tbuckley/cabot-search huggingface dataset:
RESTORATION OF THE SUNKEN NOSE
Authors: H. Burrows
Journal: BMJ (1922)

~~~~~~He gave a history of three weeks' illness.He had general oedema, evening temperature 1010 F., pulse 124.He was -bled, given ani enema and hot pack, with only water to (drink.He recovered consciousness under this treatment.I saw him a fortnight after.He was then genuerally oedematous, passing 20 oz. of urine, wlicl contained a large quantity of albumin and a few pus cells.S. albuts anid streptococci were isolated.He wvas givenl 25 million staphylococcus antigen + 2U streptococcus antigen on December 18thl, 1919, aln(d the doses were increased to 1,000 + 100.The series was 25 + 21,50 + 5,75 + 7i,100 + 10,150 + 15,200 + 20,300 + 3),400 + 40,800 + 75,1,000 + 100.He had distinct focal and general reactions after thie first fewv doses.After the first his temperature went to 101.80 F., and his urine iniereased from 20 to 40 oz. in twenty-four hours.He was discharged apparently cured on February 11th, 1920.CASE IV.J. K., aged 39, labourer, was admitted into Dr.Steevens's Vospital on December 23rd, 1919, with severe headache and general oedema.He was passing 15 oz. of urine loaded with albumin.He gave a history of several similar attacks.When I saw hiim at the end of January, 1920, he was still oedematous and ha(l severe headaches.His urine contained 4 grams per litre of albunini, al-d he Was passing about 70 oz. in the twenty-four hours.S. otlbiis was isolated from hiis urine and 5 million antigen was giveni on February 2nid, 1920.The series of (loses was 5, 10, 15, 20, 30, 40, 50, 60, 75, 100, 150, 200, 300, 400, 600, 800, 1,000, 1,250, 1,500, 1,7 0. 2,000.He steadily improved, losing his headache anid edema, ai:d was discharged May 9th, 1920, his urine containiing 0.75 to 1 giam per litre.He returnied to work June 20th,'1920, and has remainied in full work ever since.His urine now (September, 1922) ccntaimns 0.5 -grani per litre, so that the improvement in his kindeys has continued.CASE V. P. C., aged 14, admitted Dr. Steevens's Hospital under Dr. Kirkpatrick with general oedema.Temperature 101 '-F., pulse
Continuing Medical Education: Past, Present, and Future
Authors: Richard S. Wilbur
Journal: JAMA (1987)

Medicine, the law, and theology have traditionally been called the<i>learned professions</i>. For centuries, one studied a profession, learned all that one's master knew of it, and practiced that body of learning for the rest of one's career. During the 20th century, the length and depth of the learning period for medical professionals has continued to expand—first by a formal medical school curriculum, then by an internship, and later by an ever longer residency program. Still, no matter how well educated or carefully certified he or she is, a physician can no longer rest comfortably in the belief that having learned it all, one has only to continue to apply that knowledge to patients to practice good medicine. To remain competent, a physician must engage in career-long learning. The explosion in the amount of medical knowledge available has mandated that medicine is today a<i>learning</i>profession. In this country, medical
Hormonal and cellular regulation of Sertoli cell anti-Müllerian hormone production in the postnatal mouse.
Authors: L Al-Attar, K Noël, M Dutertre, C Belville, M G Forest, P S Burgoyne, N Josso, R Rey
Journal: Journal of Clinical Investigation (1997)

Anti-Müllerian hormone (AMH) is secreted by immature testicular Sertoli cells. Clinical studies have demonstrated a negative correlation between serum AMH and testosterone in puberty but not in the neonatal period. We investigated AMH regulation using mouse models mimicking physiopathological situations observed in humans. In normal mice, intratesticular, not serum, testosterone repressed AMH synthesis, explaining why AMH is downregulated in early puberty when serum testosterone is still low. In neonatal mice, AMH was not inhibited by intratesticular testosterone, due to the lack of expression of the androgen receptor in Sertoli cells. We had shown previously that androgen-insensitive patients exhibit elevated AMH in coincidence with gonadotropin activation. In immature normal and in androgen-insensitive Tfm mice, follicle stimulating hormone (FSH) administration resulted in elevation of AMH levels, indicating that AMH secretion is stimulated by FSH in the absence of the negative effect of androgens. The role of meiosis on AMH expression was investigated in Tfm and in pubertal XXSxrb mice, in which germ cells degenerate before meiosis. We show that meiotic entry acts in synergy with androgens to inhibit AMH. We conclude that AMH represents a useful marker of androgen and FSH action within the testis, as well as of the onset of meiosis.
Indirect Measures of Arterial Stiffness and Cognitive Performance in Individuals Without Traditional Vascular Risk Factors or Disease
Authors: Jose Gutierrez, Randolph S. Marshall, Ronald M. Lazar
Journal: JAMA Neurology (2015)

Whether cognition is influenced by arterial stiffness in the absence of vascular disease remains uncertain.To test the hypotheses that indirect measures of arterial stiffness are important predictors of cognitive performance and that this relationship varies depending on the presence of vascular disease.Participants included 2573 noninstitutionalized US adults randomly selected from 2 cycles of the National Health and Nutrition Examination Survey (1999-2002). The sample was stratified by groups based on the presence (VASC+) vs the absence (VASC-) of vascular variables negatively associated with cognition to assess the effects of indirect measures of arterial stiffness on cognitive performance. We used logistic regression to obtain odds ratios (ORs) and their 95% CIs. P < .05 was considered statistically significant.The Digit Symbol Substitution Test score was used as a continuous variable, and the lowest quintile was designated as an indicator of poorer cognitive performance.In the VASC+ group, poorer cognitive performance was more likely with increasing age (OR, 1.12 [95% CI, 1.08-1.17]; P < .001), a sedentary lifestyle (OR, 2.99 [95% CI, 1.62-5.55]; P = .002), and the use of dihydropyridine calcium channel blockers (OR, 9.24 [95% CI, 1.35-63.23]; P = .02). Poorer cognitive performance in the VASC+ group was less likely in women (OR, 0.37 [95% CI, 0.18-0.72]; P = .02), non-Hispanic white individuals (OR, 0.16 [95% CI, 0.09-0.26]; P < .001), those with higher educational attainment (OR, 0.23 [95% CI, 0.14-0.38]; P < .001), those with higher income levels (OR, 0.56 [95% CI, 0.72-0.76]; P < .001), and those who used renin-angiotensin system blockers (OR, 0.24 [95% CI, 0.07-0.79]; P = .02). In the VASC- group, the most important significant predictors of poorer cognitive performance were an ankle brachial index greater than 1.30 (OR, 18.56 [95% CI, 2.94-117.05]; P = .002) and increased blood pressure variability (OR, 3.49 [95% CI, 1.07-11.35]; P = .04). Among participants in the VASC- group who had both of these variables, the prevalence of poorer cognitive performance was greater (β = 16.65; P < .001).Two indirect measures of arterial stiffness, an ankle brachial index greater than 1.30 and increased blood pressure variability, are associated with poorer cognitive performance among adults 60 years or older without clinical atherosclerotic disease. Among those with vascular disease, factors capable of influencing arterial stiffness, such as exercise and the use of renin-angiotensin system blockers, may be protective against poorer cognitive performance.
Effects of sarin on the nervous system in rescue team staff members and police officers 3 years after the Tokyo subway sarin attack.
Authors: Y Nishiwaki, K Maekawa, Y Ogawa, N Asukai, M Minami, K Omae
Journal: Environmental Health Perspectives (2001)

Although the clinical manifestations of acute sarin poisoning have been reported in detail, no comprehensive study of the chronic physical and psychiatric effects of acute sarin poisoning has been carried out. To clarify the chronic effects of sarin on the nervous system, a cross-sectional epidemiologic study was conducted 3 years after the Tokyo subway sarin attack. Subjects consisted of the rescue team staff members and police officers who had worked at the disaster site. Subjects consisted of 56 male exposed subjects and 52 referent subjects matched for age and occupation. A neurobehavioral test, stabilometry, and measurement of vibration perception thresholds were performed, as well as psychometric tests to assess traumatic stress symptoms. The exposed group performed less well in the backward digit span test than the referent group in a dose-effect manner. This result was the same after controlling for possible confounding factors and was independent of traumatic stress symptoms. In other tests of memory function, except for the Benton visual retention test (mean correct answers), effects related to exposure were also suggested, although they were not statistically significant. In contrast, the dose-effect relationships observed in the neurobehavioral tests (psychomotor function) were unclear. None of the stabilometry and vibration perception threshold parameters had any relation to exposure. Our findings suggest the chronic decline of memory function 2 years and 10 months to 3 years and 9 months after exposure to sarin in the Tokyo subway attack, and further study is needed.
Inositol Trisphosphate, Calcium, Lithium, and Cell Signaling
Authors: Michael John Berridge
Journal: JAMA (1989)

Inositol lipids play a major role in cell signaling by functioning as precursors of second messengers. Of the three common inositol-containing lipids found in the plasma membrane, phosphatidylinositol (4,5)-bisphosphate is hydrolyzed to give diacylglycerol, which stimulates protein kinase C, and inositol 1,4,5-trisphosphate, which diffuses into the cell to release intracellular calcium. Inositol 1,4,5-trisphosphate is metabolized to give free inositol by two separate pathways. Lithium inhibits the final dephosphorylation step of both pathways, thus reducing the supply of the free inositol required to maintain the lipid precursors used for signaling. An inositol-depletion hypothesis may explain both the teratogenic effects of lithium and its therapeutic action in controlling manic-depressive illness. One of the metabolic pathways generates inositol tetrakisphosphate, which may also play a messenger role by expanding the size of the inositol 1,4,5-trisphosphate-sensitive pool of calcium. Calcium imaging of single cells has begun to reveal that this inositol 1,4,5-trisphosphate/calcium signaling system is organized in complex patterns, which include localization of calcium signals to discrete regions of cells and the generation of both calcium waves and calcium oscillations.
Intrauterine Hyperglycemia Modifying the Development of (Monogenic) Diabetes?
Authors: Tiinamaija Tuomi, Leif Groop
Journal: Diabetes Care (2003)

During the last decade, mutations in the glucokinase and hepatic nuclear factor (HNF) genes were found to cause maturity-onset diabetes of the young (MODY), which is characterized by a dominant autosomal mode of inheritance, high penetrance, lack of cardiovascular morbidity, and defective insulin response to glucose stimulus combined with normal, or even supranormal, insulin sensitivity (1,2). Most forms of MODY are caused by mutations in transcription factors such as HNF-1α (MODY3), HNF-4α (MODY1), insulin promoter factor (IPF)-1 (MODY4), HNF-1β (MODY5), or glukokinase (MODY2) (1). Although the precise mechanisms by which mutations in these transcription factors cause diabetes are not known, they are thought to involve transcription of a number of β-cell genes (3). Despite the fact that the defects are already present at birth, diabetes is rarely manifested at birth. Instead, the monogenic forms of diabetes are in fact heterogeneous with respect to age at diabetes diagnosis and severity of the insulin secretory defect (1). It has been hypothesized that high insulin sensitivity could maintain normoglycemia, despite minimal insulin secretory capacity, and that any deterioration in insulin sensitivity could result in hyperglycemia. This is supported by frequent deterioration of glucose tolerance during puberty or pregnancy.

The age at diagnosis of diabetes …
Doctors and Administrators — Hospital Planning — Air Ambulance
Authors: John Lister
Journal: New England Journal of Medicine (1955)

ONE of the results of the National Health Service has been the growth of an enormous army of hospital administrators. Whereas before the service the smaller voluntary hospitals were administered by a house governor, a clerk and a lay committee, most of these hospitals have now multiplied their previous staff many times. Form filling, paying salaries to previous honorary staff members, attending previously nonexistent committees and rendering reports to higher authority are some of the reasons for the increase.It is the question of higher authority with its centralized control that has probably caused the greatest criticism. In the teaching . . .
Conduct disorder, substance use disorders, and coexisting conduct and substance use disorders in adolescent inpatients
Authors: C M Grilo, D F Becker, D C Fehon, W S Edell, T H McGlashan
Journal: American Journal of Psychiatry (1996)

The authors examined the association between conduct disorder and substance use disorders in adolescent inpatients.Structured diagnostic interviews were given to 165 adolescent inpatients to assess the presence of DSM-III-R axis I disorders and personality disorders from axis II. Patients with conduct disorder (N = 25), substance use disorders (N = 24), and coexisting conduct and substance use disorders (N = 54) were compared to determine whether additional axis I and axis II disorders presented at significantly different rates.The groups with conduct disorder and coexisting conduct and substance use disorders had a higher proportion of male subjects than the group with substance use disorders alone. Patients with conduct disorder had an earlier age at first psychiatric contact and were diagnosed significantly more often with attention deficit hyperactivity disorder than the other two groups. Borderline personality disorder was diagnosed more frequently in the patients with substance use and coexisting conduct and substance use disorders than in the patients with conduct disorder. These differential co-occurrence patterns were observed for both male and female subjects.Conduct disorder and substance use disorders have high comorbidity rates with other psychiatric disorders in adolescent inpatients. The additional psychiatric comparison group (patients with coexisting conduct and substance use disorders) allowed for finer distinctions regarding psychiatric comorbidity. The validity of subtyping conduct disorder on the basis of the presence of a coexisting substance use disorder is suggested; conduct disorder patients without a coexisting substance use disorder are more likely to have attention deficit hyperactivity disorder.
Shortening Treatment for Tuberculosis — Back to Basics
Authors: Digby F. Warner, Valerie Mizrahi
Journal: New England Journal of Medicine (2014)

With approximately 8 million incident cases and 1.3 million deaths each year, increasing drug resistance, and exacerbating coexisting conditions such as the human immunodeficiency virus–acquired immunodeficiency syndrome and diabetes, tuberculosis continues to pose a massive threat to global health. In the absence of a vaccine to provide long-term protection, control of drug-susceptible tuberculosis is largely dependent on a standard 6-month chemotherapy regimen that has been in use for more than three decades. Any experimental therapy designed to modify this short-course regimen — which comprises a 2-month intensive phase with four drugs (rifampin, isoniazid, pyrazinamide, and ethambutol) followed by a 4-month . . .
Sensitization of dog and guinea pig heart myofilaments to Ca2+ activation and the inotropic effect of pimobendan: comparison with milrinone.
Authors: K Fujino, N Sperelakis, R J Solaro
Journal: Circulation Research (1988)

We compared the effects of the newer inotropic drugs, pimobendan (UD-CG 115 BS) and milrinone (Win 47203), on the electrical, mechanical and biochemical activity of intact and detergent-skinned preparations of cardiac muscle. Both of these agents increased contractile force of guinea pig papillary muscle preparations bathed under physiological conditions or depolarized with 25 mM K+o. The positive inotropic action was associated with potentiation of the Ca2+-dependent slow action potentials (APS). Contractile force developed in the presence of 25 mM [K]o and 1 microM isoproterenol was increased further by addition of 50 microM pimobendan with no effect on the slow action potential. Milrinone (50 microM) did not produce a further increase in the force or potentiate the slow APs. Pimobendan, in a dose-dependent manner, increased active tension developed by chemically-skinned dog heart muscle fibers at submaximally activating concentrations of Ca2+, whereas milrinone did not. At pCa 6.25, the half-maximal concentration of pimobendan for stimulation of force development was about 40 microM. At maximally activating levels of Ca2+ (pCa 4.5), pimobendan had little or no effect on force development. The effect of pimobendan on force was paralleled by changes in the Ca2+-activated Mg-ATPase activity of the isometric skinned fiber preparations. Moreover, the tension-cost (unit increase in ATPase rate/unit increase in force) was unchanged in the presence of pimobendan. Milrinone did not affect ATP hydrolysis by the skinned fiber preparations. Force-pCa and ATPase-pCa relations of skinned fiber preparations contracting isometrically were shifted to the left by 0.15-0.20 pCa units in the presence of 50 microM pimobendan. In contrast, there was no effect of pimobendan on the ATPase activity of unloaded myofibrillar preparations. The stimulation of force and ATPase activity of the skinned heart muscle fibers could be accounted for by an effect of pimobendan on the affinity of the regulatory (low affinity, Ca2+-specific) binding sites of cardiac troponin C. Ca2+ binding to the "structural" high affinity sites of troponin C was slightly inhibited. The results indicate that the positive inotropic actions of pimobendan, but not milrinone, may involve activation of the cardiac myofilaments by a direct effect involving an increased affinity of the regulatory site on troponin C for Ca2+.
Genesis of Body Surface Potentials in Varying Types of Right Ventricular Hypertrophy
Authors: SARAH D. BLUMENSCHEIN, MADISON S. SPACH, JOHN P. BOINEAU, ROGER C. BARR, THOMAS M. GALLIE, ANDREW G. WALLACE, PAUL A. EBERT
Journal: Circulation (1968)

Isopotential body surface maps and the sequence of epicardial excitation were studied in children with three types of pure right ventricular hypertrophy; that is, secundum atrial defects, valvular pulmonic stenosis, and tetralogy of Fallot. Patients with similar types of hypertrophy demonstrated internal consistency as to the anatomy, sequence of epicardial excitation of the right ventricular free wall, and body surface potential distribution; however, these phenomena varied between the three groups for each type of hypertrophy. These studies indicate that diagnostic information is available on the body surface to distinguish: (1) right ventricular hypertrophy due primarily to dilatation (secundum atrial septal defects), (2) right ventricular hypertrophy with symmetrical increase in thickness throughout the right ventricle (valvular pulmonic stenosis with moderate to severe right ventricular hypertrophy), and (3) right ventricular hypertrophy proximal to infundibular narrowing (tetralogy of Fallot) from one another. The body surface events could be accounted for in part by the events measured at the epicardial surface.
Comparative Trial of a New Anticholinergic Bronchodilator, Sch 1000, and Salbutamol in Chronic Bronchitis
Authors: H. Poppius, Y. Salorinne
Journal: BMJ (1973)

In 20 patients with chronic bronchitis and moderate or severe airways obstruction inhalation of 40 μg of a new anticholinergic drug, Sch 1000, was found to produce stronger and more persistent bronchodilation than inhalation of 200 μg of salbutamol.
Dreaming has content and meaning not just form
Authors: Milton Kramer
Journal: Behavioral and Brain Sciences (2000)

The biological theories of dreaming provide no explanation for the transduction from neuronal discharge to dreaming or waking consciousness. They cannot account for the variability in dream content between individuals or within individuals. Mind-brain isomorphism is poorly supported, as is dreaming's link to REM sleep. Biological theories of dreaming do not provide a function for dreaming nor a meaning for dreams. Evolutionary views of dreaming do not relate dream content to the current concerns of the dreamer and using the nightmare as the paradigm dream minimizes the impact of poor sleep on adaptations. [Hobson et al.; Nielsen; Revonsuo; Solms]
Prophylaxis of Plasmodium falciparum Malaria with Azithromycin Administered to Volunteers
Authors: Steven L. Anderson
Journal: Annals of Internal Medicine (1995)

Objective: To determine whether azithromycin, 250 mg/d, is effective prophylaxis for liver infection or for both liver and subsequent blood infection with Plasmodium falciparum. Design: Controlled phase II trial with two cohorts entered sequentially. Setting: Clinical trials center of Walter Reed Army Institute of Research, Washington, D.C. Patients: Each of the two cohorts consisted of 12 normal adult volunteers who had not had malaria during the previous 2 years: 10 who received azithromycin prophylaxis and 2 controls who did not receive treatment. Intervention: For cohort 1, prophylactic efficacy against liver infection alone during the initial 7 days of the infection was determined by loading participants with azithromycin before challenge with P. falciparum-infected mosquitoes on day 0 and by then giving the drug for 7 days after the challenge. The regimen was 500 mg on day 14 before the challenge, followed by 250 mg/d from day 13 before the challenge through day 7 after the challenge. For cohort 2, prophylactic efficacy against both the liver infection and the subsequent blood infection was determined by continuing drug administration for 28 days after the challenge. Measurements: Plasmodium falciparum infection was diagnosed through peripheral blood smears obtained up to 70 days after challenge. Malarial symptoms and adverse drug reactions were also monitored. Results: In cohort 1, 4 of 10 volunteers who received azithromycin prophylaxis (40%) did not develop parasitemia. In cohort 2, none of the 10 volunteers receiving azithromycin prophylaxis (100%) developed parasitemia. For each cohort, both control volunteers became parasitemic on days 9 through 13 after the challenge. Adverse drug reactions were few and mild. Conclusions: In this model, prophylaxis with azithromycin (250 mg/d) was partially effective against liver parasites and completely successful against the combination of liver and blood parasites. These data suggest that azithromycin has the potential to be an effective, well-tolerated clinical prophylactic agent for P. falciparum malaria.