tbuckley/cabot-search huggingface dataset:
Letter: Confidentiality of medical records.
Authors: D R Addenbrooke, F Clarke
Journal: BMJ (1975)

Antagonizing the glucagon signaling pathway represents an attractive therapeutic approach for reducing excess hepatic glucose production in patients with type 2 diabetes. Despite extensive efforts, there is currently no human therapeutic that directly inhibits the glucagon/glucagon receptor pathway. We undertook a novel approach by generating high-affinity human monoclonal antibodies (mAbs) to the human glucagon receptor (GCGR) that display potent antagonistic activity in vitro and in vivo. A single injection of a lead antibody, mAb B, at 3 mg/kg, normalized blood glucose levels in <i>ob</i>/<i>ob</i> mice for 8 days. In addition, a single injection of mAb B dose-dependently lowered fasting blood glucose levels without inducing hypoglycemia and improved glucose tolerance in normal C57BL/6 mice. In normal cynomolgus monkeys, a single injection improved glucose tolerance while increasing glucagon and active glucagon-like peptide-1 levels. Thus, the anti-GCGR mAb could represent an effective new therapeutic for the treatment of type 2 diabetes.
Eradication rate of Helicobcter pylori.
Authors: H Y Xia, C T Keane, C A O'Morain
Journal: Gut (1995)

since been shown to have impaired synthesis of metallothionein in culture fibroblasts.3In our case,4 however, basal and metal induced metallothionein synthesis in skin fibroblasts was normal,5 indicating that heterogeneity exists among cases of primary, non-environ- mental, non-Wilsonian copper toxicosis.
Possible Bromocriptine-Induced Myocardial Infarction
Authors: Fabrice Larrazet
Journal: Annals of Internal Medicine (1993)

We report a case of a postpartum myocardial infarction in a 32-year-old multiparous woman receiving bromocriptine. The patient had an uncomplicated pregnancy. She had been sent home with bromocriptine to suppress lactation. Ten days postpartum, she presented with chest pain. Her electrocardiogram showed marked ST-segment elevation in leads II, III, and aVF. Coronary angiography showed a total occlusion of the midportion of the right coronary artery. Angioplasty was immediately done, and the right coronary artery was reopened. One month later, she was tested with bromocriptine. At the peak of action of bromocriptine, a severe narrowing of the right coronary artery occurred, which probably corresponded to a bromocriptine-induced spasm. Bromocriptine is an ergopeptine derivative, and it should be considered as a possible etiologic agent causing postpartum myocardial infarction in patients with a predisposition to coronary vasospasm.
THE PHYSICIAN AS A DENTIST.
Authors: CALVIN WILLIAM KNOWLES
Journal: JAMA (1905)

The physician has practiced his dental specialty for many years previous to the establishment of a dental college, which took place in about the year 1839.When conditions pertaining to the medical side of dentistry arose, in years gone by, it was customary for these cases to be referred to the medical specialist or general practitioner.Dental colleges being organized and a more thor- ough medical knowledge being required, it was not so
Laparoscopy and Biopsy of the Pancreas in Miniature Pigs and Piglets: A New Way for Investigations of the Pancreas in Animal Experiments
Authors: R. Klapdor, R. Humke
Journal: Endoscopy (1974)

The possibilities of inspection and biopsy of the pancreas by laparoscopy were investigated in 3 anaesthetized mini-pigs and 3 piglets. In all experiments the pancreas could be inspected inside the duodenal C without further manipulations. Biopsies were taken without severer bleedings showing parts of the exocrine and endocrine system. These studies emphasize a new way for investigations of the pancreas in animal experiments.
Perioperative Supraventricular Tachyarrhythmia
Authors: David Amar
Journal: Annals of Internal Medicine (1999)

Letters18 May 1999Perioperative Supraventricular TachyarrhythmiaThomas H. Lee, MD and Carisi A. Polanczyk, MDThomas H. Lee, MDPartners Community HealthCare, Inc.; Boston, MA 02199 (Lee)Brigham and Women's Hospital; Boston, MA 02115 (Polanczyk)Search for more papers by this author and Carisi A. Polanczyk, MDPartners Community HealthCare, Inc.; Boston, MA 02199 (Lee)Brigham and Women's Hospital; Boston, MA 02115 (Polanczyk)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-10-199905180-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Amar that age is a continuous risk factor; we chose to express it as a dichotomous factor to allow easier appreciation of its importance. The mean (±SD) ages of patients with and without supraventricular arrhythmia in our cohort were 68 ± 9.6 and 66 ± 9.6 years, respectively (P < 0.01). We also agree that the finding of a lower rate of arrhythmia among patients having thoracic surgery who were using digoxin before surgery should be interpreted with caution, as indicated in our article. However, the magnitude in the reduction in risk for supraventricular arrhythmia among ... Author, Article, and Disclosure InformationAffiliations: Partners Community HealthCare, Inc.; Boston, MA 02199 (Lee)Brigham and Women's Hospital; Boston, MA 02115 (Polanczyk) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSupraventricular Arrhythmia in Patients Having Noncardiac Surgery: Clinical Correlates and Effect on Length of Stay Carisi A. Polanczyk , Lee Goldman , Edward R. Marcantonio , E. John Orav , and Thomas H. Lee Perioperative Supraventricular Tachyarrhythmia David Amar Metrics 18 May 1999Volume 130, Issue 10Page: 864KeywordsArrhythmiaForecastingMedical risk factorsOdds ratioTachycardiaThoracic surgery Issue Published: 18 May 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Changes Brewing for Food Labels as National Concern About Diet and Health Continues to Grow
Authors: Charles Marwick
Journal: JAMA (1989)

AMID the diet-disease debate, while scientists seek to answer the public's and medical profession's nutrition questions, changes are taking form in food labeling. What that form will be remains to be determined. At present, the labels of all foods are required to list all ingredients in order of descending weight. Moreover, approximately 60% of all foods bear labels that list the number of calories and percentages of protein, carbohydrate, fat, sodium, and the US daily requirement of vitamins, although only those foods with added nutrients and those for which the manufacturers have made nutrition claims are required to do so. The Center for Science in the Public Interest, a Washington, DC, consumer organization, suggests that an "improved" label would indicate the serving size (probably in ounces), the number of servings per container, the total number of calories, and (in grams or milligrams) the total level of fat, cholesterol-raising fat, cholesterol,
Health Access America's Coverage of Detoxification
Authors: Anthony B. Radcliffe
Journal: JAMA (1993)

<h3>To the Editor.</h3> —In Paul Cotton's article in the Medical News &amp; Perspectives section of<i>JAMA</i><sup>1</sup>describing basic benefits in various health insurance plans, the author erroneously states that the American Medical Association's plan does not cover detoxification. Detoxification originally was excluded in Health Access America's basic benefits package, but the Medical Society of the State of New York and the American Society of Addiction Medicine argued at the 1991 Interim Meeting that if the exclusion were to stand, it would have many negative repercussions, including setting exclusion of detoxification as the standard for health insurers; sending a message that detoxification is not part of the mainstream of acute medical care; deterring hospitals from establishing detoxification services or from maintaining present services; admitting alcoholics to hospitals under alternative diagnoses and lessening opportunities for adequate follow-up care; and taking a giant step backward in the effort to aid persons suffering
Comparison of the Durations of Mild Therapeutic Hypothermia on Outcome After Cardiopulmonary Resuscitation in the Rat
Authors: Sen Ye, Yinlun Weng, Shijie Sun, Wei Chen, Xiaobo Wu, Zilong Li, Max Harry Weil, Wanchun Tang
Journal: Circulation (2011)

Background— Current studies have demonstrated that applying therapeutic hypothermia for 12 to 24 hours after resuscitation from cardiac arrest improves the outcomes of cardiopulmonary resuscitation. The present study investigated whether a shorter duration of therapeutic hypothermia induced quickly and early after resuscitation would provide an equal improvement in the outcomes of cardiopulmonary resuscitation. Methods and Results— Ventricular fibrillation was induced and untreated for 8 minutes in 24 male Sprague-Dawley rats. Defibrillation was attempted after 8 minutes of cardiopulmonary resuscitation. Seven minutes after resuscitation, animals were randomized into 4 groups (n=6 each): normothermic, hypothermic–2 hours, hypothermic–5 hours, and hypothermic–8 hours. Animals in the hypothermic groups received rapid cooling, which was started 7 minutes after restoration of spontaneous circulation and maintained at 33±0.5°C for 2, 5, or 8 hours. Normothermic animals were maintained at 37±0.2°C. All animals were anesthetized and ventilated for 8 hours after resuscitation. Blood temperature was significantly decreased in the hypothermic groups. Postresuscitation myocardial function, neurological deficit scores, and 72-hour survival were significantly better in animals treated with hypothermia regardless of the duration of cooling. However, significantly better postresuscitation tissue microcirculation, myocardial ejection fraction, and neurological deficit scores were observed in the hypothermic–2 hours animals. Conclusions— In a rat model of cardiopulmonary resuscitation, a shorter duration of mild hypothermia induced rapidly and early after restoration of spontaneous circulation improved postresuscitation microcirculation, myocardial and cerebral functions, and survival as well as, or better than, prolonged duration of hypothermia after resuscitation.
Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program
Authors: Michael A. Pulsipher, Pintip Chitphakdithai, Brent R. Logan, Bronwen E. Shaw, John R. Wingard, Hillard M. Lazarus, Edmund K. Waller, Matthew Seftel, David F. Stroncek, Angela M. Lopez, Dipnarine Maharaj, Peiman Hematti, Paul V. O'Donnell, Alison W. Loren, Susan F. Leitman, Paolo Anderlini, Steven C. Goldstein, John E. Levine, Willis H. Navarro, John P. Miller, Dennis L. Confer
Journal: Blood (2012)
HLA‐DR53 protects against thrombotic thrombocytopenic purpura/adult hemolytic uremic syndrome
Authors: Geetha Joseph, Kenneth J. Smith, Terence J. Hadley, Benjamin Djulbegovic, Gary M. Troup, John Oldfather, Robert L. Barker
Journal: American Journal of Hematology (1994)

Class I and Class II HLA antigens were tested in patients treated for thrombotic thrombocytopenic purpura or hemolytic uremic syndrome (TTP/HUS) to determine whether there is a disease association. Based on the results of a pilot trial, retrospective HLA-typing of 18 patients with a diagnosis of TTP/HUS and prospective typing of 12 newly diagnosed patients with TTP/HUS were performed. Twenty-one patients were non-Hispanic Caucasians, 7 were African-Americans, and 2 were Hispanic-Caucasians. Of 30 patients tested, 28 were positive for DR52 (chi-squared = 5.14, P < 0.05), and only two were positive for DR53 compared to 57% of controls (chi-squared = 18.5, P < 0.0005). Diverse DR52 subtypes (DRB3*0101, DRB3*02, and DRB3*0301) were found by oligonucleotide testing in 15 patients, suggesting the association was not with DR52 but with absence of the DR53 antigen. The 2 patients with DR53 were not homozygous. This study suggests that the supertypic antigen, DR53, may govern susceptibility to TTP/HUS, since the relative risk of this disease among DR53 positives is reduced at 0.09 (95% confidence interval, 0.01-0.28). This finding indicates a possible immunogenetic component in the pathogenesis of TTP.
Systolic Time Intervals in Chronic Obstructive Pulmonary Disease
Authors: ROBERT G. HOOPER, MICHAEL E. WHITCOMB
Journal: Circulation (1974)

In an attempt to clarify the relationship between left ventricular function and chronic obstructive pulmonary disease (COPD), systolic time intervals (STI) were measured in 12 control subjects and 28 patients with COPD who had only moderate arterial blood gas abnormalities and who had no cardiac symptomatology or clinical evidence of organic heart disease. The patients with COPD were divided into three groups of increasingly severe airway obstruction based on the percent predicted forced expired volume in one second. Significant differences in pre-ejection period index (PEP 1 ) and left ventricular ejection time index (LVET 1 ) existed between the control subjects and the patients with the most severe lung disease (Group III). A highly significant difference in PEP/LVET existed between these two groups. The abnormalities of STI demonstrated in these patients are characteristic of left ventricular dysfunction and indicate that subclinical left ventricular dysfunction is frequently present in patients with moderate obstructive lung disease.
A Risk Score for Predicting Near-Term Incidence of Hypertension: The Framingham Heart Study
Authors: Nisha I. Parikh, Michael J. Pencina, Thomas J. Wang, Emelia J. Benjamin, Katherine J. Lanier, Daniel Levy, Ralph B. D'Agostino, William B. Kannel, Ramachandran S. Vasan
Journal: Annals of Internal Medicine (2008)

Background: Studies suggest that targeting high-risk, nonhypertensive individuals for treatment may delay hypertension onset, thereby possibly mitigating vascular complications. Risk stratification may facilitate cost-effective approaches to management. Objective: To develop a simple risk score for predicting hypertension incidence by using measures readily obtained in the physician's office. Design: Longitudinal cohort study. Setting: Framingham Heart Study, Framingham, Massachusetts. Patients: 1717 nonhypertensive white individuals 20 to 69 years of age (mean age, 42 years; 54% women), without diabetes and with both parents in the original cohort of the Framingham Heart Study, contributed 5814 person-examinations. Measurements: Scores were developed for predicting the 1-, 2-, and 4-year risk for new-onset hypertension, and performance characteristics of the prediction algorithm were assessed by using calibration and discrimination measures. Parental hypertension was ascertained from examinations of the original cohort of the Framingham Heart Study. Results: During follow-up (median time over all person-examinations, 3.8 years), 796 persons (52% women) developed new-onset hypertension. In multivariable analyses, age, sex, systolic and diastolic blood pressure, body mass index, parental hypertension, and cigarette smoking were significant predictors of hypertension. According to the risk score based on these factors, the 4-year risk for incident hypertension was classified as low (<5%) in 34% of participants, medium (5% to 10%) in 19%, and high (>10%) in 47%. The c-statistic for the prediction model was 0.788, and calibration was very good. Limitations: The risk score findings may not be generalizable to persons of nonwhite race or ethnicity or to persons with diabetes. The risk score algorithm has not been validated in an independent cohort and is based on single measurements of risk factors and blood pressure. Conclusion: The hypertension risk prediction score can be used to estimate an individual's absolute risk for hypertension on short-term follow-up, and it represents a simple, office-based tool that may facilitate management of high-risk individuals with prehypertension.
Use of Misoprostol in Pregnancy
Authors: Ralph W. Hale, Stanley Zinberg
Journal: New England Journal of Medicine (2001)

The article by Goldberg et al. in this issue of the Journal reviews the evidence supporting the use of misoprostol in women at various stages of pregnancy.1 The authors identified more than 200 studies involving more than 16,000 women who received misoprostol and conclude that “misoprostol is one of the most important medications in obstetrical practice.”1 The product-information enclosure approved by the Food and Drug Administration (FDA) states that misoprostol is indicated for the prevention of gastric ulcers caused by nonsteroidal antiinflammatory drugs in patients who are at high risk for these ulcers.2 The contraindications include pregnancy, because of misoprostol's . . .
Airway hyperresponsiveness in patients with microvascular angina. Evidence for a diffuse disorder of smooth muscle responsiveness.
Authors: R O Cannon, D B Peden, C Berkebile, W H Schenke, M A Kaliner, S E Epstein
Journal: Circulation (1990)

Anginal chest pain in patients with angiographically normal coronary arteries may be caused by a limited coronary flow response to stress because of abnormal function of the coronary microcirculation (microvascular angina). Studies of forearm arterial function suggested that patients with microvascular angina may have a diffuse disorder of smooth muscle tone. Because dyspnea is common in these patients and seems disproportionate to the severity of myocardial ischemia, we studied air flow (forced expiratory volume in 1 second, or FEV1) in the basal state and after methacholine inhalation to determine whether bronchial smooth muscle is affected in this syndrome. Five of 36 patients with microvascular angina had a basal FEV1 of less than 70% of that predicted and did not receive methacholine. Of the remaining 31 patients, 14 (45%) had a more-than-20% reduction in FEV1 after methacholine inhalation (as much as 25 mg/ml), a response significantly greater than that of nine patients with heart disease (0%, p less than 0.025) and 24 normal volunteers of similar age and gender distribution (13%, p less than 0.025). Furthermore, the product of the methacholine dose inhaled and the magnitude of decline in FEV1 from baseline (methacholine response score) was significantly lower in patients with microvascular angina than in normal volunteers (16 +/- 8.6 versus 22.2 +/- 3.7, p = 0.026). We conclude that airway hyperresponsiveness is frequently demonstrable in patients with microvascular angina; these findings are consistent with our hypothesis that this syndrome may represent a more generalized abnormality of vascular and nonvascular smooth muscle function.
Comparison of Community Health Worker–Led Diabetes Medication Decision-Making Support for Low-Income Latino and African American Adults With Diabetes Using E-Health Tools Versus Print Materials
Authors: Michele Heisler, Hwajung Choi, Gloria Palmisano, Rebecca Mase, Caroline Richardson, Angela Fagerlin, Victor M. Montori, Michael Spencer, Laurence C. An
Journal: Annals of Internal Medicine (2014)

Health care centers serving low-income communities have scarce resources to support medication decision making among patients with poorly controlled diabetes.To compare outcomes between community health worker use of a tailored, interactive, Web-based, tablet computer-delivered tool (iDecide) and use of print educational materials.Randomized, 2-group trial conducted from 2011 to 2013 (ClinicalTrials.gov: NCT01427660).Community health center in Detroit, Michigan, serving a Latino and African American low-income population.188 adults with a hemoglobin A1c value greater than 7.5% (55%) or those who reported questions, concerns, or difficulty taking diabetes medications.Participants were randomly assigned to receive a 1- to 2-hour session with a community health worker who used iDecide or printed educational materials and 2 follow-up calls.Primary outcomes were changes in knowledge about antihyperglycemic medications, patient-reported medication decisional conflict, and satisfaction with antihyperglycemic medication information. Also examined were changes in diabetes distress, self-efficacy, medication adherence, and hemoglobin A1c values.Ninety-four percent of participants completed 3-month follow-up. Both groups improved across most measures. iDecide participants reported greater improvements in satisfaction with medication information (helpfulness, P = 0.007; clarity, P = 0.03) and in diabetes distress compared with the print materials group (P < 0.001). The other outcomes did not differ between the groups.The study was conducted at 1 health center during a short period. The community health workers were experienced in behavioral counseling, thereby possibly mitigating the need for additional support tools.Most outcomes were similarly improved among participants receiving both types of decision-making support for diabetes medication. Longer-term evaluations are necessary to determine whether the greater improvements in satisfaction with medication information and diabetes distress achieved in the iDecide group at 3 months translate into better longer-term diabetes outcomes.Agency for Healthcare Research and Quality and National Institute of Diabetes and Digestive and Kidney Diseases.
The Work Physiology of Fishing
Authors: Kåre Rodahl, Zdenek Vokac
Journal: Psychotherapy and Psychosomatics (1979)

Circulatory strain, energy output and urinary catecholamine excretion were determined in 24 coastal, 6 trawler, 5 bank and 3 capelin fishermen. From these studies it is evident that fishing may represent hard physical work. However, if properly organized with job rotation and adequate creq numbers, it may, in some respects, be comparable with many occupations ashore. The introduction of mechanization and automation has led to increased tempo and greater stress. Consequently, the older fishermen, due to declining physical work capacity, may find it difficult to keep up with their younger colleagues. Yet, the official Norwegian statistics show that the percentage of older fishermen is increasing.
Health Education: Panacea, Pernicious or Pointless?
Authors: Carl I. Cohen, Ellen J. Cohen
Journal: New England Journal of Medicine (1978)

As a consequence of the frustrations spawned by the escalating costs and the low returns of disease-oriented medicine, health education has begun to be touted as an antidote to the nation's health ills.At the federal level, interest in health education was aroused as early as 1971 with the appointment of the prestigious President's Committee on Health Education.1 Subsequent activities at the executive and congressional levels culminated in the enactment of the National Consumer Health Information and Health Promotion Act of 1976. This law established within HEW a high-level Office of Health Information and Health Promotion. It also directed the . . .