tbuckley/cabot-search huggingface dataset:
Interestingly complex stories
Authors: J. Smith
Journal: BMJ (2010)

Those who revel in the complexities of primary care should enjoy the four research papers and editorial on managing urinary tract infections in this week’s issue. In a series of studies Paul Little and his colleagues examine the clinical (doi:10.1136/bmj.c199) and cost (doi:10.1136/bmj.c346) effectiveness of different approaches to managing urinary tract infection; the natural course of the infection (doi:10.1136/bmj.b5633); and women’s views about the management and cause of such infections (doi:10.1136/bmj.c279). The message, according to Dee Mangin in her editorial, is that “empirical prescription, delayed empirical prescription, and empirical prescription based on dipstick results (with back up delayed prescription) are all rational options for different reasons” (doi:10.1136/bmj.c657). For her the most interesting finding is that symptoms were less severe and …
Redefining the “Planning” in Advance Care Planning: Preparing for End-of-Life Decision Making
Authors: Rebecca L. Sudore
Journal: Annals of Internal Medicine (2010)

The traditional objective of advance care planning has been to have patients make treatment decisions in advance so that clinicians can attempt to provide care consistent with their goals. The authors contend that the objective for advance care planning ought to be the preparation of patients and surrogates to participate with clinicians in making the best possible in-the-moment medical decisions. They provide practical steps for clinicians to help patients and surrogate decision makers achieve this objective in the outpatient setting. Preparation for in-the-moment decision making shifts the focus from having patients make premature decisions based on incomplete information to preparing them and their surrogates for the types of decisions and conflicts they may encounter when they do have to make in-the-moment decisions. Advance directives, although important, are just one piece of information to be used at the time of decision making.
Betaine and Glycocyamine in Treatment of Poliomyelitis
Authors: Arthur L. Watkins
Journal: New England Journal of Medicine (1953)

THE purpose of this study Was to investigate the purported value of betaine and glycocyamine in the treatment of late residual muscular weakness resulting from poliomyelitis.‡ To make the evaluation as objective as possible the strength of the muscles studied was measured by means of a special instrument known as a myodynemeter utilizing a strain gauge with calibrated recording device and standardized test positions that experience in this laboratory had shown to be highly accurate.Method or StudyNine patients, all of them Cooperative adults, who had had poliomyelitis, with residual weakness, one or more years previously were selected. They . . .
Analysis of Sodium o-Iodohippurate Renogram
Authors: Chester C. Winter
Journal: JAMA (1962)

To  Editor:—  This note is in reference to an article by Wax and McDonald, entitled Analysis of  I131Sodium o-Iodohippurate Renogram, that appeared inThe Journal(179:140 [Jan. 13] 1962). I wish to comment on some aspects of their experimentation, offer some pertinent observations from our work, and express a disagreement with their statement that the term 'vascular phase,' which has been used widely in applying  renogram to hyptertensive studies, is misleading and should be discarded.  Their experiments, in dogs, were carried out with  ratemeter set at a 10-second time constant. This means that there was a 35-second lag in a record made by an instrument that has too good a memory, and thereby allows a false impression to be made of what may be taking place during a period of rapid change. In  analysis of  renogram's initial segment that is completed
Abstract 4343: Ionizing radiation reduces VLA4 mediated adhesion of macrophage via generation of ROS
Authors: Ye Yuan, Shiyong Wu
Journal: Cancer Research (2012)

Abstract Adhesion molecules have direct connection with radiation-associated atherosclerosis which is an adverse effect observed after radiation therapy, but the mechanism is still not fully understood. Considerable interest has been focused on the effect of radiation on endothelial cells. Previous work has demonstrated that adhesion molecules of endothelium are up-regulated after exposure to ionizing radiation, which facilitates adhesion of leukocytes and lymphocytes. However, as the initiator in the atherosclerosis development, not enough attention was paid to macrophages which are exposed to the same radiation. In this study, we report that the adhesion between very late Antigen-4 (VLA-4) and its ligand vascular cell adhesion molecule-1 (VCAM-1), the most important adhesion molecules for atherosclerotic lesion formation, was reduced after a clinical dose of radiation (5 Gy). All the adhesion evaluations were tested under flow conditions by using a parallel plate flow chamber to mimick physiological shear stress. We found that the adhesion decreased after irradiation despite macrophage surface expression of VLA-4 was up-regulated in a time dependent manner. Total level of alpha-4 integrin increased whereas beta-1 had no change. Pretreatment with free radical scavenger N-acetylcysteine (NAC) did not change integrin expression but eliminated the adhesion difference following irradiation. Taken together, we hypothesize high levels of ROS generated by ionizing radiation inhibits the affinity of VLA-4 to VCAM-1, in which integrin expression is not the dominant factor. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4343. doi:1538-7445.AM2012-4343
The Problems with Punitive Damages in Lawsuits against Managed-Care Organizations
Authors: David M. Studdert, Troyen A. Brennan
Journal: New England Journal of Medicine (2000)

Five years ago, a jury in southern California awarded $89 million to the estate of Nelene Fox because her insurer, Health Net, did not approve treatment with autologous bone marrow transplantation and high-dose chemotherapy for breast cancer. Nearly 90 percent of the amount awarded ($77 million) consisted of “punitive damages” — a special supplement to the award designed to punish the defendant. Fox v. Health Net made headlines as an example of the kind of retribution that managed-care organizations could face for withholding medical care.1 However, its effect was limited, in part because the case was later settled during an . . .
Music evoked emotions<i>are</i>different–more often aesthetic than utilitarian
Authors: Klaus Scherer, Marcel Zentner
Journal: Behavioral and Brain Sciences (2008)

Abstract We disagree with Juslin &amp; Västfjäll's (J&amp;V's) thesis that music-evoked emotions are indistinguishable from other emotions in both their nature and underlying mechanisms and that music just induces some emotions more frequently than others. Empirical evidence suggests that frequency differences reflect the specific nature of music-evoked emotions: aesthetic and reactive rather than utilitarian and proactive. Additional mechanisms and determinants are suggested as predictors of emotions triggered by music.
Book Review Evaluation of the Psychiatric Patient: A primer (Critical Issues in Psychiatry.) By Seymour L. Halleck. 216 pp. New York, Plenum, 1991. $35. Dilemmas and Difficulties in the Management of Psychiatric Patients Edited by Keith Hawton and Philip Cowen. 257 pp. New York, Oxford University Press, 1991. $38.
Authors: Carol C. Nadelson
Journal: New England Journal of Medicine (1991)
Correspondence of Mr. Lucas and Dr. Franz
Authors: A. Franz, P. B. Lucas, J. J. M. Wardrop, R. Hingeston
Journal: BMJ (1840)

mipsion and the operation, repeated purgatives were given, which, with the free exhibition of demulcents, and the occasional use of the warm bath, relieved him very muchl.He was sounded two or three different times, and a stone distinctly felt.On the 29th of Sept. he was carried into * [We hope oon to have an opportunity of giving a fullanalysis of Dr. Glove's valuable essay on the physiological and remeidial action of bromine and its compounds-Ess.1
Increased proteolysis. An effect of increases in plasma cortisol within the physiologic range.
Authors: P S Simmons, J M Miles, J E Gerich, M W Haymond
Journal: Journal of Clinical Investigation (1984)

Prolonged exposure to glucocorticoids in pharmacologic amounts results in muscle wasting, but whether changes in plasma cortisol within the physiologic range affect amino acid and protein metabolism in man has not been determined. To determine whether a physiologic increase in plasma cortisol increases proteolysis and the de novo synthesis of alanine, seven normal subjects were studied on two occasions during an 8-h infusion of either hydrocortisone sodium succinate (2 micrograms/kg X min) or saline. The rate of appearance (Ra) of leucine and alanine were estimated using [2H3]leucine and [2H3]alanine. In addition, the Ra of leucine nitrogen and the rate of transfer of leucine nitrogen to alanine were estimated using [15N]leucine. Plasma cortisol increased (10 +/- 1 to 42 +/- 4 micrograms/dl) during cortisol infusion and decreased (14 +/- 2 to 10 +/- 2 micrograms/dl) during saline infusion. No change was observed in plasma insulin, C-peptide, or glucagon during either saline or cortisol infusion. Plasma leucine concentration increased more (P less than 0.05) during cortisol infusion (120 +/- 1 to 203 +/- 21 microM) than saline (118 +/- 8 to 154 +/- 4 microM) as a result of a greater (P less than 0.01) increase in its Ra during cortisol infusion (1.47 +/- 0.08 to 1.81 +/- 0.08 mumol/kg X min for cortisol vs. 1.50 +/- 0.08 to 1.57 +/- 0.09 mumol/kg X min). Leucine nitrogen Ra increased (P less than 0.01) from 2.35 +/- 0.12 to 3.46 +/- 0.24 mumol/kg X min, but less so (P less than 0.05) during saline infusion (2.43 +/- 0.17 to 2.84 +/- 0.15 mumol/kg X min, P less than 0.01). Alanine Ra increased (P less than 0.05) during cortisol infusion but remained constant during saline infusion. During cortisol, but not during saline infusion, the rate and percentage of leucine nitrogen going to alanine increased (P less than 0.05). Thus, an increase in plasma cortisol within the physiologic range increases proteolysis and the de novo synthesis of alanine, a potential gluconeogenic substrate. Therefore, physiologic changes in plasma cortisol play a role in the regulation of whole body protein and amino acid metabolism in man.
Limulus Lysate Test for Gram-Negative Bacterial Meningitis
Authors: Sydney Ross
Journal: JAMA (1975)

The limulus lysate assay on cerebrospinal fluid was evaluated in 335 infants and children as a method for the rapid diagnosis of<i>Gram-negative</i>bacterial meningitis. Positive limulus tests were obtained within one hour in 33 of 34 cases of<i>Hemophilus influenzae</i>meningitis; four additional patients with Gram-negative meningitis also showed positive limulus lysate tests. Conversely, 13 patients with<i>Gram-positive</i>bacterial meningitis all yielded negative limulus assays. All 48 cases of aseptic meningitis and 236 children with no meningitis showed negative limulus assays. Antibiotic therapy prior to hospitalization did not vitiate the validity of the test. A bedside adaptation of the limulus test, performed by house officers and medical students, showed approximately 98% agreement with the laboratory assay. (<i>JAMA</i>233:1366-1369, 1975)
ADOPTION PRACTICES AND THE PHYSICIAN
Authors: R. L. JENKINS
Journal: JAMA (1934)

In this article adoption is considered in its purely human aspects as it concerns the medical profession. The relation of adoption to legal inheritance is beyond its province.  It is generally conceded that there is no social institution that can be regarded as an adequate substitute for the home in the training and socialization of children. There was a time when the inability of parents to support their children was considered a sufficient reason for the placement of the children outside the home. What such a policy would mean during the present crisis of unemployment must be apparent to all. There is a general agreement at present that, in instances in which it is necessary, children are best safeguarded by the conservation of the home through relief or social case work, with the exception of that small minority of instances in which the home is unfit.  There are certain children
AIDA 0493 protocol for newly diagnosed acute promyelocytic leukemia: very long-term results and role of maintenance
Authors: Giuseppe Avvisati, Francesco Lo-Coco, Francesca Paola Paoloni, Maria Concetta Petti, Daniela Diverio, Marco Vignetti, Roberto Latagliata, Giorgina Specchia, Michele Baccarani, Eros Di Bona, Giuseppe Fioritoni, Filippo Marmont, Alessandro Rambaldi, Francesco Di Raimondo, Maria Grazia Kropp, Giovanni Pizzolo, Enrico M. Pogliani, Giuseppe Rossi, Nicola Cantore, Francesco Nobile, Attilio Gabbas, Felicetto Ferrara, Paola Fazi, Sergio Amadori, Franco Mandelli
Journal: Blood (2011)
Abstract 10914: Percutaneous Repair of Paravalvular Prosthetic Regurgitation: Acute and 30-Day Outcomes in 103 Patients
Authors: Paul Sorajja, Allison K Cabalka, Donald J Hagler, Frank Cetta, Charanjit S Rihal
Journal: Circulation (2010)

Background: Percutaneous repair has emerged as a potential therapy for patients with peri-prosthetic valvular regurgitation. However, there is a paucity of data on feasibility and outcome of the pr...
Pneumopericardium Secondary to a Fistula
Authors: Charles Pfaff
Journal: JAMA (1976)

"SPONTANEOUS" pneumopericardium is a rarely encountered entity.<sup>1-3</sup>The case reported here is unusual, as it was secondary to a fistulous communication with a subphrenic-colonic abscess. <h3>Report of a Case</h3> A 65-year-old woman complained of diarrhea, fever, and rapidly progressing debilitation for one week. The only available past history was the report of an inoperable malignant neoplasm of the colon, diagnosed six months earlier in another country by barium enema. She was dyspneic and severely dehydrated, and she had atrial fibrillation and a palpable abdominal mass in the left upper quadrant. An admission chest roentgenogram showed a large pneumopericardium (Fig 1). Pericardiocentesis yielded approximately 300 cc of gas and 50 ml of thick, brown liquid with a fecal odor. Emergency extraperitoneal subcostal exploration disclosed a large left anterior subphrenic abscess that communicated with the pericardial cavity through an opening 1 cm in diameter in the central tendon of the diaphragm.
Relation of Trihalomethane Concentrations in Public Water Supplies to Stillbirth and Birth Weight in Three Water Regions in England
Authors: Mireille B. Toledano, Mark J. Nieuwenhuijsen, Nicky Best, Heather Whitaker, Peter Hambly, Cornelis de Hoogh, John Fawell, Lars Jarup, Paul Elliott
Journal: Environmental Health Perspectives (2004)

We investigated the association between total trihalomethanes (TTHMs) and risk of stillbirth and low and very low birth weight in three water regions in England, 1992-1998; associations with individual trihalomethanes (THMs) were also examined. Modeled estimates of quarterly TTHM concentrations in water zones, categorized as low (< 30 microg/L), medium (30-59 microg/L), or high (> or = 60 microg/L), were linked to approximately 1 million routine birth and stillbirth records using maternal residence at time of birth. In one region, where there was a positive socioeconomic deprivation gradient across exposure categories, there was also a positive, significant association of TTHM with risk of stillbirth and low and very low birth weight. Overall summary estimates across the three regions using a random-effects model to allow for between-region heterogeneity in exposure effects showed small excess risks in areas with high TTHM concentrations for stillbirths [odds ratio (OR) = 1.11; 95% confidence interval (CI), 1.00-1.23), low birth weight (OR = 1.09; 95% CI, 0.93-1.27), and very low birth weight (OR = 1.05; 95% CI, 0.82-1.34). Among the individual THMs, chloroform showed a similar pattern of risk as TTHM, but no association was found with concentrations of bromodichloromethane or total brominated THMs. Our findings overall suggest a significant association of stillbirths with maternal residence in areas with high TTHM exposure. Further work is needed looking at cause-specific stillbirths and effects of other disinfection by-products and to help differentiate between alternative (noncausal) explanations and those that may derive from the water supply.
455 HCV VIRAL KINETICS DURING RIBAVIRIN MONOTHERAPY: RESULTS OF A RANDOMIZED PARTIALLY DOUBLE BLIND PLACEBO CONTROLLED CLINICAL TRIAL
Authors: U. Mihm, M.W. Welker, G. Teuber, H. Wedemeyer, T. Berg, A. Breske, S. Zeuzem, C. Sarrazin, E. Herrmann
Journal: Journal of Hepatology (2011)
Overcoming Insulin Insufficiency by Forced Follistatin Expression in β -cells of db/db Mice
Authors: Chunxia Zhao, Chunping Qiao, Ru-Hang Tang, Jiangang Jiang, Jianbin Li, Carrie Bette Martin, Karen Bulaklak, Juan Li, Dao Wen Wang, Xiao Xiao
Journal: Molecular Therapy (2015)

Diabetes poses a substantial burden to society as it can lead to serious complications and premature death. The number of cases continues to increase worldwide. Two major causes of diabetes are insulin resistance and insulin insufficiency. Currently, there are few antidiabetic drugs available that can preserve or protect β-cell function to overcome insulin insufficiency in diabetes. We describe a therapeutic strategy to preserve β-cell function by overexpression of follistatin (FST) using an AAV vector (AAV8-Ins-FST) in diabetic mouse model. Overexpression of FST in the pancreas of db/db mouse increased β-cell islet mass, decreased fasting glucose level, alleviated diabetic symptoms, and essentially doubled lifespan of the treated mice. The observed islet enlargement was attributed to β-cell proliferation as a result of bioneutralization of myostatin and activin by FST. Overall, our study indicates overexpression of FST in the diabetic pancreas preserves β-cell function by promoting β-cell proliferation, opening up a new therapeutic avenue for the treatment of diabetes.
Remodelling of peripheral lung tissue in COPD
Authors: J. C. Hogg, R. A. Pierce
Journal: European Respiratory Journal (2008)

Chronic obstructive pulmonary disease (COPD) is a major worldwide public health problem caused by the inhalation of toxic particles and gases primarily as a result of tobacco smoking 1. In 2001, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) assembled an international panel of experts to develop, continuously monitor and upgrade guidelines for diagnosis of the disease, classification of its severity and the optimum management of COPD 1, 2. The criteria for diagnosis and severity of COPD are based on measurement of post-bronchodilator forced expiratory volume in one second (FEV1) and its ratio to forced vital capacity (FVC) 1, 2. Because these measurements reflect the time constant for lung emptying, they detect the combined effect of resistance offered by the airways and lung compliance, which determines the elastic force required to drive air out of the lungs. However, these measurements cannot separate one from the other. The lesions at both the site of airway obstruction and emphysematous destruction contain a persistent infiltration of inflammatory immune cells that becomes more extensive and severe as COPD progresses 3–6. This inflammatory immune response is inextricably linked to a repair and remodelling process that thickens the walls and narrows the lumen of small conducting airways and causes emphysematous destruction of gas-exchanging tissue 6, 7. Although the lungs from most patients with COPD have a mixture of lesions, studies based on high-resolution computed tomography indicate that they can be separated into phenotypes in which either airway obstruction or emphysematous destruction predominate 8, 9.

In the current issue of the European Respiratory Journal , Black et al. 10 provide new information concerning the elastin …
Nicotine is addictive, says advisory panel in US
Authors: J Roberts
Journal: BMJ (1994)

The US took a step closer to regulating cigarettes last week when an advisory panel of the Food and Drug Administration (FDA) said that nicotine is addictive. The panel had been asked to determine whether nicotine is addictive, whether an addictive threshold exists, and, if so, what that threshold is. The nine doctors and scientists heard testimonies from health and tobacco experts during a nine hour hearing. Cigars and other tobacco products were not discussed because nicotine doses in …
Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a measles epidemic and side effects of the vaccine
Authors: R. J Roberts, Q. D Sandifer, M. R Evans, M. Z Nolan-Farrell, P. M Davis
Journal: BMJ (1995)

To investigate the reasons for poor uptake of immunisation (non-immunisation) and the possible side effects of measles, mumps, and rubella vaccine in a catch up immunisation campaign during a community outbreak of measles.Descriptive study of reasons for non-immunisation and retrospective cohort study of side effects of the vaccine.Secondary schools in South Glamorgan.Random cluster sample of the parents of 500 children targeted but not immunised and a randomised sample of 2866 of the children targeted.Reasons for non-immunisation; symptoms among immunised and non-immunised children.Immunisation coverage of the campaign was only 43.4% (7633/17,595). The practical problems experienced included non-return of consent forms (6698/17,595), refusal of immunisation (2061/10,897 forms returned), and absence from school on day of immunisation (1203/8836 children with consent for immunisation). The most common reasons cited for non-immunisation were previous measles infection (145/232), previous immunisation against measles (78/232), and concern about side effects (55/232). Symptoms were equally common among immunised and non-immunised subjects. However, significantly more immunised boys than non-immunised boys reported fever (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to 3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)).Many of the objections raised by parents could be overcome by emphasising that primary immunisation does not necessarily confer immunity and that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is safe in children aged 11-15.
Emetic response to salt.
Authors: N C Hypher
Journal: BMJ (1977)

whereas 19 % of the women on diuretics had hypokalaemia of varying degrees.My conclusions are that the evidence in favour of a general recommendation of potassium supplementation in elderly, non- digitalised cardiac patients on diuretics is insufficient and that elderly women are prob- ably more prone to diuretic-associated hypo- kalaemia than elderly men.R