tbuckley/cabot-search huggingface dataset:
Low Total Vitamin C Plasma Level Is a Risk Factor for Cardiovascular Morbidity and Mortality in Hemodialysis Patients
Authors: Robert Deicher, Farzad Ziai, Christian Bieglmayer, Martin Schillinger, Walter H. Hörl
Journal: Journal of the American Society of Nephrology (2005)

Hemodialysis patients are prone to deficiency of vitamin C, which constitutes the most abundant nonenzymatic antioxidant in blood. Because antioxidants are involved in the pathogenesis of atherosclerosis, the authors examined the association of total vitamin C plasma level with cardiovascular outcomes in such patients. One hundred thirty-eight consecutive maintenance hemodialysis patients (median age 61 yr, 90 males) were enrolled in a single-center study. At baseline, routine laboratory parameters were recorded, and predialysis total vitamin C plasma levels were measured by high-pressure liquid chromatography. Patients were prospectively followed-up for the occurrence of a primary composite endpoint consisting of fatal and nonfatal major adverse cardiovascular events (MACE) and for all-cause and cardiovascular mortality. MACE occurred in 35 patients (25%) over a period of median 30 mo, and 42 patients (30%) died [29 cardiovascular deaths (21% of total)]. Using Cox proportional hazards modeling, adjusted hazard ratios for the occurrence of MACE were 3.90 (95% confidence interval [CI]: 1.42 to 10.67; P = 0.008) and 3.03 (95% CI: 1.03 to 8.92; P = 0.044) for patients in the lower (<32 micromol/L) and middle (32 to 60 micromol/L) tertile of total vitamin C levels, compared with patients in the upper tertile (>60 micromol/L). Hazard ratios for cardiovascular death were 3.79 (95% CI: 1.23 to 11.66; P = 0.020) and 2.89 (95% CI: 0.89 to 9.37; P = 0.076). Total vitamin C levels were not independently associated with all-cause mortality. This study concludes that low total vitamin C plasma levels predict adverse cardiovascular outcomes among maintenance hemodialysis patients. Future studies should address the potential protective effect of an adequate vitamin C supplementation.
Screening for sulphonylureas in the investigation of hypoglycaemia
Authors: P Y P Kwong, J D Teale
Journal: Journal of the Royal Society of Medicine (2002)

The most important cause of hypoglycaemia in the presence of high insulin and C-peptide concentrations is insulinoma. However, a similar picture arises from use of sulphonylureas, which is sometimes covert. All specimens received in two years by a supraregional assay service laboratory from adults with low glucose and inappropriately high insulin and C-peptide concentrations were tested for sulphonylureas by a radioimmunoassay that employed antibodies to glibenclamide. In sulphonylurea-positive cases a questionnaire was sent to the consultant responsible for the patient, to elicit further information. Samples from 93 adult patients met the criteria, and 34 (37%) of these gave a positive result on screening for sulphonylureas. The consultants provided further information on 31 of the 34, and in 20 the presence of a sulphonylurea was unexpected. In 10 the features were such as to raise the possibility of factitious drug ingestion. A simple screening technique applied to specimens from patients with hyperinsulinaemic hypoglycaemia indicated that, in a substantial proportion of cases, the patient was taking a sulphonylurea.
Physicians, Cost Control, and Ethics
Authors: Daniel P. Sulmasy
Journal: Annals of Internal Medicine (1992)

Rising health care expenditures have led to numerous cost-control proposals. An examination of the ethical questions surrounding the role that physicians play in the control of health care costs suggests that unilateral rationing decisions by individual physicians at the bedside are morally unacceptable. Such decisions are arbitrary, ineffective in redistributing health care resources, and formally unjust. Restrictive gatekeeping (the creation of financial incentives for physicians to limit care given to individual patients) also seems unacceptable because of its morally significant effects. First, it disguises the role of those actually responsible for cost-control decisions; second, it routinely creates a "moral stress test" by forcing physicians to act in ways that are contrary to their own interests in order to serve the needs of patients; third, it undermines the trust between doctor and patient; and fourth, it rations by class of persons rather than class of technology. In contrast, a morally sound system would attempt to control costs by honestly informing patients and assigning responsibility justly, would encourage physicians to act in the interests of patients, would foster trust, and would recognize the great importance of equal treatment for all patients. Such a system would depend on input from an informed public and would apply equally to all members of society.
Spitting images: our medical philologist, Jeff Aronson, comments
Authors: J. K Aronson
Journal: BMJ (2010)

The Greek word πτύeιν (ptuein) meant to spit and πτύαλον (ptualon) saliva. These words came from the same onomatopoeic Indo-European root that gives us spew and puke; spit, spittle, and sputum; spout, sputter, and splutter; spittoon and cuspidor. A ptyalogogue is a substance that induces the flow of saliva, ptyalin …
Problems in Medical Licensure
Authors: Kenneth H. Schnepp
Journal: JAMA (1970)

To the Editor.—  Vasilios G. Letsou, MD ( 210: 1764, 1969), a member of the Massachusetts Board of Registration in Medicine, focuses attention on that perennial problem of licensure, universal reciprocity, and endorsement between the states, when he says:  Difficulties arise when one attempts to evaluate the significance of a license given by state authorities after their own examinations. Examinations given by most states vary and even when the same examination is given by various states the accepted passing mark varies from state to state, and, as a matter of fact, may vary from year to year in the same state. In the less than two-year period that I have served on the State Board of Registration in Medicine in Massachusetts, the accepted passing mark has been altered on two separate occasions, so that during that period, three sets of standards have applied to the same examination.  In quoting Letsou, there
Guidelines for clinical trials in melasma
Authors: A. Pandya, M. Berneburg, J-P. Ortonne, M. Picardo
Journal: British Journal of Dermatology (2006)

There have been very few well-conducted trials in melasma and this makes the process of comparing treatment outcome between trials difficult. The Pigmentary Disorders Academy has examined the issues relating to clinical trials on melasma, and has proposed recommendations on how they should be conducted. This covers all aspects including correct diagnosis of the condition, evaluation of efficacy and safety outcome, and overall clinical trial design. It is anticipated that the establishment of accepted guidelines on the conduct of clinical trials in melasma will greatly assist the dermatological community.
RORSCHACH'S TEST AS A DIAGNOSTIC AID IN BRAIN INJURY
Authors: JOHN A. AITA, RALPH M. REITAN, JANE M. RUTH
Journal: American Journal of Psychiatry (1947)

The Rorschach test records of 60 post-traumatic, brain injured patients have been compared with those of 100 control patients in an effort to find factors characteristic of organic cerebral alterations. Piotrowski's ten signs of cerebral disturbance have been evaluated. The results indicate that impotence, perplexity, automatic phrases, repetition, and color naming are of value in identifying brain injured patients. Nine additional signs, which are found to be helpful in diagnosis, are named and discussed. A review of the test records from an interpretive viewpoint indicates that anxiety, depression and hypochondriasis were frequently present and schizophrenic-like disturbances were occasionally present among the brain injured patients.
Hypoxia and Glucose Metabolism in Malignant Tumors
Authors: Joseph G. Rajendran, David A. Mankoff, Finbarr O’Sullivan, Lanell M. Peterson, David L. Schwartz, Ernest U. Conrad, Alexander M. Spence, Mark Muzi, D. Greg Farwell, Kenneth A. Krohn
Journal: Clinical Cancer Research (2004)

Abstract Purpose: The aim of this study is to compare glucose metabolism and hypoxia in four different tumor types using positron emission tomography (PET). 18F-labeled fluorodeoxyglucose (FDG) evaluates energy metabolism, whereas the uptake of 18F-labeled fluoromisonidazole (FMISO) is proportional to tissue hypoxia. Although acute hypoxia results in accelerated glycolysis, cellular metabolism is slowed in chronic hypoxia, prompting us to look for discordance between FMISO and FDG uptake. Experimental Design: Forty-nine patients (26 with head and neck cancer, 11 with soft tissue sarcoma, 7 with breast cancer, and 5 with glioblastoma multiforme) who had both FMISO and FDG PET scans as part of research protocols through February 2003 were included in this study. The maximum standardized uptake value was used to depict FDG uptake, and hypoxic volume and maximum tissue:blood ratio were used to quantify hypoxia. Pixel-by-pixel correlation of radiotracer uptake was performed on coregistered images for each corresponding tumor plane. Results: Hypoxia was detected in all four patient groups. The mean correlation coefficients between FMISO and FDG uptake were 0.62 for head and neck cancer, 0.47 for breast cancer, 0.38 for glioblastoma multiforme, and 0.32 for soft tissue sarcoma. The correlation between the overall tumor maximum standardized uptake value for FDG and hypoxic volume was small (Spearman r = 0.24), with highly significant differences among the different tumor types (P &amp;lt; 0.005). Conclusions: Hypoxia is a general factor affecting glucose metabolism; however, some hypoxic tumors can have modest glucose metabolism, whereas some highly metabolic tumors are not hypoxic, showing discordance in tracer uptake that can be tumor type specific.
THE INFLUENZA EPIDEMIC OF 1918: COLOUR OF THE BLOOD IN FATAL CASES
Authors: J. S. Haldane
Journal: BMJ (1929)

ONE of the most striking facts about the world-wide and extraordinarily fatal epidemic of " influenza " in, 1918 was that in the bad cases one of the symptoms was a peeuliar blne or violet form of cyanosis.At the time this cvanosis was attributed to bronchi-puenmonia; bTut aga;inst thi.s explanIiationi was the fact that administration of oxygen failed to abolish or diminish the cyanosis, whereas in the cyanosis which sometimes accompanies ordiniar-y lobar pteu- moiia, or the lung iniflanmmation of poisoning by irritant g:as, the eyallosis cani usually be abolished easily by adding s6nme oxygen to the inspired air.In a paper puiblished in the British, Medical Joirnal of August 1st, 1925 (p.187), on the presence pest mortem of
The resistance of breast cancer stem cells to conventional hyperthermia and their sensitivity to nanoparticle-mediated photothermal therapy
Authors: Andrew R. Burke, Ravi N. Singh, David L. Carroll, James C.S. Wood, Ralph B. D’Agostino, Pulickel M. Ajayan, Frank M. Torti, Suzy V. Torti
Journal: Biomaterials (2012)
SIGNIFICANT SIGNS IN EARLY DIAGNOSIS
Authors: H. W. EMSHEIMER
Journal: JAMA (1913)

The term  is used advisedly. There are certain symptoms or signs which at all times are indicative of pathologic processes. Their theoretical value in diagnosis we would never think of denying; and yet practically it is just this evidence that we are prone to overlook in rendering our decisions, blinded as we often are by an over-abundance of signs, the very multitude of which tends to obscure the clinical picture. Symptoms such as hematemesis, melena and chills, and physical signs like petechiae, localized tenderness and markedly dilated veins always signify abnormal conditions, and cannot under any circumstances be discarded as valueless diagnostic evidence. They mean something—they are what are termed in this paper significant signs.  I am firmly convinced that many mistakes in diagnosis are avoidable, the errors in these instances being the result of inability to discriminate between salient and unimportant facts. The snap diagnostician startles his audience,
Definitive Chemoradiation for the Treatment of Locally Advanced Non–Small-Cell Lung Cancer
Authors: A. William Blackstock, Ramaswamy Govindan
Journal: Journal of Clinical Oncology (2007)

A third of patients with newly diagnosed non–small-cell lung cancer (NSCLC) have locally advanced disease not amenable for curative resection. Addition of chemotherapy to thoracic radiation improves survival in patients with locally advanced NSCLC when compared with thoracic radiation alone. Over the past two decades, we have made slow but steady progress in improving the outcomes of therapy in this subset of patients. This review summarizes the past two decades of research and outlines the direction we need to pursue to significantly enhance the outcomes. The widespread use of positron emission tomography (identifying those with occult distant metastatic disease and sparing them combined-modality therapy), improved radiation techniques, and better supportive care resulting in improved chemotherapy delivery have resulted in improved outcomes. There is considerable interest in studying the role of higher doses of thoracic radiation (74 Gy) in this disease, and this is the subject of an ongoing intergroup study. Despite some recent setbacks, molecularly targeted therapies need to be studied carefully in combination with chemoradiotherapy. There is an urgent need to develop regimens that incorporate chemotherapy agents that can be administered at doses that are systemically active and yet tolerable.
Biochemical components of bronchoalveolar lavage in early experimental asbestosis of the sheep: phospholipase A2 activity, prostaglandin E2 and proteins.
Authors: P Sirois, G Drapeau, R Bégin
Journal: Environmental Health Perspectives (1983)

Biochemical analyses of bronchoalveolar lavage (BAL) supernatants of sheep treated with weekly intratracheal instillations (for 6 months) of saline, 2 mg, or 128 mg of asbestos (chrysotile B; UICC) were performed. Our results showed that proteins (either total or its various components) and phospholipase A2 activity were unchanged in the low exposure group as compared to controls. However, in the high exposure group, with histopathological evidence of early asbestosis, there were significant increases in total proteins, albumin, alpha 2-globulin, beta- and gamma-globulins as well as phospholipase A2 activity of BAL fluid. Prostaglandin E2 activity was significantly increased in both low and high dose groups. These changes in protein and lipid components of BAL following asbestos exposure constitute early indices of lung inflammatory reactions which may contribute to the development of asbestosis.
Endothelial function in individuals with coronary artery disease with and without type 2 diabetes mellitus
Authors: Gissette Reyes-Soffer, Steve Holleran, Marco R. Di Tullio, Shunichi Homma, Bernadette Boden-Albala, Rajasekhar Ramakrishnan, Mitchell S. Elkind, Ralph L. Sacco, Henry N. Ginsberg
Journal: Metabolism (2010)
A randomized comparison of intravenous heparin with oral aspirin and dipyridamole 24 hours after recombinant tissue-type plasminogen activator for acute myocardial infarction. National Heart Foundation of Australia Coronary Thrombolysis Group.
Authors: P L Thompson, P E Aylward, J Federman, R W Giles, P J Harris, R L Hodge, G I Nelson, A Thomson, A M Tonkin, W F Walsh
Journal: Circulation (1991)

BACKGROUND This study addressed the need for heparin administration to be continued for more than 24 hours after coronary thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). METHODS AND RESULTS A total of 241 patients with acute myocardial infarction were treated with 100 mg rt-PA and a bolus of 5,000 units i.v. heparin followed by 1,000 units/hr i.v. heparin for 24 hours. At 24 hours, 202 patients were randomized to continue intravenous heparin therapy (n = 99) in full dosage or to discontinue heparin therapy and begin an oral antiplatelet regimen of aspirin (300 mg/day) and dipyridamole (300 mg/day) (n = 103). On prospective recording, there were no differences in the pattern of chest pain, reinfarction, or bleeding complications. Coronary angiography on cardiac catheterization at 7-10 days showed no differences in patency of the infarct-related artery. The proportion of patients with total occlusion (TIMI grade 0-1) of the infarct-related artery was 18.9% in the heparin group and 19.8% in the aspirin and dipyridamole group. In the patients with an incompletely occluded infarct-related artery, the lumen was reduced by 69 +/- 2% of normal in the heparin group and 67 +/- 2% in the aspirin and dipyridamole group. Left ventricular function assessed on cardiac catheterization and radionuclide study at day 2 and at 1 month showed no differences between the two groups. Left ventricular ejection fraction on radionuclide ventriculography at 1 month was 52.4 +/- 1.2% in the heparin group and 51.9 +/- 1.2% in the aspirin and dipyridamole group. CONCLUSIONS We conclude that heparin therapy can be discontinued 24 hours after rt-PA therapy and replaced with an oral antiplatelet regimen without any adverse effects on chest pain, reinfarction, coronary patency, or left ventricular function.
Internists' and Surgeons' Attitudes toward Guns and Firearm Injury Prevention
Authors: Christine K. Cassel
Journal: Annals of Internal Medicine (1998)

Background: The high rates of death, injury, and long-term disability related to firearms in the United States have led to growing concern in the health care community. Medical organizations and journals are devoting increasing attention to firearm violence as a public health problem; however, few reports discuss physician attitudes toward guns and prevention of firearm-related injury. Objective: To determine internists' and surgeons' attitudes toward guns and firearm injury prevention. Design: Analysis of results of a structured telephone interview. Setting: Internal medicine and surgical offices. Participants: 457 internists and 458 surgeons. Measures: 55 questions that covered six domains: experience with firearms, knowledge about clinical sequelae of firearm injury, knowledge about public policies on firearm violence, attitudes toward public policies on firearm violence, clinical practice behavior, and education and training. Results: The interview response rate was 45.3%, with a compliance rate of 82.5% and a 95% probability (error rate, ± 5%). Ninety-four percent of internists and 87% of surgeons believe firearm violence is a major public health issue. A majority of internists and surgeons also support community efforts to enact legislation to restrict the possession or sale of handguns (84% and 64%, respectively). Furthermore, although 84% of internists and 72% of surgeons believe that physicians should be involved with firearm injury prevention, less than 20% of respondents usually engage in some form of firearm injury prevention practice in patient care. Conclusion: Many internists and surgeons think that firearm injuries are a public health issue of growing importance, that physicians should incorporate firearm safety screening and counseling into their practice, that physicians should join community efforts to regulate handguns, and that specific gun regulation measures should be adopted as public policy.
High glucose induces DNA damage in cultured human endothelial cells.
Authors: M Lorenzi, D F Montisano, S Toledo, A Barrieux
Journal: Journal of Clinical Investigation (1986)

Morphologic and functional abnormalities of vascular endothelium are well recognized in diabetes. In view of our previous finding that high glucose concentrations accelerate death and hamper replication of cultured human endothelial cells, we have investigated in the same model the possibility that exposure to high glucose may result in DNA damage. DNA from human endothelial cells--but not from fibroblasts--exposed to 30 mM glucose for 9-14 d manifested an accelerated rate of unwinding in alkali indicative of an increased number of single strand breaks (P less than 0.001 vs. control). Endothelial cells exposed to high glucose also manifested an increased amount of hydroxy-urea-resistant thymidine incorporation (333 +/- 153 cpm/10(5) cells vs. 88 +/- 42 in control cells, mean +/- SD, P = 0.04), which is indicative of increased DNA repair synthesis. Neither DNA damage nor repair synthesis were increased by medium hypertonicity achieved with 30 mM mannitol. These findings suggest the possibility that, under conditions of high ambient glucose, excess glucose entry in cells that are insulin independent for glucose transport may, directly or indirectly, perturb DNA function. Further, they suggest the possibility that different individual capabilities to repair DNA damage--a process that is under genetic control--may represent a mechanism for different individual susceptibilities to development of diabetic vascular complication.
The effect of polystyrene sodium sulfonate grafting on polyethylene terephthalate artificial ligaments on in vitro mineralisation and in vivo bone tissue integration
Authors: Cédryck Vaquette, Véronique Viateau, Sandra Guérard, Fani Anagnostou, Mathieu Manassero, David G. Castner, Véronique Migonney
Journal: Biomaterials (2013)
Pretreatment with activated protein C or active human urinary thrombomodulin attenuates the production of cytokine-induced neutrophil chemoattractant following ischemia/reperfusion in rat liver
Authors: Y Yamaguchi, N Hisama, K Okajima, M Uchiba, K Murakami, Y Takahashi, S Yamada, K Mori, M Ogawa
Journal: Hepatology (1997)

We investigated the role of anticoagulant in the ischemia/reperfusion injury of the liver, using activated protein C (APC), active human urinary thrombomodulin (UTM), and factor Xa blocked at the active site (DEGR-Xa). Liver ischemia was induced in male Wistar rats by occlusion of the portal vein with a microvascular clip for 30 minutes. Each anticoagulant was injected intravenously 10 minutes before clamping the portal vein. Serum concentrations of cytokine-induced neutrophil chemoattractant (CINC) were determined by enzyme-linked immunosorbent assay. The serum levels of CINC increased significantly following reperfusion, reaching a peak in 6 hours, and then decreasing gradually to control levels by 24 hours. CINC levels in rats pretreated with APC (500 U/kg), UTM (3,000 TMU/kg), or DEGR-Xa (10 mg/kg) peaked 3 hours following reperfusion and decreased rapidly to baseline level within 6 and 12 hours, respectively. These peak values were significantly lower than those observed in untreated rats (P < .01). Expression of CINC transcripts in liver tissue of untreated rats was evaluated by Northern blot analysis and peaked 3 hours following reperfusion. Pretreatment with these anticoagulants significantly decreased the expression of CINC messenger RNA transcripts as compared with untreated animals. Myeloperoxidase activity and the number of neutrophils accumulated into the liver 24 hours following ischemia/reperfusion were also significantly decreased in animals pretreated with these anticoagulants. In addition, correlations between the peak values of liver enzymes and serum CINC levels were found to be significant (P < .001). The inactive derivative of factor Xa, a selective inhibitor of thrombin generation, inhibited ischemia/reperfusion-induced increases in the serum concentration and messenger RNA transcript quantities of CINC. The inactive factor Xa also reduced hepatic accumulation of neutrophils after ischemia/reperfusion. These results indicate that the release of CINC is likely related to the hepatic microcirculation disturbance induced by microthrombotic occlusion following ischemia/reperfusion.