tbuckley/cabot-search huggingface dataset:
The human gut mobile metagenome
Authors: Brian V. Jones
Journal: Gut Microbes (2010)

Using the culture independent TRACA system in conjunction with a comparative metagenomic approach, we have recently explored the pool of plasmids associated with the human gut mobile metagenome. This revealed that some plasmids or plasmid families are present in the gut microbiomes of geographically isolated human hosts with a broad global distribution (America, Japan and Europe), and are potentially unique to the human gut microbiome.
Prophylaxis for Stress-related Gastric Hemorrhage in the Medical Intensive Care Unit
Authors: Tamir Ben-Menachem, Ronald Fogel, Rakesh V. Patel, Mark Touchette, Barbara J. Zarowitz, Neven Hadzijahic, George Divine, Joel Verter, Robert S. Bresalier
Journal: Annals of Internal Medicine (1994)

Objective: To determine the efficacy and safety of cimetidine and sucralfate prophylaxis for stress-related gastrointestinal hemorrhage in patients admitted to a medical intensive care unit. Setting: Medical intensive care unit of a nonprofit, university-affiliated teaching hospital. Patients: 300 patients admitted to the medical intensive care unit during a 10-month period. Design: Randomized, controlled, single-blind clinical trial. Intervention: Patients were assigned to receive no prophylaxis (control), 1 g sucralfate given orally every 6 hours, or continuous intravenous cimetidine titrated to maintain gastric pH at 4.0. Intervention was maintained until the occurrence of clinically severe hemorrhage, onset of drug-related complications, death, or discharge from the medical intensive care unit. Outcome Measures: The primary outcome measure was the incidence of clinically severe hemorrhage from endoscopically verified stress-related gastritis. Other outcome measures were transfusion requirements, duration of medical intensive care unit stay, incidence of nosocomial pneumonia, adverse drug reactions, and death. Results: 100 patients were randomly assigned to each treatment. The three groups were similar with regard to demographic characteristics, intensive care unit admission diagnoses, and APACHE II scores. Stress-related hemorrhage was seen in 6% of control participants and in 5% of those receiving sucralfate or cimetidine (relative risk compared with control, 0.83 for each group; 95% CI, 0.26 to 2.64; P = 0.75). No statistically significant differences were found for transfusion requirements, duration of medical intensive care unit stay, and mortality rates among the three groups. Nosocomial pneumonia was diagnosed in 6%, 12%, and 13% of controls, sucralfate recipients, and cimetidine recipients, respectively (sucralfate: relative risk, 2.0 [CI, 0.79 to 5.01], P = 0.14; cimetidine: relative risk, 2.2 [CI, 0.88 to 5.33], P = 0.09). Prophylaxis caused no definite adverse drug reactions. Conclusions: The observed effects of cimetidine and sucralfate on the incidence and severity of hemorrhage from stress-related gastritis were not significant when compared with no treatment. Routine prophylaxis with these agents for patients entering the medical intensive care unit does not seem warranted.
Through the Patient's Eyes: Understanding and Promoting Patient-Centered Care
Authors: Richard E. Peschel
Journal: JAMA (1994)

The current debate on national health care reform focuses on issues such as universal access to high-quality health care, universal and movable health insurance coverage, capping health care costs, health maintenance organizations, and governmental intrusion into the health care system. After reading<i>Through the Patient's Eyes: Understanding and Promoting Patient-Centered Care</i>, one is left with the impression that even if all of the issues listed above were successfully resolved and implemented, we would still be left with a health care system that many patients would find frustrating, confusing, and impersonal. This book concentrates exclusively on the experiences of hospitalized patients. The research-based conclusions that are reached are distressing.
Diagnosis and Management of Pain Syndromes
Authors: Lester J. Wallman
Journal: JAMA (1969)

Pain is an intensely personal experience. The component which may be termed neurological is subject to rather precise analysis, relative to the neural pathways involved; and neurosurgical procedures such as cordotomy, designed to interrupt these pathways, may be evaluated statistically, sometimes at autopsy. But the physician not only shares in solving the problem; he is part of the problem itself. Pain, if chronic or associated with malignant disease, may take on the quality of suffering in which the patient and the doctor interact to reinforce each other's distress. Or, if the pain is obscure in origin, the patient and the physician may come to distrust each other on the question of whether the pain is real. Either situation may be prevented or palliated if the physician can offer at least a reasonable explanation for the mechanism of the pain and a specific plan for its management.  Dr. Finneson's book should
CD40 Ligand Mediates Inflammation Independently of CD40 by Interaction With Mac-1
Authors: Andreas Zirlik, Christoph Maier, Norbert Gerdes, Lindsey MacFarlane, Juliana Soosairajah, Udo Bavendiek, Ingo Ahrens, Sandra Ernst, Nicole Bassler, Anna Missiou, Zsofia Patko, Masanori Aikawa, Uwe Schönbeck, Christoph Bode, Peter Libby, Karlheinz Peter
Journal: Circulation (2007)

Strong evidence supports a role for CD40 ligand (CD40L) as marker and mediator of inflammatory diseases such as atherosclerosis. Despite extensive characterization of CD40, the classic receptor of CD40L, its role in immune defense against inflammatory diseases remains uncertain. The present study aimed to characterize the contribution of CD40 signaling to atherogenesis.Surprisingly, mice deficient in both CD40 and the low-density lipoprotein receptor did not develop smaller lesions in the aortic arch, root, and thoracoabdominal aorta compared with mice deficient only in the low-density lipoprotein receptor that consumed an atherogenic diet for 8 and 16 weeks. By flow cytometry, radioactive binding assays, and immunoprecipitation, we demonstrate that CD40L interacts with the integrin Mac-1, which results in Mac-1-dependent adhesion and migration of inflammatory cells as well as myeloperoxidase release in vitro. Furthermore, mice deficient in CD40L show significantly reduced thioglycolate-elicited invasion of inflammatory cells into the peritoneal cavity compared with mice deficient in CD40 and wild-type controls. Inhibition of Mac-1 in low-density lipoprotein receptor-deficient mice attenuates lesion development and reduces lesional macrophage accumulation.These observations identify the interaction of CD40L and Mac-1 as an alternative pathway for CD40L-mediated inflammation. This novel mechanism expands understanding of inflammatory signaling during atherogenesis.
We Need Further Studies for the Development of “Optimized Antiplatelet Therapy” Based on Ethnicity
Authors: Young-Hoon Jeong, Kevin P. Bliden, Udaya S. Tantry, In-Suk Kim, Yongwhi Park, Paul A. Gurbel
Journal: Journal of the American College of Cardiology (2011)

We read with interest the CILON-T (Influence of Cilostazol-based Triple Antiplatelet Therapy on Ischemic Complication After Drug-Eluting Stent Implantation) trial on the efficacy of cilostazol on ischemic complications after drug-eluting stent (DES) implantation ([1][1]), which suggested the
Effect of 40-kHz Ultrasound on Acute Thrombotic Ischemia in a Rabbit Femoral Artery Thrombosis Model
Authors: V. N. Suchkova, R. B. Baggs, C. W. Francis
Journal: Circulation (2000)

Background —We have shown previously that 40-kHz ultrasound (US) at low intensity accelerates fibrinolysis in vitro with little heating and good tissue penetration. These studies have now been extended to examine the effects of 40-kHz US on thrombolysis and tissue perfusion in a rabbit model. Methods and Results —Treatment was administered with either US alone at 0.75 W/cm 2 , streptokinase alone, or the combination of US and streptokinase. US or streptokinase resulted in minimal thrombolysis, but reperfusion was nearly complete with the combination after 120 minutes. US also reversed the ischemia in nonperfused muscle in the absence of arterial flow. Tissue perfusion decreased after thrombosis from 13.7±0.2 to 6.6±0.8 U and then declined further to 4.5±0.4 U after 240 minutes. US improved perfusion to 10.6±0.5 and 12.1±0.5 U after 30 and 60 minutes, respectively. This effect was reversible and declined to pretreatment values after US was discontinued. Similarly, tissue pH declined from normal to 7.05±0.02 after thrombosis, but US improved pH to 7.34±0.03 after 60 minutes. US-induced improvement in tissue perfusion and pH also occurred after femoral artery ligation, indicating that thrombolysis did not cause these effects. Conclusions —40-kHz US at low intensity markedly accelerates fibrinolysis and also improves tissue perfusion and reverses acidosis, effects that would be beneficial in treatment of acute thrombosis.
The Spectrum of Transposition of the Great Arteries
Authors: DANIEL A. GOOR, JESSE E. EDWARDS
Journal: Circulation (1973)

One hundred and sixty five cases of various types of transposition complexes were studied. Based on this and on recent studies of the embryology of the conotruncus, the following observations were made. Regardless of their relations with the ventricles, the semilunar valves may show d -transposition or l -transposition. In the situs solitus heart, the d -type of semilunar transposition is found in the bulboventricular heart, double outlet right ventricle type II, Taussig-Bing malformation, complete transposition of the great arteries, and double outlet left ventricle. This type of transposition of the great arteries results from lack of conotruncal inversion and the differences between the various entities are manifestations of varying degrees of leftward shift of the conoventricular junction and conal absorption. In l -transposition, the conotruncus rotates in the wrong direction. This may occur as an isolated process as in anatomic corrected transposition of the great arteries or with l -looping as in physiologic corrected transposition. Conal absorption and conoventricular shift account for the various entities in each of these two groups of l -transposition. It is proposed that the term transposition of the great arteries should refer only to the mutual interrelationships of the semilunar valves regardless of their ventricular origin.
MPs want more people to pay for prescriptions
Authors: J Warden
Journal: BMJ (1994)

Radical changes in the way that the NHS controls its pounds sterling3.3bn annual drugs budget are proposed in a report from the Commons health committee. The proposals range from creating a national prescribing list to allowing fewer exemptions from prescription charges.

Tighter controls are also proposed on the prescribing behaviour of general practitioners, subject to all patients being entitled to receive the drugs that they need. The government is urged to introduce sanctions against underprescribing, which the committee says can be just as harmful to patients as overprescribing. It calls for doctors' target budgets to be based on capitation to take account of social deprivation, to encourage generic prescribing as …
Cognitive dysfunction in cirrhosis is associated with falls: A prospective study
Authors: Germán Soriano, Eva Román, Joan Córdoba, Maria Torrens, Maria Poca, Xavier Torras, Càndid Villanueva, Ignasi J. Gich, Víctor Vargas, Carlos Guarner
Journal: Hepatology (2011)

Falls are frequent among patients with debilitating disorders and can have a serious effect on health status. Mild cognitive disturbances associated with cirrhosis may increase the risk for falls. Identifying subjects at risk may allow the implementation of preventive measures. Our aim was to assess the predictive value of the Psychometric Hepatic Encephalopathy Score (PHES) in identifying patients likely to sustain falls. One hundred and twenty-two outpatients with cirrhosis were assessed using the PHES and were followed at specified intervals. One third of them exhibited cognitive dysfunction (CD) according to the PHES (&lt;−4). Seventeen of the forty-two patients (40.4%) with CD had at least one fall during follow-up. In comparison, only 5 of 80 (6.2%) without CD had falls ( P &lt; 0.001). Fractures occurred in 4 patients (9.5%) with CD, but in no patients without CD ( P = 0.01). Patients with CD needed more healthcare (23.8% versus 2.5%; P &lt; 0.001), more emergency room care (14.2% versus 2.5%; P = 0.02), and more hospitalization (9.5% versus 0%; P = 0.01) as a result of falls than patients without CD. Patients taking psychoactive treatment (n = 21) had a higher frequency of falls, and this was related to an abnormal PHES. In patients without psychoactive treatment (n = 101), the incidence of falls was 32.4% in patients with CD versus 7.5% in those without CD ( P = 0.003). In the multivariate analysis, CD was the only independent predictive factor of falls (odds ratio, 10.2; 95% confidence interval, 3.4–30.4; P &lt; 0.001). The 1-year probability of falling was 52.3% in patients with CD and 6.5% in those without ( P &lt; 0.001). Conclusion: An abnormal PHES identifies patients with cirrhosis who are at risk for falls. This psychometric test may be useful to promote awareness of falls and identify patients who may benefit from preventive strategies.
Relevance of assessing quadriceps endurance in patients with COPD
Authors: C. Coronell, M. Orozco‐Levi, R. Méndez, A. Ramírez‐Sarmiento, J.B. Gáldiz, J. Gea
Journal: European Respiratory Journal (2004)

The aims of this study were to investigate whether the impairment in endurance of limb muscles is a general finding in chronic obstructive pulmonary disease (COPD) patients, affecting even those with mild-to-moderate disease or relatively normal physical activity. In addition, this study aimed to determine the physiopathology of exhaustion in local endurance tests and whether the reduction in quadriceps endurance can be predicted from muscle strength measurements. A total of 75 volunteers were assigned to one of two groups according to pulmonary function tests: COPD patients or healthy age-matched controls. Functional assessment included both quadriceps strength (maximum voluntary contraction (Q MVC )), and quadriceps endurance (contractions against a load equivalent to 10% Q MVC until task failure or for up to a limiting time of 30 min (Q Tlim )). COPD patients showed a decrease of ∼43% in Q MVC and ∼77% in Q Tlim compared with controls. Task failure occurred only in COPD patients and was due to muscle fatigue, since limiting symptoms were associated with a decrease in the median frequency of quadriceps electromyographical signal and a reversible decrease in Q MVC . The impairment in skeletal muscle endurance was present even in patients with mild-to-moderate airflow obstruction and individuals with relatively normal physical activity, and was irrespective of lung function variables, anthropometrical data or quadriceps strength. Peripheral muscle endurance was impaired in chronic obstructive pulmonary disease patients, even in those with relatively normal physical activity and mild-to-moderate airflow obstruction. This impairment associated with an early onset of muscle fatigue and could not be predicted from the severity of the disease or the reduction in quadriceps strength.
THE VENOUS CHANNELS OF THE AURAL REGION.
Authors: B. ALEXANDER RANDALL
Journal: JAMA (1898)

Study of the venous channels of the head had no great interest for most aural surgeons until a comparatively recent period; for, their important relations to septic processes in the ear and throughout the body were known and appreciated by few. Many knew that the sigmoid sinus lay uncomfortably near to their field of operation in opening the mastoid, and gave their attention largely to its avoidance. Latterly, among general surgeons especially, there has been rather a swing in the opposite direction in their readiness, on slight occasion, to expose and explore this sinus and take other liberties which better judgement and more diagnostic acumen would have showed them to be needless. Important as is this channel, it is far from being the only one demanding thoughtful consideration in a case of otitic pyemia. The position and relation of the great sinuses of the brain need not detain us, for
MEDICAL EDUCATION AND THE STATE.
Authors: WALTER A. WELLS
Journal: JAMA (1902)

As one of the significant indications of our country's intellectual growth might be cited the very general active interest which is being taken in the advancement of technical and professional education. Although not with equal pace with other branches of learning, great progress has been made likewise in the methods of teaching medicine. Twenty-five years ago the best medical colleges of which we could boast were satisfied to have the student attend but two courses of lectures, each of these less than four months' duration, with none or but very slight provision either for clinical or laboratory studies. The lectures were almost wholly didactic and confined to a few practical branches; the "fundamentals," as they are called, and the allied scientific branches were either neglected or at least but very superficially treated. To-day all first-class medical colleges have a four-year course of study. Each student is obliged to devote a
Peritoneal Lavage White Cell Counts
Authors: Balazs Imre Bodai
Journal: JAMA (1983)

<h3>To the Editor.—</h3> In their article, Vij and co-workers describe a small group of patients with penetrating injuries who have a lavage fluid RBC count of less than 100,000/cu mm yet a WBC count of greater than 500/cu mm and suggest that were it not for the WBC count, these patients might not have undergone laparotomy. This is of concern because the nonsurgical emergency room physician may think that, because of the negative peritoneal lavage finding, surgical consultation need not be urgently obtained. The scene for tragedy is set. Selective management of penetrating abdominal injuries is a decision to be made by the surgeon, and most would currently explore such injuries. Certainly, peritoneal lavage in face of a gunshot wound, the path of the bullet always being uncertain, is never indicated. A recent study evaluated the morbidity of a negative finding at laparotomy in abdominal trauma.<sup>1</sup>On review of
Analysis of Adeno-associated Virus Progenitor Cell Transduction in Mouse Lung
Authors: Xiaoming Liu, Meihui Luo, Chenhong Guo, Ziying Yan, Yujiong Wang, Diana CM Lei-Butters, John F Engelhardt
Journal: Molecular Therapy (2008)

Although recombinant adeno-associated virus (rAAV) has been widely used in lung gene therapy approaches, it remains unclear to what extent commonly used AAV serotypes transduce adult progenitors in the lung. In this study, we evaluated the life span and proliferative capacity of rAAV1-, 2-, and 5-transduced airway cells in mouse lung, using a LacZ-CRE reporter transgenic model and Cre-expressing rAAV. In this model, the expression of CRE recombinase led to permanent genetic marking of transduced cells and their descendants with LacZ. To investigate whether the rAAV-transduced cells included airway progenitors, we injured the airways of rAAV-infected mice with Naphthalene, while simultaneously labeling with 5-bromodeoxyuridine (BrdU) to identify slow-cycling progenitor/stem cells that entered the cell cycle and retained label. Both rAAV5 and rAAV1 vectors were capable of transducing a subset of long-lived Clara cells and alveolar type II (ATII) cells that retained nucleotide label and proliferated following lung injury. Importantly, rAAV1 and 5 appeared to preferentially transduce conducting airway epithelial progenitors that had the capacity to clonally expand, both in culture and in vivo following lung injury. These studies suggest that rAAV may be a useful vector for gene targeting of airway stem/progenitor cells.
Book Review Infertility: A clinician's guide to diagnosis and treatment By Melvin L. Taymor. 300 pp., illustrated. New York, Plenum, 1990. $59.50. Infertility in the Male Second edition. Edited by Larry I. Lipshultz and Stuart S. Howards. 468 pp., illustrated. St. Louis, Mosby—Year Book, 1991. $85.
Authors: Kevin R. Loughlin
Journal: New England Journal of Medicine (1991)
New self-administered medical questionary.
Authors: J. Anderson, J. L. Day
Journal: BMJ (1968)

BR NAL some future date inevitably arise, and we must begin to plan for it now.Nevertheless, its future emergence cannot be allowed to hold up the control and eradication of endemic disease, because the promotion of health and prevention of disease is a basic human right, and it is recognized that control and eradication programmes must proceed concurrently with equally vigorous programmes of improved agricultural produc- tivity and health education.'state registration ' provisions in., preventing
THE UREA INDEX AS A TEST FOR KIDNEY FUNCTION IN A WAR HOSPITAL
Authors: REGINALD FITZ
Journal: JAMA (1918)

During the past nine months, observations on nephritis have been made in this hospital, with McLean's<sup>1</sup>urea index as a test for kidney function. The results have been so helpful for diagnosis and prognosis that the technic employed and certain case protocols are recorded in order to show that the test can be carried out advantageously in a tent hospital with only elementary laboratory facilities. McLean's directions were followed absolutely. Before each test the patient was given from 150 to 200 c.c. of water, to insure a free flow of urine. One half hour later, in order to start with the bladder empty, he voided. The time of voiding was recorded to within one minute. About thirty-six minutes later, at least 3 c.c. of blood were withdrawn from an arm vein into a dry tube containing a few milligrams of potassium oxalate to prevent clotting. At the end of
Thrombospondin cooperates with CD36 and the vitronectin receptor in macrophage recognition of neutrophils undergoing apoptosis.
Authors: J Savill, N Hogg, Y Ren, C Haslett
Journal: Journal of Clinical Investigation (1992)

We have investigated the cell surface recognition mechanisms used by human monocyte-derived macrophages (M phi) in phagocytosis of intact aging human neutrophils (PMNs) undergoing apoptosis. This study shows that the adhesive protein thrombospondin (TSP) was present in the interaction, both associated with the M phi surface and in solution at a mean concentration of 0.59 micrograms/ml. The interaction was inhibited by treatment of M phi (but not aged PMN) with cycloheximide, but could be "rescued" by replenishment with exogenous TSP. Under control conditions, M phi recognition of aged PMNs was specifically potentiated by purified platelet TSP at 5 micrograms/ml, present either in the interaction or if preincubated with either cell type, suggesting that TSP might act as a "molecular bridge" between the two cell types. In support, both aged PMN and M phi were found to adhere to TSP, and phagocytosis of aged PMN was specifically inhibited by (a) excess soluble TSP; (b) antibodies to TSP that also inhibit TSP-mediated adhesion to aged PMN; and (c) down-regulation of M phi receptors for TSP by plating M phi on TSP-coated surfaces. Furthermore, inhibition with mAbs/Arg-Gly-Asp-Ser peptide of the candidate M phi receptors for TSP, CD36, and alpha v beta 3 exerted synergistic effects on both M phi recognition of aged PMN and M phi adhesion to TSP, indicating that "two point" adhesion of TSP to these M phi structures is involved in phagocytosis of aged PMN. Our findings indicate newly defined roles for TSP and CD36 in phagocytic clearance of senescent neutrophils, which may limit inflammatory tissue injury and promote resolution.