tbuckley/cabot-search huggingface dataset:
Elimination of the action of glucagon-like peptide 1 causes an impairment of glucose tolerance after nutrient ingestion by healthy baboons.
Authors: D A D'Alessio, R Vogel, R Prigeon, E Laschansky, D Koerker, J Eng, J W Ensinck
Journal: Journal of Clinical Investigation (1996)

Glucagon-like peptide 1 (GLP-1) is an insulinotropic hormone released after nutrient ingestion which is known to augment insulin secretion, inhibit glucagon release, and promote insulin-independent glucose disposition. To determine the overall effect of GLP-1 on glucose disposition after a meal we studied a group of healthy, conscious baboons before and after intragastric glucose administration during infusions of saline, and two treatments to eliminate the action of GLP-1: (a) exendin-[9-39] (Ex-9), a peptide receptor antagonist of GLP-1; or (b) an anti-GLP-1 mAb. Fasting concentrations of glucose were higher during infusion of Ex-9 than during saline (4.44 +/- 0.05 vs. 4.16 +/- 0.05 mM, P < 0.01), coincident with an elevation in the levels of circulating glucagon (96 +/- 10 vs. 59 +/- 3 ng/liter, P < 0.02). The postprandial glycemic excursions during administration of Ex-9 and mAb were greater than during the control studies (Ex-9 13.7 +/- 2.0 vs. saline 10.0 +/- 0.8 mM, P = 0.07; and mAb 13.6 +/- 1.2 vs. saline 10.6 +/- 0.9 mM, P = 0.044). The increments in insulin levels throughout the absorption of the glucose meal were not different for the experimental and control conditions, but the insulin response in the first 30 min after the glucose meal was diminished significantly during treatment with Ex-9 (Ex-9 761 +/- 139 vs. saline 1,089 +/- 166 pM, P = 0.044) and was delayed in three of the four animals given the neutralizing antibody (mAb 946 +/- 262 vs. saline 1,146 +/- 340 pM). Thus, elimination of the action of GLP-1 impaired the disposition of an intragastric glucose meal and this was at least partly attributable to diminished early insulin release. In addition to these postprandial effects, the concurrent elevation in fasting glucose and glucagon during GLP-1 antagonism suggests that GLP-1 may have a tonic inhibitory effect on glucagon output. These findings demonstrate the important role of GLP-1 in the assimilation of glucose absorbed from the gut.
The Hedgehog and the hair follicle: a growing relationship
Authors: Andrzej Dlugosz
Journal: Journal of Clinical Investigation (1999)

The various forms of hair loss (alopecia) constitute an extremely common complaint among both men and women. Although sometimes dismissed as merely cosmetic, these conditions can be psychologically and socially devastating. The desire to regrow hair is at the root of a multi-billion dollar industry worldwide; however, there are few truly effective treatments. Given the recent progress in elucidating some of the signals regulating hair follicle growth and development, there is hope that more useful therapies may soon be available. The timely report by Sato et al. (1) presents interesting new data bearing on this issue.
Autologous Hematopoietic Stem Cell Transplantation vs Intravenous Pulse Cyclophosphamide in Diffuse Cutaneous Systemic Sclerosis
Authors: Jacob M. van Laar, Dominique Farge, Jacob K. Sont, Kamran Naraghi, Zora Marjanovic, Jérôme Larghero, Annemie J. Schuerwegh, Erik W. A. Marijt, Madelon C. Vonk, Anton V. Schattenberg, Marco Matucci-Cerinic, Alexandre E. Voskuyl, Arjan A. van de Loosdrecht, Thomas Daikeler, Ina Kötter, Marc Schmalzing, Thierry Martin, Bruno Lioure, Stefan M. Weiner, Alexander Kreuter, Christophe Deligny, Jean-Marc Durand, Paul Emery, Klaus P. Machold, Francoise Sarrot-Reynauld, Klaus Warnatz, Daniel F. P. Adoue, Joël Constans, Hans-Peter Tony, Nicoletta Del Papa, Athanasios Fassas, Andrea Himsel, David Launay, Andrea Lo Monaco, Pierre Philippe, Isabelle Quéré, Éric Rich, Rene Westhovens, Bridget Griffiths, Riccardo Saccardi, Frank H. van den Hoogen, Willem E. Fibbe, Gérard Socié, Alois Gratwohl, Alan Tyndall
Journal: JAMA (2014)

High-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HSCT) have shown efficacy in systemic sclerosis in phase 1 and small phase 2 trials.To compare efficacy and safety of HSCT vs 12 successive monthly intravenous pulses of cyclophosphamide.The Autologous Stem Cell Transplantation International Scleroderma (ASTIS) trial, a phase 3, multicenter, randomized (1:1), open-label, parallel-group, clinical trial conducted in 10 countries at 29 centers with access to a European Group for Blood and Marrow Transplantation-registered transplant facility. From March 2001 to October 2009, 156 patients with early diffuse cutaneous systemic sclerosis were recruited and followed up until October 31, 2013.HSCT vs intravenous pulse cyclophosphamide.The primary end point was event-free survival, defined as time from randomization until the occurrence of death or persistent major organ failure.A total of 156 patients were randomly assigned to receive HSCT (n = 79) or cyclophosphamide (n = 77). During a median follow-up of 5.8 years, 53 events occurred: 22 in the HSCT group (19 deaths and 3 irreversible organ failures) and 31 in the control group (23 deaths and 8 irreversible organ failures). During the first year, there were more events in the HSCT group (13 events [16.5%], including 8 treatment-related deaths) than in the control group (8 events [10.4%], with no treatment-related deaths). At 2 years, 14 events (17.7%) had occurred cumulatively in the HSCT group vs 14 events (18.2%) in the control group; at 4 years, 15 events (19%) had occurred cumulatively in the HSCT group vs 20 events (26%) in the control group. Time-varying hazard ratios (modeled with treatment × time interaction) for event-free survival were 0.35 (95% CI, 0.16-0.74) at 2 years and 0.34 (95% CI, 0.16-0.74) at 4 years.Among patients with early diffuse cutaneous systemic sclerosis, HSCT was associated with increased treatment-related mortality in the first year after treatment. However, HCST conferred a significant long-term event-free survival benefit.isrctn.org Identifier: ISRCTN54371254.
France examines its poor record for using condoms
Authors: A Dorozynski
Journal: BMJ (1994)

France lags behind most other countries in the European Union when it comes to using condoms. A survey by Agence Francaise de Lutte Contre le Sida - a French agency that fights AIDS - shows that the number of condoms used by Europeans varies from 1.7 to 3.8 per person per year and that the popularity of condoms is not related to cost.

Spain uses the most condoms even though they cost 60p on average. In 1992 about …
Rupture of the Gall Bladder with Intraperitoneal Hemorrhage
Authors: Carl B. Mason, Charles S. Judd, Rogers Lee Hill
Journal: New England Journal of Medicine (1957)

THE problem of the diagnosis of an acute abdominal disease is often a challenging one. In the absence of a history of trauma, one is confronted with the possibility of an inflammatory condition or the complication of some disease of congenital or neoplastic origin. Vascular accidents, a complication of pregnancy, diaphragmatic hernia or chest conditions may cause the symptoms. Diffuse insult to the peritoneum and hemorrhage within the peritoneal cavity often produce shock, which may complicate the general picture of pain, tenderness and rigidity.A careful history and physical examination frequently enable a physician to make an accurate diagnosis. In . . .
31. Somatic Gene Therapy for ADA-SCID Following Cessation of PEG-ADA and Use of a Mild Conditioning Regime
Authors: Hubert B. Gaspar, Emma Bjorkegren, Katherine Parsley, Kimberly C. Gilmour, Jo Sinclair, Fang Zhang, Lynette D. Fairbanks, Doug King, Graham Davies, Paul A. Veys, Christine Kinnon, Adrian J. Thrasher
Journal: Molecular Therapy (2005)

We have initiated a trial of somatic gene therapy for ADA (adenosine deaminase) deficient SCID. Patients lacking a fully matched donor and who show a poor response to PEG-ADA enzyme replacement were eligible for entry. PEG-ADA replacement was stopped one month prior to the gene therapy. Autologous bone marrow CD34+ cells were isolated and transduced using a retroviral vector encoding the hADA cDNA which was driven from the SFFV LTR. Patients received one dose of Melphalan (140mg/m2) prior to return of gene modified cells. To date one patient has been treated on this study. The patient was started on PEG-ADA 2 mths after birth but the response was suboptimal with low T cell numbers and poor immunoglobulin production. Autologous BM was harvested and the efficiency of gene transduction was 25-30%. Transduced cells were returned after conditioning and the patient required both platelet and red blood cell transfusions. One year after gene therapy, substantial immune recovery from gene modified cells has been observed and is stable. The absolute lymphocyte count is 500 cells/mm3 with CD3>250 cells/mm3, CD4>100 cells/mm3 and CD16/56 NK cells > 50 cells/mm3 with evidence of recovery of na|[iuml]|ve T cells. CD19 recovery has been slower due to Rituximab administration for EBV reactivation. These values are equivalent if not superior to those seen on PEG-ADA. Quantitative PCR shows that |[sim]|40% of T cells and |[sim]|50% NK cells contain ADA transgene. During this time, there has been good metabolite correction with dATP levels equivalent to those seen after BMT. Clinically the patient has remained very well and has been at home, attending normal school with ongoing antibiotic prophylaxis. In summary, this gene therapy protocol has been well tolerated and there is evidence of progressive immune recovery from gene modified cells and continued metabolic detoxification. Further follow up and recruitment of more patients will determine the extent and longevity of immune recovery. This study and a recent Italian trial demonstrate that gene therapy for ADA SCID using mild conditioning is well tolerated and offers good correction of the immunological defects.
Electron-beam therapy in Arndt-Gottron's scleromyxoedema
Authors: M.C. KOEPPEL, C. AQUILINA, G. TERRIER, J. SAYAG
Journal: British Journal of Dermatology (1993)

We report a patient with Arndt‐Gottron's scleromyxoedema whose skin lesions responded to electron‐beam therapy. This treatment appears to be effective in improving the cutaneous signs and functional impairment of this disease.
Psoriasis, psoriatic arthritis and the possible association with Sjogren's syndrome
Authors: P. COLLINS, SARAH ROGERS, J. JACKSON, B. McCARTAN
Journal: British Journal of Dermatology (1992)

Thirty patients with psoriatic arthropathy (PA) were age- and sex-matched with patients with plaque psoriasis alone to investigate a possible link between Sjögren's syndrome (SS) and PA. The results of clinical examination, Schirmer's test, maximal stimulated salivary flow rate, haematological and serological investigations were compared in the two groups. Median maximal stimulated salivary flow rate was significantly reduced in patients with PA suggesting that salivary glands are affected in this condition. One patient with PA had SS.
Plasma levels of brain natriuretic peptide in patients with cirrhosis
Authors: Giorgio La Villa, Roberto Giulio Romanelli, Vincenzo Casini Raggi, Cristina Tosti-Guerra, Maria Laura De Feo, Fabio Marra, Giacomo Laffi, Paolo Geñtilini
Journal: Hepatology (1992)

Plasma levels of brain natriuretic peptide, a recently identified cardiac hormone with natriuretic activity, were measured in 11 healthy subjects, 13 cirrhotic patients without ascites, 18 nonazotemic cirrhotic patients with ascites and 6 patients with cirrhosis, ascites and functional kidney failure. Plasma levels of brain natriuretic peptide were similar in healthy subjects and cirrhotic patients without ascites (5.56 ± 0.65 and 7.66 ± 0.68 fmol/ml, respectively). In contrast, cirrhotic patients with ascites, with and without functional kidney failure, had significantly higher plasma concentrations of brain natriuretic peptide (19.56 ± 1.37 and 16.00 ± 1.91 fmol/ml, respectively) than did healthy subjects and patients without ascites (p &lt; 0.01); no significant difference was found between the two groups of cirrhotic patients with ascites with respect to this parameter. In the whole group of cirrhotic patients included in the study, brain natriuretic peptide level was directly correlated with the degree of impairment of liver and kidney function, plasma renin activity and plasma levels of aldosterone and atrial natriuretic peptide. The results of this study indicate that brain natriuretic peptide is increased in cirrhotic patients with ascites and suggest that sodium retention in cirrhosis is not due to deficiency of this novel cardiac hormone. (Hepatology 1992;16:156-161.)
Soluble transferrin receptor in the study of fetal erythropoietic activity
Authors: Giovanni Carpani, Mauro Buscaglia, Luciano Ghisoni, Denise Pizzotti, Nadia Vozzo, Maria Bellotti, Gianalessandro Moroni
Journal: American Journal of Hematology (1996)

In order to evaluate fetal erythropoiesis we measured red blood cells, hemoglobin, hematocrit, serum transferrin receptor (sTfR), and iron status parameters in fetuses undergoing percutaneous umbilical blood sampling, and in normal newborns at term. We found high levels of sTfR in fetuses and newborns as compared with normal adults (3,149 +/- 181 vs. 1,881 +/- 137 ng/ml, P < 0.00001). Concentrations of sTfR correlate with gestational age and red blood cell numbers (r = 0.441, P < 0.001; r = 0.366, P = 0.06). sTfR concentrations do not show correlation with iron status parameters. The increased sTfR concentration is consistent with the fact that fetal life is characterized by cell proliferation and tissue growth. sTfR concentration correlates with gestational age and numbers of red blood cells, and can therefore be considered a good indicator of fetal erythropoiesis. It is conceivable that, during intrauterine life, sTfR expression is independent from iron status. sTfR determination will help in reaching a better understanding of some aspects of fetal physiology, and will help elucidate the physiopathology of fetal hematological diseases.
Examinations and Fruits
Authors: DAVID W. WESTRTNG
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 August 1973Examinations and FruitsDAVID W. WESTRTNG, M.D.DAVID W. WESTRTNG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-2-290_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dilip Kumar Roy, writing in the Journal of the Indian Medical Association (59:220-222, 1972), a part of which was excerpted in the March issue (Ann Intern Med 78:340, 1973), tells us that a tree is known by its fruits. He then suggests that the fruits of medical education are the scores achieved by students on their examinations.This seems to reflect a rather narrow concept, one that is under increasing attack in U.S. medical schools (and, apparently, Indian medical schools as well). Those who oppose examination scores as an end rather than a means view these exercises... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1973Volume 79, Issue 2Page: 290-291KeywordsExerciseMedical education Issue Published: 1 August 1973 PDF downloadLoading ...
Self management education and good professional consultation skills for patients with diabetes
Authors: F. J. Snoek
Journal: BMJ (2012)

Their effect on clinical outcomes in routine practice is time limited

It is well recognised that people with diabetes, both young ones with type 1 disease and adults with type 2 diabetes, need to develop skills in self management to manage their condition successfully. In the past few decades different strategies aimed at promoting self management have been developed and tested across a wide range of patient groups and settings. Two linked papers (doi:10.1136/bmj.e2333; doi:10.1136/bmj.e2359), which examine two different approaches delivered in routine practice, improve our understanding of the longitudinal dose-response relation between educational and consultation interventions and improvements in the self management behaviours and subsequent health outcomes of patients with diabetes.1 2 

A systematic review found that group based programmes for self management strategies in type 2 diabetes were effective in terms of improving blood glucose, blood pressure, body weight, and requirement for antidiabetes drugs.3 The Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) programme was developed in the United Kingdom and tested in 824 patients who had been newly diagnosed with type 2 diabetes in a clustered randomised trial in primary care. At one year follow-up, the programme was shown to …
Surviving Adult Cancers. Part 2: Psychosocial Implications
Authors: Deborah Welch-McCaffrey
Journal: Annals of Internal Medicine (1989)

Purpose: To address the psychosocial implications of surviving adult cancers by a comprehensive review of the literature. Data Identification: An English-language literature search using MEDLINE (1970 to 1988), Index Medicus (1970 to 1988), and bibliographic reviews of textbooks and review articles. Study Selection: Of 103 originally identified articles, 58 that specifically addressed the stated purpose were selected. Data Extraction: Four authors reviewed and critiqued the literature extrapolating the major themes on this topic. Results of Data Synthesis: There is little information on the many psychosocial variables that affect an adult's long-term cancer survival trajectory. Collation of data identified the following significant psychosocial themes: fear of recurrence and death, relationships with the health care team, adjustment to physical compromise, alterations in customary social support, isolationism, psychosocial reorientation, and employment and insurance problems. Conclusions: The continuation of a rehabilitation effort begun around the initial diagnosis of cancer would be instrumental in providing post-therapy evaluation and guidance needed by adult long-term survivors of cancer. Education, research, and support interventions need to be mobilized for this population of adults with a history of cancer.
Baseline Results of Therapy for Burned Patients
Authors: Irving Feller
Journal: JAMA (1976)

Baseline results of therapy for burned patients have been determined. The data (21,000 cases) from the National Burn Information Exchange have been analyzed by probit analysis to determine survival as it is influenced by the size and depth of the burn, age and sex of patients, topical agents, and the institution providing treatment. The results demonstrate that survival is influenced by the size and depth of the burn; that there is increased survival of males, compared to that of females; that five different age categories can be identified that influence survival; that the topical agent used has little effect on survival; and that there is a significant difference in survival when the institution providing the treatment is considered. (<i>JAMA</i>236:1943-1947, 1976)
Circumferential resection margin involvement: an independent predictor of survival following surgery for oesophageal cancer
Authors: S P L Dexter, H Sue-Ling, M J McMahon, P Quirke, N Mapstone, I G Martin
Journal: Gut (2001)

BACKGROUND For rectal carcinoma, the presence of tumour within 1 mm of the circumferential margin is an important independent prognostic factor for both local recurrence and survival. Similar prospective data have not been reported for oesophageal carcinoma and we wished to ascertain the prognostic importance of this variable following potentially curative resection for oesophageal carcinoma. AIM To prospectively assess the impact of circumferential margin involvement (tumour within 1 mm) following potentially curative resection for oesophageal carcinoma. PATIENTS AND METHODS In a prospective study, resection specimens of 135 patients treated with potentially curative oesophageal resection alone were studied for the presence of tumour within 1 mm of the circumferential margin (margin positive), using inked margins and cross sectional slicing of the specimen. All tumours were also staged using the 1987 UICC TNM classification. Patients were followed for a mean of 19 months, and overall and cancer specific survival analysed. RESULTS The finding of tumour cells within 1 mm of the circumferential margin (CRM+) was a significant and independent predictor of survival following potentially curative oesophageal resection. Overall, 64 (47%) patients were CRM+. Median survival in this group was 21 months compared with 39 months in the CRM− group (p=0.015). The impact of CRM status on survival was only seen in patients with a low nodal metastatic burden (&lt;25% nodes positive). The odds ratio for the risk of dying from oesophageal cancer was 2.08 when the CRM was involved (p=0.013). CONCLUSIONS The presence of tumour within 1 mm of the circumferential margin following potentially curative resection for oesophageal carcinoma is an important independent prognostic variable and should be reported routinely.
Measles in the 21st Century
Authors: E. Kim Mulholland, Ulla Kou Griffiths, Robin Biellik
Journal: New England Journal of Medicine (2012)

Between 2000 and 2008, measles control improved markedly worldwide, but with poorer countries focused on polio eradication and some richer countries falling prey to opposition to vaccination, the measles genie seems to have slipped out of the bottle in recent years.
Gene-expression profiling of systemic anaplastic large-cell lymphoma reveals differences based on ALK status and two distinct morphologic ALK+ subtypes
Authors: Laurence Lamant, Aurélien de Reyniès, Marie-Michèle Duplantier, David S. Rickman, Frédérique Sabourdy, Sylvie Giuriato, Laurence Brugières, Philippe Gaulard, Estelle Espinos, Georges Delsol
Journal: Blood (2006)
Fibroelastolytic papulosis of the neck: a report of 20 cases
Authors: L. BALUS, A. AMANTEA, P. DONATI, M. FAZIO, M.C. GIULIANO, M. BELLOCCI
Journal: British Journal of Dermatology (1997)

The clinical and histological features of the entities known as 'white fibrous papulosis of the neck' (WFPN) and 'acquired elastolysis of the papillary dermis simulating pseudoxanthoma elasticum' (PDE) are not clearly defined. This study was conducted to compare our experience of WFPN/PDE with those described in the literature. Twenty patients presented at our institution with papular eruptions involving the neck. The asymptomatic lesions, which ranged in colour from normal skin tones to yellowish, were isolated or coalescent. Microscopically, the papules showed elastolysis and fibrosis of the upper reticular and papillary dermis. A review of the literature shows similar characteristics in cases reported as WFPN and PDE. This study indicates that WFPN and PDE are variants of a single disorder that can be more precisely defined as 'fibroelastolytic papulosis of the neck' and which appears to be a manifestation of intrinsic skin ageing.
Effect of Potassium and "Toxic" Doses of Digitalis on the Myocardium
Authors: CHARLES FISCH, EDWARD F. STEINMETZ, ALFRED F. FASOLA, B. L. MARTZ
Journal: Circulation Research (1959)

This study was designed to evaluate further the antagonism between digitalis and potassium. Potassium was given by intravenous infusion to six dogs (1) before digitalization, (2) after injection of "therapeutic" doses of digitoxin, and finally (3) after injection of "toxic" doses of the drug.
Fibroblast Growth Factor-23, Cardiovascular Prognosis, and Benefit of Angiotensin-Converting Enzyme Inhibition in Stable Ischemic Heart Disease
Authors: Jacob A. Udell, David A. Morrow, Petr Jarolim, Sarah Sloan, Elaine B. Hoffman, Thomas F. O'Donnell, Amit N. Vora, Torbjørn Omland, Scott D. Solomon, Marc A. Pfeffer, Eugene Braunwald, Marc S. Sabatine
Journal: Journal of the American College of Cardiology (2014)