tbuckley/cabot-search huggingface dataset:
UREA EXCRETION IN HUMAN SWEAT AS A TRACER FOR MOVEMENT OF WATER WITHIN THE SECRETING GLAND
Authors: Irving L. Schwartz, Jørn Hess Thaysen, Vincent P. Dole
Journal: The Journal of Experimental Medicine (1953)

Previous workers have found that the concentration of urea in human sweat exceeds the concentration of urea in plasma. This fact has been confirmed in the present work and extended by measurements of the concentrations of urea in the sweat and the corresponding concentrations of urea in the plasma over a range of 25- fold variation in the latter. An analysis of the data showed that the ratio of the concentration of urea in sweat to the concentration of urea in plasma, S/P, was independent of the plasma concentration, independent of the absolute flux of urea or water, and independent of the calculated energy expenditure. Two experiments showed that the concentration of urea in sweat followed a rising concentration in plasma with a time lag of approximately 5 minutes; this fact indicates that the accumulation of urea in sweat is a continuous process which is in operation during the observed discharge. These observations suggest that urea is carried into the gland in some precursor solution and subsequently raised to a higher concentration by the reabsorption from this solution of a constant fraction of the water.
Muskelin Regulates Actin Filament- and Microtubule-Based GABAA Receptor Transport in Neurons
Authors: Frank F. Heisler, Sven Loebrich, Yvonne Pechmann, Nikolaus Maier, Aleksandar R. Zivkovic, Mariko Tokito, Torben J. Hausrat, Michaela Schweizer, Robert Bähring, Erika L.F. Holzbaur, Dietmar Schmitz, Matthias Kneussel
Journal: Neuron (2011)
TREATMENT OF CEREBRAL VASCULAR ACCIDENTS
Authors: H. J. Roberts
Journal: JAMA (1960)

To the Editor:—  The review of therapy for cerebral vascular accidents by Dr. George A. Wolf Jr. inThe Journal( 172 :562 [Feb. 6] 1960) is a fair statement of the indications, contraindications, and limiting factors of currently accepted regimens. I take issue, however, with the statement that treatment during the acute phase of a cerebral vascular accident is limited to the supportive measures listed in this article. I should like to call attention to another valuable approach to the management of selected patients with acute and subacute cerebrovascular accidents, particularly those with significant brain stem involvement: the use of the adrenocortical steroids. My observations in such patients for the past four years ( J. Am. Geriatrics Soc . 6 :686 [Sept.] 1958) may be summarized here by stating that dramatic improvement has been observed repeatedly in critically ill patients with clinically progressive cerebral infarction in whom it appeared that remissions either
US public health service needs strengthening to fight infectious disease
Authors: C. Marwick
Journal: BMJ (2003)

Infectious diseases are a global threat, and the United States should take the lead in addressing it, says a new report from the US Institute of Medicine. Such an initiative would mean that the United States would have to strengthen its public health service, the report says, and to help other nations monitor and respond to outbreaks of infectious disease, including enhancing global disease surveillance.

“Infectious diseases continue to burden populations around the world. Both natural infections and the possibility of a bioterrorist attack hold increasing potential to cause disease, disability, and death,” said Dr Margaret Hamburg, co-chairperson of the committee that prepared the report. Dr Hamburg is vice president …
Pulmonary Vasoconstriction Elicited by Stimulation of the Hypothalamic Integrative Area for the Defense Reaction
Authors: FRED L. ANDERSON, ARTHUR M. BROWN, Pasquale A. Concilia
Journal: Circulation Research (1967)

Changes in the pulmonary circulation evoked by stimulation of the hypothalamic integrative area for the defense reaction were studied in 22 cats anesthetized with a chloralose-urethane mixture. Pulmonary arterial pressure and flow, left and right atrial pressures, aortic pressure, arterial flow to the skinned hind limb, and heart rate were all significantly increased. The calculated pulmonary vascular resistance was also significantly increased. The rise in pulmonary vascular resistance was abolished by bilateral stellectomy or by hexamethonium infusion; it was not affected by bilateral cervical vagotomy. Therefore, the increase in pulmonary vascular resistance was mediated by the thoracic sympathetic nerves. The increase in pulmonary arterial flow was mainly caused by an increase in heart rate; a small rise in calculated stroke volume also occurred.
Mother challenges decision to make Virgin preferred bidder for children's services
Authors: C. Dyer
Journal: BMJ (2012)

The mother of two children with mental health problems challenged a decision to award a contract to run children’s services in Devon to Richard Branson’s private healthcare company in the High Court this week.

The woman, who has not been named to protect her children’s anonymity, claimed that Devon County Council and the primary care cluster of NHS Devon, Plymouth and Torbay had failed to properly carry out the equality impact assessment required before accepting Virgin Care as preferred bidder for the £132m (€164m; $211m) contract. The law requires public authorities to ensure that their decisions do not have a disproportionately negative effect on …
Early assessment of minimal residual disease in AML by flow cytometry during aplasia identifies patients at increased risk of relapse
Authors: Köhnke T, Sauter D, Ringel K, Hoster E, Laubender Rp, Hubmann M, Bohlander Sk, Kakadia Pm, Schneider S, Dufour A, Sauerland Mc, Berdel We, Büchner T, Wörmann B, Braess J, Hiddemann W, Spiekermann K, Subklewe M
Journal: Leukemia (2014)
What Makes a Generalist Physician?
Authors: John I. Fishburne
Journal: JAMA (1994)

<h3>To the Editor.</h3> —The article by Dr Rivo and colleagues<sup>1</sup>contains several basic flaws in the analyses of training components for generalist physician skills. Had the authors contacted the American College of Obstetricians and Gynecologists, the Residency Review Committee, or the American Board of Obstetrics and Gynecology to obtain accurate data, their conclusions most certainly would have been different. Based on review of our educational objectives,<sup>2</sup>obstetrics and gynecology training programs meet 89% of the competencies required. It is of interest, for example, to note that Rivo and colleagues gave a yes to general pediatrics and internal medicine for management of common gynecological problems when in a recent article<sup>3</sup>it was noted that few pediatricians or internists perform these examinations. On the other hand, they gave a no to continuity of care for obstetrics and gynecology because a specific length is not designated in the Residency Review
How Do Financial Incentives Affect Physicians' Clinical Decisions and the Financial Performance of Health Maintenance Organizations?
Authors: Alan L. Hillman, Mark V. Pauly, Joseph J. Kerstein
Journal: New England Journal of Medicine (1989)

Abstract It has been suggested that the use of financial incentives by health maintenance organizations (HMOs) may change physicians' behavior toward individual patients. To test this hypothesis, we used a regression analysis of data from a survey of HMOs to examine the relation between the presence of financial incentives and two measures of the use of resources (the rate of hospitalization and the rate of visits for outpatient services) and one measure of the HMOs' financial viability (the achievement of break-even status). When we controlled for the effect of market-area variables, we found that some forms of compensation were significantly associated with these indicators of decision making by physicians. Among methods of paying physicians, the use of capitation or salaries was associated with a lower rate of hospitalization than the use of fee-for-service payment; physicians in for-profit HMOs and group-model HMOs also used the hospital less often. Placing physicians at financial risk as individuals and imposing penalties for deficits in the HMO's hospital fund beyond the loss of withheld funds were associated with fewer outpatient visits per enrollee, but a higher percentage of HMO patients in a physician's caseload was associated with more frequent visits. HMOs were more likely to break even if they were larger, older, had physicians who treated more HMO patients, and placed physicians at personal financial risk for the cost of outpatient tests; break-even status was also related to the type of HMO. We conclude that the use of some, but not all, financial incentives, as well as the type of HMO, does influence the behavior of physicians toward patients. It remains to be determined how these factors affect the quality of care. (N Engl J Med 1989; 321:86–92.)
Physicians Are Part of the Problem
Authors: TORREY C. BROWN
Journal: Annals of Internal Medicine (1972)

Editorial Notes1 August 1972Physicians Are Part of the ProblemTORREY C. BROWN, M.D., F.A.C.P.TORREY C. BROWN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-2-316 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThere are 9 000 000 alcoholics in the United States, and each individual alcoholic impinges on the lives of four other people. Drunken drivers kill 30 000 people each year. Alcoholism costs 15 billion dollars each year (1). Everyone, including physicians, has heard those statistics, but physicians in their practice are directly affected by alcoholism because it is a disease in itself and is the proximate cause of further illness. In a survey at The Johns Hopkins Hospital, one third of the patients on the medical service were alcoholics and one fifth of the hospitalizations were a direct result of...References1. : Alcohol and Health: First Annual Report to the Congress. Washington, D.C., U.S. Government Printing Office, 1972 Google Scholar2. Personal communication: Luther Cloud, M.D., Senior Associate Medical Director, Equitable Life Assurance Society, New York, N.Y. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: TORREY C. BROWN, M.D., F.A.C.P.Affiliations: Alcoholism Programs Office of Health Care Programs The Johns Hopkins Medical Institutions Baltimore, Md. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byComparison of Outcomes Between Acute Care General Hospital Transfers and Direct Admissions to a Detoxification UnitAlcohol-Related Disabilities in General Hospital Patients: A Critical Assessment of the EvidenceOutlook for Treating Patients with Self-Destructive HabitsJOHN F. BURNUM, M.D., F.A.C.P. 1 August 1972Volume 77, Issue 2Page: 316-317KeywordsAlcoholicsAlcoholismHospitalizationsMedical services ePublished: 1 December 2008 Issue Published: 1 August 1972 PDF downloadLoading ...
Controversial costs of cocaine:
Authors: N. F. Miele
Journal: JAMA (1992)

To the Editor.  —Phibbs et al 1 report some extremely important findings regarding increased neonatal costs of maternal cocaine use. Their findings become more substantial when one realizes that they report only the tip of the iceberg when reporting neonatal costs. As they allude to in the last paragraph of their article, the costs of care (and the costs to society) for these infants after their neonatal hospitalizations can be substantial. I concur with their opinion that further study on the long-term consequences of maternal cocaine use is needed.  As I read through the study, one question came to mind. Were the physicians for the newborn infants blinded (at least initially) to the maternal drug use history? If they were not blinded, could a positive maternal drug use history have influenced the initial decision as to whether to admit an infant to the neonatal intensive care unit? Although there should
Tolmetin-lnduced Pseudoproteinuria
Authors: Leroy C. Knodel, Bruce A. Wachsman, William D. Linn
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Tolmetin sodium, a nonsteroidal anti-inflammatory drug (NSAID), is widely prescribed for the treatment of inflammatory disorders and pain. Although gastrointestinal side effects of agents in this pharmacologic class are well known, untoward renal effects have been substantiated only in recent years. These effects include acute renal failure, chronic renal injury, nephrotic syndrome and interstitial nephritis, as well as alterations in water and electrolyte homeostasis.<sup>1</sup>Many are directly related to inhibition of prostaglandin synthesis in the kidney and readily resolve on discontinuing use of the drug. Proteinuria is noted in most cases of NSAID-induced renal dysfunction. We wish to report a case of pseudoproteinuria that was clearly related to administration of tolmetin. <h3>Report of a Case.—</h3> A 55-year-old man with a 20-year history of hypertension and a 15-year history of degenerative joint disease was seen in clinic on Dec 11, 1984. Laboratory evaluation revealed a serum creatinine
A novel role for human leukocyte antigen-DP in chronic hepatitis B infection: A genomewide association study
Authors: Jessica A. Howell, Kumar Visvanathan, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2009)

Chronic hepatitis B is a serious infectious liver disease that often progresses to liver cirrhosis and hepatocellular carcinoma; however, clinical outcomes after viral exposure vary enormously among individuals. Through a two-stage genome-wide association study using 786 Japanese chronic hepatitis B cases and 2201 controls, we identified a significant association of chronic hepatitis B with 11 SNPs in a region including HLA-DPA1 and HLA-DPB1. We validated these associations by genotyping two SNPs from the region in three additional Japanese and Thai cohorts consisting of 1300 cases and 2100 controls (combined P = 6.34 × 10−39 and 2.31 × 10−38, OR = 0.57 and 0.56, respectively). Subsequent analyses revealed risk haplotypes (HLA-DPA1*0103-DPB1*0501 and HLA-DPA1*0202- DPB1*0301, OR = 1.45 and 2.31, respectively) and protective haplotypes (HLA-DPA1*0103-DPB1*0402 and HLA-DPA1*0103-DPB1*0401, OR = 0.52 and 0.57, respectively). Our findings show that genetic variants in the HLA-DP locus are strongly associated with risk of persistent infection with hepatitis B virus.
Assessment of acid-base disturbances.
Authors: J B Stoker, C T Kappagoda, R J Linden, H M Snow
Journal: BMJ (1973)

three infants were delivered vaginally, of which 10 were in poor condition (oneminute Apgar score of five or less and re- quiring intubation).In all 10 there was usually more than one abnormal feature in the fetal heart record.Specific features were variable decelerations (10/10), baseline tachycardia (7/10), and loss of beat-to-beat variation (7/10).In three cases the cord was found to be prolapsed.A pH estimation was made at the start of the second stage in three cases, the values being 7-31, 7-29, and 7.10 respectively.In cases of breech delivery where other high-risk factors will not usually apply, com- pression of the umbilical cord is the most likely cause of asphyxia.There is now con- siderable evidence demonstrating significant changes in the fetal heart rate when this occurs.Our own data suggest that cord problems are readily detected in breech de- liveries by continuous monitoring of the fetal heart and we believe that, because of its continuous nature, this will play a greater role in the management of the breech than fetal blood sampling.-Weare, etc.,
Measurement of digitalis-like compound in plasma: application in studies of essential hypertension.
Authors: M A Devynck, M G Pernollet, J B Rosenfeld, P Meyer
Journal: BMJ (1983)

A digitalis-like compound was detected in human plasma by tritiated ouabain competition binding to the sodium pump. The study comprised analyses of plasma extracts from 17 normal controls, 17 normotensive subjects with one or both parents hypertensive, and 16 patients with untreated essential hypertension. In two thirds of the untreated hypertensive and several of the normotensive subjects with a family history of hypertension the potency of the digitalis-like compound, as measured by its interference with ouabain binding, was significantly greater than in the controls. In the untreated hypertensive patients the potency of the compound was significantly correlated with the urinary sodium output. Measurement of this salt-related, digitalis-like compound may be useful in clinical studies of hypertension.
Aryl Hydrocarbon Receptor Deficiency Enhances Insulin Sensitivity and Reduces PPAR-α Pathway Activity in Mice
Authors: Chun Wang, Can-Xin Xu, Stacey L. Krager, Kathleen M. Bottum, Duan-Fang Liao, Shelley A. Tischkau
Journal: Environmental Health Perspectives (2011)

Numerous man-made pollutants activate the aryl hydrocarbon receptor (AhR) and are risk factors for type 2 diabetes. AhR signaling also affects molecular clock genes to influence glucose metabolism.We investigated mechanisms by which AhR activation affects glucose metabolism.Glucose tolerance, insulin resistance, and expression of peroxisome proliferator-activated receptor-α (PPAR-α) and genes affecting glucose metabolism or fatty acid oxidation and clock gene rhythms were investigated in wild-type (WT) and AhR-deficient [knockout (KO)] mice. AhR agonists and small interfering RNA (siRNA) were used to examine the effect of AhR on PPAR-α expression and glycolysis in the liver cell line Hepa-1c1c7 (c7) and its c12 and c4 derivatives. Brain, muscle ARNT-like protein 1 (Bmal1) siRNA and Ahr or Bmal1 expression plasmids were used to analyze the effect of BMAL1 on PPAR-α expression in c7 cells.KO mice displayed enhanced insulin sensitivity and improved glucose tolerance, accompanied by decreased PPAR-α and key gluconeogenic and fatty acid oxidation enzymes. AhR agonists increased PPAR-α expression in c7 cells. Both Ahr and Bmal1 siRNA reduced PPAR-α and metabolism genes. Moreover, rhythms of BMAL1 and blood glucose were altered in KO mice.These results indicate a link between AhR signaling, circadian rhythms, and glucose metabolism. Furthermore, hepatic activation of the PPAR-α pathway provides a mechanism underlying AhR-mediated insulin resistance.
Inotropic and Sympathetic Responses to the Intracoronary Infusion of a β <sub>2</sub> -Receptor Agonist
Authors: Gary E. Newton, Eduardo R. Azevedo, John D. Parker
Journal: Circulation (1999)

Background —On the basis of the presence of β 2 -receptors within the sympathetic nervous system, β 2 -stimulation may increase cardiac sympathetic outflow. We addressed the hypothesis that sympathoexcitatory β 2 -receptors are present in the human left ventricle. Methods and Results —The β 2 -agonist salbutamol was infused into the left coronary artery in 3 groups of patients: group 1 (n=9, no β-blocker therapy), group 2 (n=7, β 1 -selective blockade with atenolol), and group 3 (n=6, nonselective β-blockade with nadolol). Left ventricular +dP/dt in response to increasing concentrations of salbutamol was measured in all groups, and cardiac norepinephrine spillover was measured in group 1. There were no systemic hemodynamic changes in any group. Salbutamol resulted in a 44±6% increase in +dP/dt in group 1, a 25±6% increase in group 2 ( P &lt;0.05 versus group 1), and no increase in group 3. Salbutamol also resulted in a 124±37% increase in cardiac norepinephrine spillover in group 1 ( P &lt;0.05). Conclusions —Evidence that salbutamol increased norepinephrine release from cardiac sympathetic nerves was provided by the observations that atenolol suppressed the salbutamol inotropic response, demonstrating that this response was mediated in part by β 1 -receptors and that salbutamol also resulted in an increase in cardiac norepinephrine spillover. This result provides in vivo evidence, in humans, for the role of sympathoexcitatory cardiac β 2 -receptors.
Body Adiposity Index, Body Mass Index, and Body Fat in White and Black Adults
Authors: Tiago V. Barreira, Deirdre M. Harrington, Amanda E. Staiano, Steven B. Heymsfield, Peter T. Katzmarzyk
Journal: JAMA (2011)

ommended adoption of a standardized recording system for all in-flight medical emergencies.This may be redundant because each airline's medical department keeps a record of emergencies and their outcome.If an emergency can be stabilized sufficiently to allow the flight to proceed without diversion, it saves the airline money, and for this reason if no other, there is a strong motivation to provide a truly useful kit.The authors also recommended a standard kit be kept in identical locations on every flight.Standardization is difficult for 2 reasons.First, the different types of routes that an airline flies demand differing provisions.Second, there are problems with drug regulations if different jurisdictions are involved.The enhancement and standardization of flightattendant training in medical emergencies was a third recommendation.It is certainly possible to train flight attendants in first aid, but there are legal problems if they seek to do more.Many airlines look favorably on trained nurses as recruits for cabin staff, but it is not possible or cost-effective to have a trained nurse or paramedic on each flight.A wider view would suggest that such trained personnel would save more lives working in a groundbased service.Finally, I suggest that the International Civil Aviation Organization require multilingual labeling and standard packaging for medical kits so that it is easy to find what is needed in the kit.
Generalized Anxiety Disorder
Authors: Gregory Fricchione
Journal: New England Journal of Medicine (2004)

During a routine visit, a 59-year-old woman, who describes herself as a lifetime "worrier" and has a family history of depression, reports having restless sleep, muscle tension, and fatigue. Recently, her worry has intensified about her children, her job, and her health, and it is having a negative effect on her family and work life. How should she be treated?
A comparative immunoelectron microscopic study of typical and atypical cases of pemphigoid
Authors: H. SHIMIZU, K. HAYAKAWA, T. NISHIKAWA
Journal: British Journal of Dermatology (1988)

Using an immunoelectron microscopic technique we have compared the ulrastructural localization of IgG and complement (C3) in the basement membrane zone of three typical cases of bullous pemphigoid and three atypical variant cases (nodular, polymorphic and localized pemphigoid, respectively). There was no significant difference in the in vivo ultrastructural localization of these immunoreactants between the typical and the atypical cases of pemphigoid. In all cases IgG and C3 were detected between the basilar surface of the basal keratinocytes and the basal lamina. Moreover, the in vitro binding sites of circulating anti-basement membrane zone antibodies were identical in the case of nodular pemphigoid and a typical pemphigoid as control. We also observed that immunoreactants were not deposited beneath melanocytes.
Individual Rights and the County Medical Society.
Authors: H. G. Mauzey
Journal: JAMA (1901)

Spokane, Wash, May 17, 1901. <h3>To the Editor:</h3> —When a medical man or woman is a graduate of a reputable medical college, and has complied with the laws of his state, regulating the practice of medicine, and is apparently eligible in every way for membership in a county society, if for a trivial reason he is denied admission to his county society, an injury is done that is far reaching in its consequence, both to him, to the local society, to the state society and to theAmerican Medical Association, and it tends to foster and keep alive a general opinion that county societies, as well as the state and national, are conducted for the benefit of the few, and that in place of these organizations being scientific primarily, they have degenerated into social and mutual admiration societies. By denying a person admission into the county society, one is denied