tbuckley/cabot-search huggingface dataset:
Acceleration of recombinant tissue-type plasminogen activator-induced thrombolysis and prevention of reocclusion by the combination of heparin and the Arg-Gly-Asp-containing peptide bitistatin in a canine model of coronary thrombosis.
Authors: R J Shebuski, I J Stabilito, G R Sitko, M H Polokoff
Journal: Circulation (1990)

The effect of tissue-type plasminogen activator (t-PA) alone or in combination with heparin, the Arg-Gly-Asp-containing peptide bitistatin, or both heparin and bitistatin was evaluated on thrombolysis time and acute reocclusion in a canine model of coronary thrombosis. Thrombus formation was elicited by electrolytic injury with a needle electrode to the endothelial surface of the circumflex coronary artery in the open-chest, anesthetized dog in the presence of a flow-limiting critical stenosis. Thirty minutes after spontaneous coronary artery occlusion, t-PA (1 mg/kg i.v. over 90 minutes) was administered. Group 1 was given t-PA alone; reperfusion occurred at 78.2 +/- 5.6 minutes with a reperfusion incidence of 60% (6/10). Group 2 received t-PA plus heparin (100 units/kg plus 50 units/kg/hr); reperfusion occurred at 61.9 +/- 9.1 minutes with a reperfusion incidence of 90% (9/10). Group 3 received t-PA plus heparin plus bitistatin (30 micrograms/kg plus 3 micrograms/kg/min); reperfusion occurred at 47.3 +/- 7.6 minutes (p less than 0.05 versus group 1) with a reperfusion incidence of 90% (9/10). Group 4 received t-PA plus bitistatin, and reperfusion occurred at 51.8 +/- 8.5 minutes; however, the reperfusion incidence was only 60% (6/10). In groups 1, 2, and 4, acute reocclusion occurred in more than 80% of the reperfused dogs, whereas in group 3 reocclusion occurred in 22% (2/9) of the reperfused dogs (p less than 0.05 versus group 1). The dose of heparin used in this study increased activated partial thromboplastin times 1.5-2.0-fold over control.(ABSTRACT TRUNCATED AT 250 WORDS)
Spain takes first steps towards banning smoking in all public spaces
Authors: M. d. Lago
Journal: BMJ (2010)

The Spanish government has taken the first step towards banning smoking in all closed public spaces. Only hotels, hostels, prisons, hospitals, and mental hospitals will be allowed to have designated smoking areas, says the draft law sent to parliamentary groups by the Ministry of Health and Social Policies.

The draft law, which is planned to be approved this autumn, will eliminate current exceptions to the general smoking ban. Under current regulations, which were approved in 2005, owners of bars, restaurants, pubs, night clubs, and casinos measuring less than 100 m2 can choose whether …
Dual Use of Department of Veterans Affairs and Medicare Benefits and Use of Test Strips in Veterans With Type 2 Diabetes Mellitus
Authors: Walid F. Gellad, Xinhua Zhao, Carolyn T. Thorpe, Maria K. Mor, Chester B. Good, Michael J. Fine
Journal: JAMA Internal Medicine (2014)

IMPORTANCE Self-monitoring of blood glucose is a costly component of care for diabetes mellitus, with unclear benefits for patients not taking insulin.Veterans with dual Department of Veterans Affairs (VA) and Medicare benefits have access to test strips through both systems, raising the potential for overuse.OBJECTIVES To examine the patterns of test strip receipt among older veterans with diabetes and determine whether receipt of strips from dual health care systems is associated with overuse. DESIGN, SETTING, AND PARTICIPANTSWe performed a cross-sectional, retrospective cohort study using national VA administrative data linked to Medicare Parts A, B, and D claims for fiscal years 2008 and 2009.A total of 363 996 community-dwelling veterans 65 years or older with diabetes who used the VA health care system and received test strips in fiscal year 2009 were included in the study.EXPOSURES Receipt of test strips from the VA only, Medicare only, or both the VA and Medicare; covariates included sociodemographics, comorbidity, diabetes complications, and hemoglobin A 1c level.MAIN OUTCOMES AND MEASURES Quantity of test strips dispensed and overuse of test strips, defined as more than 1 strip per day (>365 strips per year) among those taking no diabetes medications, oral diabetes medications alone, or long-acting insulin without short-acting insulin or more than 4 strips per day (>1460 strips per year) among those taking short-acting insulin.RESULTS Overall, 260 688 older veterans (71.6%) with diabetes received strips from the VA only, 82 826 (22.8%) from Medicare only, and 20 482 (5.6%) from the VA and Medicare.Veterans receiving strips from both the VA and Medicare received more strips (median, 600; interquartile range [IQR], 350-1000) than the Medicare only (median, 400; IQR, 200-700) and VA only (median, 200; IQR, 100-500) groups (P < .001)and had substantially greater odds of overuse than the VA only group (55.4% vs 15.8%) (adjusted odds ratio [OR], 16.3; 95% CI, 14.6-18.1 for no medications; 55.3% vs 6.0%; OR, 19.8; 95% CI, 18.9-20.8for oral medications; 87.4% vs 65.5%; OR, 3.69; 95% CI, 3.30-4.14for long-acting insulin; and 32.8% vs 13.5%; OR, 3.24; 95% CI, 3.05-3.45for short-acting insulin).Patterns were similar when using more conservative thresholds of overuse.CONCLUSIONS AND RELEVANCE Veterans who receive glucose test strips through both the VA and Medicare use more strips and are more likely to potentially overuse strips.These results illustrate the profound importance of understanding dual VA and Medicare coverage and are emblematic of waste and inefficiency.
Laser-resistant Guide Probe for Laser Treatment of Endoscopically Impassable Tumour Stenoses
Authors: Ch. Ell, J. Hochberger, G. Lux, J. F. Riemann
Journal: Endoscopy (1986)

A laser-resistant guide probe that can be placed endoscopically, for use in the laser treatment of impassable tumour stenosis is described. It meets the necessary requirements such as low level of absorption of YAG laser light (1,064 nm wavelength), high thermal stability and low heat conduction. So far, the probe has been used complication-free, in four patients.
HCFA Focuses on New Plans for Quality Care
Authors: Rebecca Voelker
Journal: JAMA (1997)

AFTER DECADES of serving as the checkbook for millions of Americans' health care, the federal Health Care Financing Administration (HCFA) wants to ensure that its beneficiaries get the most bang for the buck. Toward that end, Congress recently approved a budget act with a mandate that HCFA establish quality requirements for managed care organizations that provide health care for people enrolled in Medicare and Medicaid. Both programs already use the Health Plan Employer Data Information Set (HEDIS)—created by the National Committee for Quality Assurance—as a means to measure the performance of managed care plans that serve their beneficiaries. But HCFA's new mandate, known as the Quality Improvement System in Managed Care (QISMC), will require that participating health plans show evidence of improvement in the health care they provide. The initiative "moves from a structural process to the next generation of standards requiring managed care organizations to improve health care," said
Rheumatic symptoms following an outbreak of campylobacter enteritis: a five year follow up.
Authors: T Bremell, A Bjelle, A Svedhem
Journal: Annals of the Rheumatic Diseases (1991)

Eighty six of 106 (81%) guests attending a party were followed up after an outbreak of Campylobacter jejuni enterocolitis. Acute diarrhoeal illness was reported in 35 subjects (33%), of whom seven showed acute rheumatic symptoms either alone or with other symptoms of infection with C jejuni. The antibody response to C jejuni corresponded well with the intensity of the disease. In the early phase of the gastrointestinal disease the patients with acute rheumatic symptoms displayed significantly higher IgM antibody levels in serum samples than the other patients in this study. Levels of antibodies to C jejuni were increased in serum samples from 31 patients (29%) without symptoms of infection with C jejuni. At a follow up after five and a half years, four of these patients suffered from chronic rheumatic disorders. One HLA-B27 positive woman developed reactive arthritis with a relapse seven years later. The remaining 20 subjects (19%) remained healthy and their antibody tests and stool cultures were negative for C jejuni. It is concluded that C jejuni enterocolitis is significantly associated with rheumatic symptoms in the early phase and may also cause chronic rheumatic disorders.
Audit my shorts
Authors: L. Farrell
Journal: BMJ (1995)

It is an innate desire of doctors to try to improve their service to their patients, and to continue to augment their knowledge and refine their skills throughout their careers. Medical audit started out as a way of encouraging this admirable professional attribute, and standardising it so that it could be applied in everyday practice and in all aspects of patient care. It is essentially a very simple idea. (a) We decide what we should be doing; (b) we find out what we are doing; and (c) we take the necessary steps to change (a) into (b). Clear as a bell, easy got as a wet foot.

But somewhere along …
Osmoprotective activity for Escherichia coli in mammalian renal inner medulla and urine. Correlation of glycine and proline betaines and sorbitol with response to osmotic loads.
Authors: S T Chambers, C M Kunin
Journal: Journal of Clinical Investigation (1987)

Escherichia coli are protected against hypertonic NaCl by human urine. We have shown that this is due in part to the presence of glycine betaine and proline betaine. Several investigators have proposed that betaines and sorbitol are concentrated in the cells of the renal inner medulla where they exert a protective role against urea and extracellular osmotic forces. E. coli was used in the present studies as an "osmosensor" to detect osmoprotective activity in mammalian tissues. The greatest activity was found in extracts of renal inner medulla and to a lesser extent in the renal outer medulla and cortex of several mammalian species. Liver extracts were more active than other nonrenal tissues. Bacterial osmoprotective activity and concentration of glycine betaine in the renal inner medulla of rabbits were found to correlate closely with urinary osmolarity. Concentrations of sorbitol were found to be also increased in the renal inner medulla during osmotic stress, but this compound is not osmoprotective for E. coli. Glycine and proline betaine were recovered in urine of rabbits and were increased in those given high osmotic loads. Only small amounts of proline betaine were recovered in the renal inner medulla. The source from which proline betaine is derived is unknown.
The Developing Liver: the Steady–State Disposition of Propranolol in Pregnant Sheep
Authors: George W. Mihaly, Denis J. Morgan, Richard Smallwood, Kenneth J. Hardy
Journal: Hepatology (1982)

The steady-state disposition of the beta-adrenoreceptor blocking drug, propranolol, and its metabolite, 4-hydroxypropranolol, was studied in the anesthetized pregnant sheep near term. Following infusion of propranolol to the mother, steady-state plasma concentrations were obtained at three dosage levels in each of the eight animals studied. Blood samples were obtained from : (i) maternal facial artery and hepatic vein; (ii) umbilical vein, and (iii) fetal carotid artery, portal vein, and right hepatic vein. Although total propranolol concentrations in maternal plasma were different from those in umbilical venous plasma, the concentrations of unbound drug were similar, suggesting that unbound drug had equilibrated across the placenta. Approximately 10% of propranolol was unbound in maternal plasma, compared with 30% in fetal plasma. Hepatic extraction of propranolol by the maternal liver was high, so that only 3 to 4% of the drug presented to the liver escaped uptake. In contrast, fetal hepatic extraction was low. Negligible amounts were removed from portal vein blood (right lobe), although one third was extracted from umbilical vein blood (left lobe). Mean peripheral arterial concentrations of 4-hydroxypropranolol were 2- to 3-fold higher in the fetus than in the mother. We conclude that the fetus is exposed to significant concentrations of propranolol and that the fetal hepatic extraction of this drug is considerably less efficient than in the adult. In contrast to the adult liver, the fetal liver does not appear to act as a single homogeneous organ, but rather as two distinct subunits.
A pilot study of recombinant interleukin-2 for treatment of chronic hepatitis C
Authors: M Pardo, I Castillo, H Oliva, A Fernandez-Flores, R Barcena, M A de Peuter, V Carreno
Journal: Hepatology (1997)

The optimal and safer interleukin-2 (IL-2) dose for treatment of chronic hepatitis C virus (HCV) infection has been studied in 33 HCV-RNA positive patients with chronic hepatitis C. Patients were randomly allocated to receive 5 days per week during 12 weeks IL-2 doses of: 0.9 MIU (n = 10), 1.8 MIU (n = 10), or 3.6 MIU (n = 13). After 12 weeks, responder patients stopped treatment, whereas nonresponders received 12 additional weeks of IL-2 at the next higher dose: 1.8, 3.6, or 5.4 MIU. As a whole, after the first 12 weeks of IL-2 alanine aminotransferase (ALT) levels significantly decreased (P < .001) with respect to the baseline values (140 +/- 63 vs. 70 +/- 30 IU/L). At the end of treatment (24 weeks), the mean ALT level (80 +/- 50 IU/L) continued significantly lower (P < .001) than the baseline one, and 24% of patients normalized ALT levels; according to dosage, ALT normalization was: 0% for 0.9 MIU, 25% for 1.8 MIU, 5% for 3.6 MIU, and 18% for 5.4 MIU. HCV-RNA levels decreased during treatment, but in none of the patients became undetectable. All patients had a local reaction at the injection site with induration, erythema, and swelling, which was dose-related. The dose of 5.4 MIU was poorly tolerated and was reduced to 3.6 MIU in 4 of 11 patients. No changes in hematological parameters were observed. At the end of follow-up (6 months) four of eight responder patients continued with normal ALT. In conclusion, IL-2 treatment for chronic hepatitis C induced a biochemical response in 8 of 33 (24%) patients at the end of therapy while at the end of follow-up, 4 of 33 (8%) patients remained with normal ALT. The dose of 1.8 MIU is well tolerated and seems to be the most efficacious.
Eradication of Tumor Colonization and Invasion by a B Cell–Specific Immunotoxin in a Murine Model for Human Primary Intraocular Lymphoma
Authors: Zhuqing Li, Sankaranarayana P. Mahesh, De Fen Shen, Baoying Liu, Willie O. Siu, Frank S. Hwang, Qing-Chen Wang, Chi-Chao Chan, Ira Pastan, Robert B. Nussenblatt
Journal: Cancer Research (2006)

Abstract Human primary intraocular lymphoma (PIOL) is predominantly a B cell–originated malignant disease with no appropriate animal models and effective therapies available. This study aimed to establish a mouse model to closely mimic human B-cell PIOL and to test the therapeutic potential of a recently developed immunotoxin targeting human B-cell lymphomas. Human B-cell lymphoma cells were intravitreally injected into severe combined immunodeficient mice. The resemblance of this tumor model to human PIOL was examined by fundoscopy, histopathology, immunohistochemistry, and evaluated for molecular markers. The therapeutic effectiveness of immunotoxin HA22 was tested by injecting the drug intravitreally. Results showed that the murine model resembles human PIOL closely. Pathologic examination revealed that the tumor cells initially colonized on the retinal surface, followed by infiltrating through the retinal layers, expanding preferentially in the subretinal space, and eventually penetrating through the retinal pigment epithelium into the choroid. Several putative molecular markers for human PIOL were expressed in vivo in this model. Tumor metastasis into the central nervous system was also observed. A single intravitreal injection of immunotoxin HA22 after the establishment of the PIOL resulted in complete regression of the tumor. This is the first report of a murine model that closely mimics human B-cell PIOL. This model may be a valuable tool in understanding the molecular pathogenesis of human PIOL and for the evaluation of new therapeutic approaches. The results of B cell–specific immunotoxin therapy may have clinical implications in treating human PIOL. (Cancer Res 2006; 66(21): 10586-93)
Interstitial Emphysema during Labour
Authors: R. Stanley
Journal: BMJ (1943)

MEDICAL MEMORANDA MEDRITI JOURNAL47Fortunately, mepacrine pigmentation scarcely ever tints the conjunctivae, so that differential diagnosis is easy.The dosage of pamaquin was 0.01 g. t.d.s. for 3 to 5 days.It was given alone subsequent to the routine course.All patients received adequate therapeutic doses of iron.ln a few who were seriously ill on admission, including the cerebral.-malariacase, intramuscular quinine was injected with
Rh Gene Evolution in Primates: Study of Intron Sequences
Authors: Pol-André Apoil, Antoine Blancher
Journal: Molecular Biology and Evolution (2000)

By amplification and sequencing of RH gene intron 4 of various primates we demonstrate that an Alu-Sx-like element has been inserted in the RH gene of the common ancestor of humans, apes, Old World monkeys, and New World monkeys. The study of mouse and lemur intron 4 sequences allowed us to precisely define the insertion point of the Alu-Sx element in intron 4 of the RH gene ancestor common to Anthropoidea. Like humans, chimpanzees and gorillas possess two types of RH intron 4, characterized by the presence (human RHCE and ape RHCE-like genes) or absence (human RHD and ape RHD-like genes) of the Alu-Sx element. This led us to conclude that in the RH common ancestor of humans, chimpanzees, and gorillas, a duplication of the common ancestor gene gave rise to two genes, one differing from the other by a 654-bp deletion encompassing an Alu-Sx element. Moreover, most of chimpanzees and some gorillas possess two types of RHD-like intron 4. The introns 4 of type 1 have a length similar to that of human RHD intron 4, whereas introns 4 of type 2 display an insertion of 12 bp. The latest insertion was not found in the human genome (72 individuals tested). The study of RH intron 3 length polymorphism confirmed that, like humans, chimpanzees and gorillas possess two types of intron 3, with the RHD-type intron 3 being 289 bases shorter than the RHCE intron 3. By amplification and sequencing of regions encompassing introns 3 and 4, we demonstrated that chimpanzee and gorilla RH-like genes displayed associations of introns 3 and 4 distinct to those found in man. Altogether, the results demonstrate that, as in humans, chimpanzee and gorilla RH genes experienced intergenic exchanges.
THE PATHOLOGIC EFFECTS OF ALCOHOL ON RABBITS.AN EXPERIMENTAL STUDY.
Authors: JULIUS FRIEDENWALD
Journal: JAMA (1905)

<h3>VARIETY OF ALCOHOL USED AND METHOD OF FEEDING THE ANIMALS.</h3> One hundred and twenty rabbits were utilized in the experiments with alcohol. Most of these animals were fed on absolute alcohol diluted; some on an inferior form of whisky known as "Calumet," 70, proof 33.6 per cent. In order to be certain of the exact dosage, the alcohol and whisky were introduced into the stomach through a catheter. The catheter is easily introduced into the stomach of a rabbit; the animal is placed flat on its back and strapped to an animal board; the ears are then firmly grasped, the mouth opened by means of a large forceps and the tube forced into the stomach. By means of a funnel attached to the end of the catheter, the liquid quickly enters the stomach; with practice the introduction of the tube becomes a matter of great ease and one need not
Deaths attributable to alcohol fall with rise in minimum price, study finds
Authors: J. Wise
Journal: BMJ (2013)

A 10% increase in the average minimum price of alcohol was associated with a 32% reduction in wholly alcohol attributable deaths, a Canadian study has found.1 The finding will lend support to the proposed introduction of a minimum price in England and Wales.2

The study, published in Addiction , analysed deaths associated with alcohol use in British Columbia between 2002 and 2009 and compared them with rises in government set prices for alcohol. The researchers used three categories of death associated with alcohol: wholly alcohol attributable, acute, and chronic. Wholly alcohol attributable deaths included alcohol poisoning, alcoholic psychoses, alcoholic cardiomyopathy, fetal alcohol syndrome, and …
A3.18 Synovial Fibroblasts Inhibit Inflammatory T Cell Responses through Tryptophan Metabolism
Authors: Lars-Oliver Tykocinski, Anna-Marie Lauffer, Antonia Bohnen, Stefan Krienke, Iris Oezen, Ulrike Litzenburger, Michael Platten, Hanns-Martin Lorenz
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background and Objectives</h3> It has been more and more accepted that fibroblasts participate in a dynamic interplay with other cells. Fibroblasts recruit immune cells and are able to influence their differentiation, proliferation, activation and survival. The development of rheumatoid arthritis (RA) is linked to functional changes of synovial fibroblasts (SFb) and a local infiltration of inflammatory cells, including B- and T cells. So far, little is known about the interaction of SFb and T cells. Here, we analysed the influence of normal SFb on the activation, proliferation and cytokine production of T cells in vitro. <h3>Materials and Methods</h3> SFb were isolated from synovectomy tissue of patients with osteoarthritis. CD4+ T cells were stimulated with PHA and interleukin (IL)-2 in the presence or absence of fibroblasts, in direct contact or separated by a transwell chamber; their proliferation was measured by <sup>3</sup>H-thymidine incorporation or by PKH-26 staining. Cytokine secretion was quantified by ELISA. Surface marker expression was analysed by flow cytometry and mRNA levels of matrix metalloprotease (MMP) 1, MMP3 and Indoleamine 2,3-dioxygenase (IDO) were quantified by real-time PCR. IDO activity was measured by kynurenine levels detected by HPLC and blocked by 1-methyl-L-tryptophan. <h3>Results</h3> SFb strongly reduced the proliferation of activated CD4+ T cells and the secretion of pro-inflammatory cytokines like interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha or IL-17. The suppression was consistent even when the T cells were separated by a transwell membrane. Interestingly, to produce suppressive mediators the SFb first needed to be stimulated by soluble factors released by activated T cells. The dynamic interplay between T cells and SFb was also shown by the fact that the SFb support the activation of T cells at early time points of coculture. The coculture induced the expression of MMP1 and MMP3, as well as IDO mRNA and the production of nitric oxide (NO) by the SFb. Blockade of IDO, but not of MMPs or iNOS, completely abrogated the suppression of T cells, indicating that the inhibitory effect of the fibroblasts is mediated by tryptophan metabolism. <h3>Conclusions</h3> Secreted products of activated T cells induce IDO expression in SFb which in turn leads to decreased proliferation and cytokine production of the activated T cells. This intercellular mechanism may play an important role in preventing inappropriate T cell activation and in the termination of immune reactions. The insights gained from this study may help to define the malfunctions of pathogenic SFb of RA patients.
PREDICTION OF BLEEDING ADMISSION IN THE FIRST YEAR AFTER ACUTE CORONARY SYNDROME AND PROGNOSTIC IMPACT: THE CARDIOCHUS BLEEDING RISK SCORE
Authors: Sergio Raposeiras Roubin, Emad HA Abu-Assi, Belen Alvarez Alvarez, Maria Cristina Gonzalez Cambeiro, Pilar Mazon-Ramos, Alejandro Virgós Lamela, Jose María García-Acuña, José Ramón González-Juanatey
Journal: Journal of the American College of Cardiology (2014)