tbuckley/cabot-search huggingface dataset:
Insulin Resistance and Clustering of Cardiometabolic Risk Factors in Urban Teenagers in Southern India
Authors: Ambady Ramachandran, Chamukuttan Snehalatha, Annasami Yamuna, Narayanasamy Murugesan, K.M. Venkat Narayan
Journal: Diabetes Care (2007)

We sought to study the occurrence of cardiometabolic risk variables, their clustering, and their association with insulin resistance among healthy adolescents in urban south India.School children aged 12-19 years (n = 2,640; 1,323 boys and 1,317 girls) from diverse socioeconomic backgrounds were studied. Demographic, social, and medical details were obtained; anthropometry and blood pressure were measured. Fasting plasma glucose, insulin, and lipid profiles were measured. Clusters of risk variables were identified by factor analysis. Association of insulin resistance (homeostasis model assessment) with individual risk variables and their clusters were assessed.One or more cardiometabolic abnormalities (i.e., low HDL cholesterol, elevated triglycerides, fasting plasma glucose, or blood pressure) was present in 67.7% of children (in 64.8% of normal weight and 85% of overweight children). Insulin resistance was associated with the above abnormalities except HDL cholesterol. It also showed significant positive association with BMI, waist circumference, body fat percentage, and total cholesterol (P < 0.0001). Factor analysis identified three distinct clusters, with minor differences in the sexes: 1) waist circumference and blood pressure; 2) dyslipidemia, waist circumference, and insulin; and 3) waist circumference, glucose, and plasma insulin, with minor differences in the sexes. Insulin was a component of the lipid and glucometabolic cluster. In girls, it was a component of all three clusters.Cardiometabolic abnormalities are present in nearly 68% of young, healthy, Asian-Indian adolescents and even among those with normal weight. Insulin resistance is associated with individual cardiometabolic factors, and plasma insulin showed association with clustering of some variables.
Pneumonia with Serological Evidence of Acute Infection with the Chlamydia-like Microorganism “Z”
Authors: DAVID LIEBERMAN, SIMONA KAHANE, DEVORA LIEBERMAN, MAUREEN G. FRIEDMAN
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

"Z" is a recently discovered microorganism that may belong to a new genus in the family Chlamydiaceae. Using an ELISA test we developed, we measured levels of serum antibody against "Z" for 308 paired sera obtained from adult patients hospitalized with community-acquired pneumonia (CAP). In 114 patients (37%), serological evidence of past infection with "Z" was found. In eight patients (2.6%) there was serological evidence of acute infection with this pathogen. In four of these eight patients, no other pathogen for CAP was identified despite an intensive serological investigation encompassing 13 etiological agents. The four patients were about 30 yr old, and three of them had no history of chronic illness. Their illness was characterized by high fever, a nonproductive cough, gastrointestinal symptoms, a shift to the left in the white blood cell count, and a prompt, dramatic response to erythromycin therapy. We conclude that the microorganism "Z", or a close variant, is infectious for humans, in some cases causing CAP. In these cases the disease is mild and responds quickly to treatment with erythromycin.
Heterotopic Gastric Mucosa in the Duodenum - Reaction to Congo Red under Fiberscopic Observation
Authors: K. Ikeda, Y. Sannohe, H. Murayama, R. Ikeda, S. Inutsuka
Journal: Endoscopy (1982)

See also: Gastric Metaplasia of the Duodenal Bulb/A Prospective Endoscopic StudyEndoscopy 1987; 19(06): 252-253DOI: 10.1055/s-2007-1013020
Absence of Emphysema in Trumpet Players
Authors: J. S. Felton
Journal: JAMA (1969)

To the Editor:—  In addition to Jerome T. Siedlecki's reply to the question of emphysema in professional trumpet players, attention is directed to an item inForeign Letters(JAMA166:1077, 1958). The study of Havermark and Lundgren in which replies to a questionnaire were received from 364 musicians, glass blowers, and others, including 187 blowers of various musical instruments, demonstrated clearly that no support could be found for the teaching that emphysema could be provoked by this kind of occupation.
Asymptomatic Hyperglycemia and Atherosclerotic Vascular Disease in the Elderly
Authors: Leena Mykkänen, Markku Laakso, Kalevi Pyörälä
Journal: Diabetes Care (1992)

OBJECTIVE To investigate the relationship between asymptomatic hyperglycemia (IGT or newly diagnosed NIDDM) and atherosclerotic vascular disease. RESEARCH DESIGN AND METHODS A representative cross-sectional population sample of 1431 subjects (511 men, 920 women; 65–74 yr old). Altogether, 312 men and 515 women had NGT, 84 men and 158 women had IGT, 33 men and 59 women had newly diagnosed NIDDM, and 82 men and 188 women had previously diagnosed NIDDM. Participation rate was 71%. Main outcome measures were prevalence rates of CHD, stroke, and intermittent claudication. RESULTS There was no difference in the prevalence of definite or possible MI verified at hospital between subjects with asymptomatic hyperglycemia and NGT (15.5 vs. 13.3% in men, 6.3 vs. 5.3% in women). Men with asymptomatic hyperglycemia had 1.5 × higher prevalence of angina pectoris (29.4 vs. 19.3%, P &amp;lt; 0.05), major Q-QS changes (21.1 vs. 12.0%, P &amp;lt; 0.05), ischemic ECG changes (59 vs. 45%, P &amp;lt; 0.05), and silent MI on ECG (14.8 vs. 7.9%, P &amp;lt; 0.05) compared to men with NGT. Women with asymptomatic hyperglycemia had more often ischemic ECG changes compared to women with NGT (48.3 vs. 39.7%, P &amp;lt; 0.05). There was no difference (NS) in the prevalence of verified stroke (3.5 vs. 4.6% in men, 2.7 vs. 2.5% in women) or claudication (7.0 vs. 7.7% in men, 4.6 vs. 4.3% in women) between subjects with asymptomatic hyperglycemia and NGT. In multiple logistic regression analyses, the association between risk factors and MI or ischemic ECG changes in subjects with asymptomatic hyperglycemia was not consistent. CONCLUSION Elderly subjects with asymptomatic hyperglycemia (particularly men) tended to have an increased prevalence of CHD. Thus, asymptomatic hyperglycemia in the elderly is not a benign phenomenon but is associated with cardiovascular morbidity.
Pulmonary haemorrhage complicating Wegener's granulomatosis and microscopic polyarteritis.
Authors: S J Haworth, C O Savage, D Carr, J M Hughes, A J Rees
Journal: BMJ (1985)

The incidence and characteristics of pulmonary haemorrhage in a series of 89 patients with systemic vasculitis were analysed. Pulmonary haemorrhage occurred in 32 of these patients and was associated with haemoptysis in all 32, alveolar shadowing in the chest radiograph in 28, and a significantly raised transfer coefficient in 30. Pulmonary haemorrhage usually resolved with treatment by immunosuppressive drugs but was the cause of death in 11 patients. In contrast with patients with antibasement membrane antibodies there was no correlation between pulmonary haemorrhage and cigarette smoking. Pulmonary haemorrhage is a cause of serious morbidity in patients with systemic vasculitis.
Structuring a Written Examination to Assess ASBH Health Care Ethics Consultation Core Knowledge Competencies
Authors: Bruce D. White, Jane B. Jankowski, Wayne N. Shelton
Journal: The American Journal of Bioethics (2014)

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities (ASBH) has published core knowledge competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models-both objective and written-must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization.
Arterio-Venous Aneurysms of the Subclavian Vessels— An Addendum.
Authors: Rudolph Matas
Journal: JAMA (1902)

New Orleans, La., Feb. 2, 1902. <h3>To the Editor:</h3> I regret that in preparing the text of this contribution the very interesting and instructive case of arterio-venous aneurysm operated upon by Dr. John F. Erdmann and reported by him to the New York Surgical Society, January, 1899 (see Annals of Surgery, pp. 618-622, vol. 29, Jan.-June, 1899) should have escaped my observation while compiling the bibliography. It presents so many unique features and is so encouraging from the operative point of view that it is well worthy of a special abstract in connection with the analytical study of the subject which has been attempted in this contribution. The case is one of arterio-venous aneurysm of the left subclavian vessels outside of the scalenes, and is not an aneurysmal varix as erroneously stated in the title of the report. The patient, a gymnast aged 20 years, was accidentally shot Aug. 19,
An Earnest Proposal
Authors: Lewis Thomas
Journal: New England Journal of Medicine (1971)

THERE is a quarter-page advertisement in the London Observer for a computer service that will enmesh your name in an electronic network of 50,000 other names, sort out your tastes, preferences, habits and deepest desires and match them up with opposite numbers, and retrieve for you, within a matter of seconds, and for a very small fee, friends. "Already," it says, "It [the computer] has given very real happiness and lasting relationships to thousands of people, and it can do the same for you!"Without paying a fee, or filling out a questionnaire, all of us are being linked in . . .
Prevalence of reflex anal dilatation
Authors: C J Hobbs, J M Wynne
Journal: BMJ (1989)

bargaining in bad faith" on the part of the politicians emerged; and the same government is currently dismantling the fee for service system of remuneration in favour of salaries, to the general (if not universal) dismay of the medical profession.The trends of an underfunded socialised health care system accompanied by increasing government encroachment and bureaucratisation will be familiar to British doctors.American colleagues with whom I have spoken on such matters view these developments with alarm and dismay, not envy.
Who needs long term psychiatric care?
Authors: T Groves
Journal: BMJ (1990)

Research Committee of the British ''horacic Associationi.E'fflectiveness ot' BCG vaccintation in Grcat Britaiti in 1978.Br,7 D)is C/hest 198t0;74:2 15-27.19 Sutherland I, Springett VH.Effectiveness of BCG vaccination
Abstract 1367: Substituted Pyrimido[4,5-<i>b</i>]indoles with single agent combination chemotherapeutic potential
Authors: Aleem Gangjee, Nilesh Zaware, Roy L. Kisliuk, Michael A. Ihnat
Journal: Cancer Research (2011)

Abstract Combinations of cytotoxic agents with antiangiogenic agents have shown significant promise in cancer treatment, and several such clinical trials are currently underway. We previously identified two compounds with a 5-(thioaryl)-9H-pyrimido[4,5-b]indole-2,4-diamine scaffold that each inhibit vascular endothelial growth factor receptor-2 (VEGFR-2) and platelet derived growth factor receptor-beta (PDGFR-β) for antiangiogenic effects and remarkably also inhibit human thymidylate synthase (hTS) for cytotoxic effects. In a COLO-205 xenograft mouse model one of these analogs demonstrated potent tumor growth inhibition, inhibition of metastasis, and antiangiogenic effects in vivo. Thus, these compounds afford combination chemotherapeutic potential in single agents. In an effort to optimize the structural requirements for antiangiogenic effects and hTS inhibition, six additional compounds were synthesized. Electron withdrawing (3,4-diClPh, 4-ClPh), electron donating (2,5-diOMePh, 4-OMePh) and bulky (1-naphthyl, 2-naphthyl) thioaryl groups in the 5-(thioaryl)-9H-pyrimido[4,5-b]indole-2,4-diamine scaffold were selected to establish optimum activity. The synthesis of these compounds involved the nucleophilic displacement of the common intermediate 5-bromo-9H-pyrimido[4,5-b]indole-2,4-diamine with appropriate benzenethiols. A novel four step synthetic scheme to the common intermediate was developed which is more efficient relative to the previously reported six step synthesis. Biological evaluation of these compounds in various RTKs indicated that in the VEGFR-2 assay the 2,5-diOMePh substituted compound was equipotent to the standard SU5416 used in this assay. In the hTS assay, the 2-naphthyl, 4-OMePh, and 4-ClPh substituted compounds were nanomolar inhibitors and were 3-fold better than or equipotent to the standard TS inhibitor raltitrexed. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1367. doi:10.1158/1538-7445.AM2011-1367
Rationing of joint replacements raises fears of further cuts
Authors: Rebecca Coombes
Journal: BMJ (2005)

A decision by NHS trusts in Suffolk to deny replacement joints to obese patients has led to concerns that other financially stretched NHS trusts could take similar steps to ration treatment.

As part of a series of new “thresholds” to treatment, three primary care trusts in east Suffolk—Ipswich, Suffolk Coastal, and Central Suffolk—have announced that patients will no longer be considered for hip or knee joint replacements if they have a body mass index (BMI) >30.

The list of thresholds was drawn up by a group of consultants who carry out the procedures at Ipswich Hospital and local GPs, led by Brian Keeble, director of public health for Ipswich …
REPORT OF A CASE OF FULL TERM ABDOMINAL PREGNANCY
Authors: R. A. Bartholomew
Journal: JAMA (1922)

A colored woman, aged 33, married, was admitted to Grady Hospital, Dec. 3, 1920, complaining of weakness and pain in the right lower abdomen. She had always been in good health and gave no history of serious illness, operations or venereal disease. Her menses had been regular. She had had three full term, normal pregnancies and labors with normal puerperia, the last one occurring in 1917. There had been no miscarriages. The menstrual periods were regular and normal during the summer and fall of 1920, and the October period began at the regular time but was more profuse than usual, and lasted two weeks. From this time on, the periods remained absent. During the latter part of October and during part of November, she was nursing a sick relative and thought that the strain of lifting the patient caused pain in the right lower abdomen. She gave no history of
THE CHEMOTHERAPY OF INTESTINAL PARASITES
Authors: ERNEST CARROLL FAUST
Journal: JAMA (1941)

In order that this discussion may be limited to the field in which I am primarily concerned and in which I have had some degree of experience, consideration will be directed to the groups of animal parasites referred to as the protozoa and the helminths. Some of the drugs available for treating animal parasites, particularly certain anthelmintics, are a heritage from the ancients of the Old World and from the Amerinds;<sup>1</sup>others, particularly certain antiprotozoan drugs, are of recent origin or recent application to parasitoses of the human body. For the most part, use of the former group is based primarily on clinical experience without antecedent pharmacologic assay, while clinical use of most of the latter group has been a sequel to adequate tests in the laboratory. It is almost axiomatic to state that a suitable chemotherapeutic is one which is as nearly specific as possible within the limits
Pancreatography in chronic pancreatitis: international definitions.
Authors: A T Axon, M Classen, P B Cotton, M Cremer, P C Freeny, W R Lees
Journal: Gut (1984)

Terminology in classification of pancreatograms was discussed at a recent international workshop on chronic pancreatitis. A new terminology based on morphological radiographic appearances and a new classification to describe the severity and localisation of pancreatogram changes were agreed. Pancreatograms in chronic pancreatitis are graded as normal or equivocal, or as showing mild, moderate, or marked changes, either diffuse or local. It is hoped that these definitions will help communication between centres, serve as a basis for prospective and comparative studies, and facilitate computerisation.
Vertigo and the pill.
Authors: J Siegler
Journal: BMJ (1977)

I have read with interest your leading article on the incidence of vertigo in children (November 5, p. 1173). My experience as an otolaryngologist has led me to believe that there are many causes of vertigo, especially in young people, which have not been recognized so far. The common causes of labyrinthine vertigo such as Meniere's disease or labyrinthitis usually occur in the older age groups, but in my personal practice I have met with an increasing number of young women who have suffered from true vertigo. Examination of their respiratory tract has not shown evidence of disease in the ears, nor has there been very much in the way of deafness or disorder of labyrinthine function as shown on an electronystagmograph. There has been 1 common thread in all these patients and that is that most of them are young women in their 20s and 30s taking a contraceptive pill. They have often related the onset of the symptoms to the time when they began taking the pill. In many cases I have persuaded the patient to discontinue the pill and perhaps adopt an alternative method of contraception and the incidence of vertigo has subsided. An attempt was made to gain the cooperation of a family planning clinic to send patients along who are on the pill with a view to testing their hearing as well as their labyrinthine function, but unfortunately most of them were unwilling to submit to such an investigation and it had to be abandoned.
ENHANCED ANTIBODY RESPONSES IN ACTIVE CHRONIC HEPATITIS: RELATION TO HLA-B8 AND HLA-B12 AND PORTO-SYSTEMIC SHUNTING
Authors: R.M. Galbraith, Roger Williams, J. Pattison, L.A. Kennedy, A.L.W.F. Eddleston, A.D.B. Webster, Deborah Doniach, J.R. Batchelor
Journal: The Lancet (1976)
Disposal of Low-Level Radioactive Waste
Authors: David R. Brill
Journal: JAMA (1985)

During 1985, low-level radioactive waste disposal has become a critical concern. The issue has been forced by the threatened closure of the three commercial disposal sites. The medical community has used radioactive isotopes for decades in nuclear medicine, radiation therapy, radioimmunoassay, and biomedical research. Loss of disposal capacity for radioactive wastes generated by these activities, by the suppliers of radioisotopes, and by pharmaceutical companies will have a profound impact on the medical profession. (<i>JAMA</i>1985;254:2449-2451)
Progressive Increases in Complexity of T-Wave Oscillations Herald Ischemia-Induced Ventricular Fibrillation
Authors: Bruce D. Nearing, Richard L. Verrier
Journal: Circulation Research (2002)

T-wave alternans (TWA), an ABAB oscillation, has been postulated as the initial pattern in a stepwise progression to higher-order oscillations, culminating in sudden arrhythmic death. The present study is the first to provide experimental evidence to support this intriguing concept. Epicardial and endocardial ECGs from 12 dogs were monitored during 8-minute left anterior descending coronary artery occlusion with right atrial pacing at 150 bpm. TWA magnitude was measured by modified moving average beat analysis, and the complexity of T-wave oscillations was assessed by complex demodulation. In 6 animals with subsequent ventricular fibrillation (VF), TWA achieved a threshold of 5.00±1.30 mV in epicardial ischemic-zone electrograms, which then exhibited a stepwise increase in T-wave oscillation complexity to quadrupling (ABCDABCD, 3 cases) or tripling (ABCABC, 2 cases) and to more complex forms (5 cases) preceding VF (6 cases). In dogs without VF, peak TWA levels did not increase from baseline, measuring a maximum of 0.35±0.10 mV ( P =NS), or only 7% the value of those with VF, and T-wave multupling was not observed (0 of 6 versus 5 of 6, P &lt;0.005). Discordant TWA episodes, with T waves alternating out of phase, were associated with increased T-wave complexity and fibrillation in 4 of 6 dogs with VF but in none of the 6 dogs without VF ( P &lt;0.025). TWA appears to be the first step in an orderly progression of T-wave complexity, episodes of discordant TWA, and VF. This demonstrated increase in T-wave complexity points to a fundamental mechanistic link underlying the ability of TWA to predict lethal arrhythmias.
Abnormalities of Gq-mediated cell signaling in Bartter and Gitelman syndromes1*1See Editorial by Warnock, p. 1197
Authors: Lorenzo Calò, Giulio Ceolotto, Monia Milani, Elisa Pagnin, Lambertus P. Van Den Heuvel, Michelangelo Sartori, Paul A. Davis, Rodolfo Costa, Andrea Semplicini
Journal: Kidney International (2001)
Cause of Death in Very Old People
Authors: J. A. Jackson
Journal: JAMA (1983)

<h3>To the Editor.—</h3> Dr Kohn's article on the "Cause of Death in Very Old People" (1982;247:2793) and the subsequent correspondence (1982;248:2448) raise some interesting points but fail to indicate one of the major problems at present facing any change in the use of the diagnosis of senescence, advocated by Dr Kohn. In the<i>International Classification of Diseases (ICD)</i>,<sup>1</sup>from which death certificates are coded, senescence is found as an "ill-defined condition" within the section "Symptoms and Ill-Defined Conditions" (Code 797, revision 9, 1979). While senescence continues to be so coded, it is not surprising that physicians are reluctant to record it as a cause of death, considering it, as Dr Zabel wrote, a "wastebasket term." The<i>Instructions for Classifying the Underlying Cause of Death</i>,<sup>2</sup>used in the preparation of the<i>Vital Statistics</i>, complicate matters still further. Using the rules contained within these instructions, just one entry on the
Tuberculosis Caused by<i>Mycobacterium bovis</i>
Authors: ALFRED G. KARLSON
Journal: Annals of Internal Medicine (1970)

At the Mayo Clinic, from 1954 through 1968, six patients with infection caused by Mycobacterium bovis were identified from among 2,086 persons with bacteriologically proved tuberculosis. Four patients were born in the United States and two in Europe; all were adults. The cultures were typically dysgonic and were inhibited by glycerine. Tests for niacin production, for nitrate reduction, and for nicotinamidase were negative. Each culture was inhibited in vitro by thiophene-2-carboxylic acid hydrazide. In animal pathogenicity studies each culture produced fatal disease in rabbits and guinea pigs. Good results were obtained in three patients by treatment with streptomycin, para-aminosalicylic acid, and isoniazid, or with a combination of two of these agents. One patient died of Hodgkin's disease and two were lost to follow-up.