h3> Tendon ruptures have been linked to anabolic steroid usage, suggesting pathological changes in tendon structure due to steroid intake. Anecdotal reports from athletes suggest a protective effect of GH on tendon, especially in those who use anabolic steroids. <h3>Aim</h3> To investigate how administration of insulin-like growth factor 1 (IGF-1), anabolic steroid and combination of the two affect the expression of genes involved in collagen metabolism. <h3>Methods</h3> Fascicles were harvested from bovine extensor tendons: n=4 to calculate optimal loading and n=8 to assess hormone plus optimal loading effect on eight genes involved in collagen metabolism. Total RNA was extracted and mRNA expression analysed by quantitative real-time reverse transcription-PCR, normalised to GAPDH and 18S ribosomal RNA±control (Con). <h3>Results</h3> Maximal collagen expression occurred at 6 h of light exercise, following 1 h of heavy loading. One tendon failed to have RNA extracted and was therefore removed from the study (n=7). IL-6 expression was significantly higher than control when exercised fascicles were exposed to: (1) anabolic steroid (normalised to: 18S; GAPDH; 18S &amp; Con and GAPDH &amp; Con); (2) IGF-1 (normalised to: GAPDH; 18S &amp; Con and GAPDH &amp; Con); (3) Dulbecco’s modified Eagle’s medium &amp; PenStrep (normalised to: 18S &amp; Con and GAPDH &amp; Con) and (4) anabolic steroid &amp; IGF-1 (normalised to: 18S &amp; Con and GAPDH &amp; Con). <h3>Conclusion</h3> The results of this study suggest that tendon is an IL-6 producing region during exercise which may also contribute to IL-6 increases in plasma during exercise.
Drugs and Candy
Authors: Antonio Navarrete
Journal: JAMA (1974)

<h3>To the Editor.—</h3> There have recently appeared on the market new modalities of mint drops and similar products closely resembling pharmaceuticals in shape, color, and packaging. One such comes under the brand name of Dentyne Dynamints. It seems to me that this novel presentation, though attractive, poses a risk for children who are given these products, as it makes it more difficult for them to discern between candy and drugs that may fall into their hands. Perhaps manufacturers would reconsider marketing their wares under this form if their attention is called to its potential hazard. In any case, parents should be warned.
How to Write a Paper
Authors: L Williams
Journal: BMJ (1994)

Ed George M Hall BMJ, pounds sterling 8.95, pp 117 ISBN 0-7279-0822-7

Aspiring registrars know that they must get some research published if they are to reach the summit of the careers mountain. Scientific advancement also depends on the quality of medical research. Yet, despite these essential points, there exists within our profession a belief that the skill of writing papers is transmitted from consultant to research registrar by a process of osmosis.

It is not enough to do the work, prove your hypothesis, and sit back. For your …
White Collar Stress: What Studies of Physicians Can Teach Us
Authors: Bengt B. Arnetz
Journal: Psychotherapy and Psychosomatics (1991)

The impact of occupational stress on physicians and their medical practice has been subject to much debate but relatively little research. This paper reviews some recent studies concerning the psychosocial work environment of physicians. Psychiatric and cardiovascular epidemiologic data indicate that physicians are at similar or enhanced risk to socio-economically comparative groups. Clinical studies of physicians reveal associations between psychosocial work characteristics and traditional cardiovascular risk factors. Further work is needed to enhance our understanding of the implication of present work environments on the health and well-being of physicians as well as other health care workers.
Bone-scanning in hypertrophic osteoarthropathy
Authors: B. Robinson
Journal: Thorax (1980)

by Lipson andStephenson,6 where the effusion was confined to the pericardium, all patients with pericardial effusions had simultaneous pleural effusions.Although pericardial tamponade is rare it should be considered as an explanation of otherwise un- explained deterioration in a patient with acute pancreatitis.
The effect of MK-0591, a novel 5-lipoxygenase activating protein inhibitor, on leukotriene biosynthesis and allergen-induced airway responses in asthmatic subjects in vivo
Authors: Zuzana Diamant, Mieke C. Timmers, Hilly van der Veen, Beth S. Friedman, Marina De Smet, Marleen Depré, Deborah Hilliard, Elisabeth H. Bel, Peter J. Sterk
Journal: Journal of Allergy and Clinical Immunology (1995)
<i>Insulin-like Growth Factor 2</i> Is Required for Progression to Advanced Medulloblastoma in <i>patched1</i> Heterozygous Mice
Authors: Ryan B. Corcoran, Tal Bachar Raveh, Monique T. Barakat, Eunice Y. Lee, Matthew P. Scott
Journal: Cancer Research (2008)

Abstract Medulloblastoma (MB) can arise in the cerebellum due to genetic activation of the Sonic Hedgehog (Shh) signaling pathway. During normal cerebellum development, Shh spurs the proliferation of granule neuron precursors (GNP), the precursor cells of MB. Mutations in the Shh receptor gene patched1 (ptc1+/−) lead to increased MB incidence in humans and mice. MB tumorigenesis in mice heterozygous for ptc1+/− shows distinct steps of progression. Most ptc1+/− mice form clusters of preneoplastic cells on the surface of the mature cerebellum that actively transcribe Shh target genes. In ∼15% of mice, these preneoplastic cells will become fast-growing, lethal tumors. It was previously shown that the loss of function of insulin-like growth factor 2 (igf2) suppresses MB formation in ptc1+/− mice. We found that igf2 is not expressed in preneoplastic lesions but is induced as these lesions progress to more advanced MB tumors. Igf2 is not required for formation of preneoplastic lesions but is necessary for progression to advanced tumors. Exogenous Igf2 protein promoted proliferation of MB precursor cells (GNP) and a MB cell line, PZp53MED. Blocking igf2 signaling inhibited growth of PZp53MED cells, implicating igf2 as a potential clinical target. [Cancer Res 2008;68(21):8788–95]
ENDOTHELIOMA OF THE GASSERIAN GANGLION; TWO SUCCESSIVE RESECTIONS OF THE GANGLION; FIRST, BY THE EXTRADURAL (HARTLEY-KRAUSE) OPERATION, AND, SECONDLY, BY AN INTRADURAL OPERATION.
Authors: F. X. DERCTJM
Journal: JAMA (1900)

<h3>DR. DERCUM'S CLINICAL REPORT.</h3> The following case, both because of the rarity of the affection from which the patient suffered and because of the interesting nature of the symptoms, is worthy of record. Mr. X., a business man, 32 years of age, married, a native of Louisville, Ky., came under my care on Nov. 20, 1899. <h3>Family History.</h3> —The father died at 68 years of age, of some affection of the heart. The mother is living and well at 60, also a brother and sister. The family history is negative as regards mental, nervous and other diseases. <h3>Personal History.</h3> —The patient was rather delicate as a baby, suffered from various diseases of childhood, had an attack of scarlet fever which resulted in disease of the ears, but in youth he seemed to be rather healthy. Twelve years ago he was said to have had an attack of typhoid fever. Some
Illustrated Encyclopedia of Dermatology
Authors: Philip C. Anderson
Journal: JAMA (1986)

Rather than a broad bridge between our best small textbooks in dermatology and the multivolume giants, short encyclopedias such as this one are more like small stepping stones. Students and other novices in this specialized field do use them, but usually as an illustrated index to other reading. The shortcomings of this guide are many, including lack of a basic explanation of the logic of its classification, insufficient details about methods of proper examination, and excessively simplified versions of real clinical problems. The better-trained residents and young practitioners will find little use for this type of picture book. Presuming one decides that one needs this sort of "stepping stone," possibly for the nursing service or the emergency department, then this one seems well prepared, low priced, and of reasonable quality. The pictures are black and white, which I think usually is not harmful to the novice reader, and useful diagrams
Insulin increases glucose transfer across the blood-brain barrier in man.
Authors: M M Hertz, O B Paulson, D I Barry, J S Christiansen, P A Svendsen
Journal: Journal of Clinical Investigation (1981)

The influence of insulin on unidirectional flux of glucose across the blood-brain barrier and on net uptake of glucose by the brain was investigated in seven fasting patients. The unidirectional extraction, E, of [14C]D-glucose was determined using 36Cl- as an intravascular reference, by the indicator dilution method. 0.4 U insulin/kg body wt was infused intravenously over 30 min while blood glucose was maintained constant by glucose infusion. Six determinations were made in each patient, two before, two during insulin infusion, and two after. In connection with each blood-brain barrier study, arterial and cerebral venous samples were taken for measurement of glucose, oxygen, insulin, K+, and phosphate. Cerebral blood flow (CBF) was measured in each patient. The main finding was an increased extraction of glucose from 14 to 21% and a highly significant increase in unidirectional flux (CBF X unidirectional extraction X arterial glucose concentration) from 0.46 to 0.66 mumol/g X min during insulin infusion (plasma insulin approximately 1,500 microU/ml). The net brain uptake of glucose (CBF X arterio-venous difference for glucose) as unaltered during the investigation period of 45 min, which is too short a time for insulin to penetrate the barrier. It follows that the backflux of glucose from the brain was increased during insulin application. The effect of insulin might be a speeding up of the glucose carrier in analogy to heart muscle.
Is Exercise Beneficial -- or Hazardous -- to Your Heart?
Authors: Gregory D. Curfman
Journal: New England Journal of Medicine (1993)

At one time or another, most physicians have encountered a patient -- perhaps even a friend or family member -- who suffered a heart attack during strenuous physical exertion. Some familiar examples include shoveling snow, recreational jogging, and sexual activity. Until now, however, a link between heavy exertion and the onset of myocardial infarction has been suggested mainly by temporal associations, anecdotal reports, and everyday experience. In this issue of the Journal, the commonly held notion that vigorous exercise can trigger heart attacks has been buttressed by solid evidence. The two new reports by Mittleman et al.1 in the United . . .
Association Between Hospital Conversions to For-Profit Status and Clinical and Economic Outcomes
Authors: Karen E. Joynt, E. John Orav, Ashish K. Jha
Journal: JAMA (2014)

An increasing number of hospitals have converted to for-profit status, prompting concerns that these hospitals will focus on payer mix and profits, avoiding disadvantaged patients and paying less attention to quality of care.To examine characteristics of US acute care hospitals associated with conversion to for-profit status and changes following conversion.Retrospective cohort study conducted among 237 converting hospitals and 631 matched control hospitals. Participants were 1,843,764 Medicare fee-for-service beneficiaries at converting hospitals and 4,828,138 at control hospitals.Conversion to for-profit status, 2003-2010.Financial performance measures, quality process measures, mortality rates, Medicare volume, and patient population for the 2 years prior and the 2 years after conversion, excluding the conversion year, assessed using difference-in-difference models.Hospitals that converted to for-profit status were more often small or medium in size, located in the south, in an urban or suburban location, and were less often teaching institutions. Converting hospitals improved their total margins (ratio of net income to net revenue plus other income) more than controls (2.2% vs 0.4% improvement; difference in differences, 1.8% [ 95% CI, 0.5% to 3.1%]; P = .007). Converting hospitals and controls both improved their process quality metrics (6.0% vs 5.6%; difference in differences, 0.4% [95% CI, -1.1% to 2.0%]; P = .59). Mortality rates did not change at converting hospitals relative to controls for Medicare patients overall (increase of 0.1% vs 0.2%; difference in differences, -0.2% [95% CI, -0.5% to 0.2%], P = .42) or for dual-eligible or disabled patients. There was no change in converting hospitals relative to controls in annual Medicare volume (-111 vs -74 patients; difference in differences, -37 [95% CI, -224 to 150]; P = .70), Disproportionate Share Hospital Index (1.7% vs 0.4%; difference in differences, 1.3% [95% CI, -0.9% to 3.4%], P = .26), the proportion of patients with Medicaid (-0.2% vs 0.4%; difference in differences, -0.6% [95% CI, -2.0% to 0.8%]; P = .38) or the proportion of patients who were black (-0.4% vs -0.1%; difference in differences, -0.3% [95% CI, -1.9% to 1.3%]; P = .72) or Hispanic (0.1% vs -0.1%; difference in differences, 0.2% [95% CI, -0.3% to 0.7%]; P = .50).Hospital conversion to for-profit status was associated with improvements in financial margins but not associated with differences in quality or mortality rates or with the proportion of poor or minority patients receiving care.
THE CLINICAL MANIFESTATIONS OF PRIMARY BRONCHIAL CARCINOMA
Authors: ELMER H. FUNK
Journal: JAMA (1930)

This report is based on an analysis of the clinical features presented by sixty-one patients with primary carcinoma of the bronchus in whom the diagnosis was verified by histologic examination of tissue removed bronchoscopically (thirty-six cases), surgically (eight cases) or post mortem (twenty cases). In this group were fifty men and eleven women, a ratio of 4.5 men to 1 woman. The youngest patient was a woman, aged 24, and the oldest a man, aged 73. Only two patients were under 35 years of age (24 and 27). Twentyseven patients (44.2 per cent) were between 35 and 45. The predominance among men, the incidence after the age of 35, and especially in the decade between 35 and 45, are factors of significance in diagnosis. The increasing clinical interest in the early diagnosis of primary carcinoma of the lung has been stimulated by the recognition that origin from the larger bronchi
Alternative Methods for Concatenation of Core Genes Indicate a Lack of Resolution in Deep Nodes of the Prokaryotic Phylogeny
Authors: E. Bapteste, E. Susko, J. Leigh, I. Ruiz-Trillo, J. Bucknam, W.F. Doolittle
Journal: Molecular Biology and Evolution (2007)

It has recently been proposed that a well-resolved Tree of Life can be achieved through concatenation of shared genes. There are, however, several difficulties with such an approach, especially in the prokaryotic part of this tree. We tackled some of them using a new combination of maximum likelihood-based methods, developed in order to practice as safe and careful concatenations as possible. First, we used the application concaterpillar on carefully aligned core genes. This application uses a hierarchical likelihood-ratio test framework to assess both the topological congruence between gene phylogenies (i.e., whether different genes share the same evolutionary history) and branch-length congruence (i.e., whether genes that share the same history share the same pattern of relative evolutionary rates). We thus tested if these core genes can be concatenated or should be instead categorized into different incongruent sets. Second, we developed a heat map approach studying the evolution of the phylogenetic support for different bipartitions, when the number of sites of different phylogenetic quality in the concatenation increases. These heatmaps allow us to follow which phylogenetic signals increase or decrease as the concatenation progresses and to detect emerging artifactual groupings, that is, groups that are more and more supported when more and more homoplasic sites are thrown in the analysis. We showed that, as far as 7 major prokaryotic lineages are concerned, only 22 core genes can be said to be congruent and can be safely concatenated. This number is even smaller than the number of genes retained to reconstruct a "Tree of One Per Cent." Furthermore, the concatenation of these 22 markers leads to an unresolved tree as the only groupings in the concatenation tree seem to reflect emerging artifacts. Using concatenated core genes as a valid framework to classify uncharacterized environmental sequences can thus be misleading.
Increasing antituberculosis drug resistance in the United Kingdom: analysis of national surveillance data
Authors: Michelle E Kruijshaar, John M Watson, Francis Drobniewski, Charlotte Anderson, Timothy J Brown, John G Magee, E Grace Smith, Alistair Story, Ibrahim Abubakar
Journal: BMJ (2008)

<b>Objective</b> To identify recent trends in, and factors associated with, resistance to antituberculosis drugs in England, Wales, and Northern Ireland. <b>Design</b> Cohort of tuberculosis cases reported to the enhanced tuberculosis surveillance system matched to data on drug susceptibility and national strain typing data. <b>Setting</b> England, Wales, and Northern Ireland 1998-2005. <b>Main outcome measures</b> Unadjusted and adjusted odds ratios for drug resistance and associated factors. Proportion of multidrug resistant tuberculosis cases clustered. <b>Results</b> 28 620 culture confirmed cases were available for analysis. The proportion of cases resistant to isoniazid increased from 5% to 7%. Rifampicin resistance increased from 1.0% to 1.2% and multidrug resistance from 0.8% to 0.9%. Ethambutol and pyrazinamide resistance remained stable at around 0.4% and 0.6%, respectively. Regression analyses showed a significant increase in isoniazid resistance outside London (odds ratio 1.04, 95% confidence interval 1.01 to 1.07, a year, associated with changes in age (0.98, 0.98 to 0.99, a year), place of birth (1.49, 1.16 to 1.92), and ethnicity (P&lt;0.05). In London, the rise (1.05, 1.02 to 1.08, a year) was related mainly to an ongoing outbreak. Increases in rifampicin resistance (1.06, 1.01 to 1.11, a year) and multidrug resistance (1.06, 1.00 to 1.12, a year) were small. A fifth of patients with multidrug resistant tuberculosis in 2004-5 had indistinguishable strain types, and one case was identified as extensively drug resistant. <b>Conclusions</b> The rise in isoniazid resistance reflects increasing numbers of patients from sub-Saharan Africa and the Indian subcontinent, who might have acquired resistance abroad, and inadequate control of transmission in London. The observed increases highlight the need for early case detection, rapid testing of susceptibility to drugs, and improved treatment completion.
PubMed Central: creating an Aladdin's cave of ideas
Authors: T. Delamothe
Journal: BMJ (2001)

> If you have an apple and I have an apple and if we exchange these apples then you and I will still each have one apple. But if you have an idea and I have an idea and we exchange these ideas, then each of us will have two ideas.

Starting this week, research articles from the BMJ will be freely available from PubMed Central, the new web based repository that will archive, organise, and distribute peer reviewed reports from biomedical journals (http://pubmedcentral.nih.gov/). This will be in addition to their continuing free availability on bmj.com. The BMJ articles join those from 15 other journals. More are expected to follow suit.

PubMed Central's distinguishing characteristic is that it offers the full text of articles, free to users. Think of it as the logical extension of Medline, which offers the bibliographic details of articles and their abstracts. It depends on publishers and societies transferring peer reviewed articles to PubMed Central, which, like Medline, is funded by the US National Institutes of Health.

The BMJ has joined PubMed Central because we agree with Nick Cozzarelli, editor of the Proceedings of the National Academy of Sciences of the United States of America (also on PubMed Central), that “free access to the scientific literature would be a phenomenal advance in scientific publishing—the greatest in our lifetime.”1 We want to align ourselves with an initiative …