tbuckley/cabot-search huggingface dataset:
Sodium in preascitic cirrhosis: please pass the salt
Authors: J CLARIA
Journal: Gut (2001)

See article on page 847 

The relationship between sodium retention, hyperactivity of the neurohumoral vasoactive systems, and ascites formation in cirrhosis is intriguing and still remains a subject of interest and debate. According to the most widely accepted theory, the so-called peripheral arteriolar vasodilatation hypothesis of sodium retention and ascites formation in cirrhosis, the predominant mechanism in the pathogenesis of these abnormalities is the presence of persistent systemic arterial vasodilation leading to arterial hypotension, low peripheral resistance, high cardiac output, and decreased effective arterial blood volume.1 These circulatory abnormalities are detected by arterial and cardiopulmonary baroreceptors which in turn initiate the homeostatic activation of the endogenous neurohumoral systems aimed at maintaining arterial pressure within normal or near normal levels. In the kidneys however homeostatic activation of the vasoactive and sodium retaining systems promotes tubular sodium reabsorption and sodium retention.1 Because the splanchnic vasculature is a major site of arteriolar vasodilatation in cirrhosis, it is not surprising that extravasation of the fluid retained by the kidneys occurs mainly in this compartment, leading to the formation of ascites.

The renin-angiotensin-aldosterone (RAAS) and sympathetic nervous (SNS) systems, together with atrial natriuretic peptide (ANP), …
Shy and retiring
Authors: B. M Southcott
Journal: BMJ (2003)

Talk to any colleagues in the medical profession of a certain age, and, sooner or later, the conversation will turn to retirement. Everyone has looked up the pension tables thoughtfully sent out by the NHS to clinicians who reach the half century mark, and we each privately estimate when the fallout from stress, political interference, arguments with the chief executive, lack of parking space, etc, will outweigh the financial pressures of school and university fees, mortgage repayments, expensive habits, etc, and take action accordingly.

“Ah, retirement,” we all say to ourselves, with a vision of the Nirvana that is to come. Well, I crossed over a few months ago—all carefully planned and with no sudden rush to the finishing line:

“How is retirement?” my colleagues ask when I see them on forays back into hospital to deal with the letters that still keep coming in.

“It's… um, well, er. I don't know really.”

“Don't know?” they echo. What can I mean? Has the break in routine made me go soft in the …
Utility of Noninvasive Pharyngometry in Epidemiologic Studies of Childhood Sleep-disordered Breathing
Authors: Kenneth J. Monahan, Emma K. Larkin, Carol L. Rosen, Gregory Graham, Susan Redline
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Measurement of pharyngeal dimensions may contribute to the characterization of anatomic risk factors for sleep-disordered breathing (SDB) in children. Acoustic pharyngometry, a noninvasive method, has been used successfully in adults, but application in children has been limited. We sought to evaluate the feasibility and utility of this technique in children, including assessment of the variation of pharyngeal measurements with height, sex, ethnicity, prematurity, and indices of SDB. Subjects were drawn from a large, community-based cohort of children of age 8–11 years. Demographic, morphologic, and sleep-related information were collected via standard questionnaires, direct measurement, and home cardiorespiratory monitoring during sleep. Pharyngeal dimensions were assessed in 203 children using acoustic pharyngometry performed with an optimized mouthpiece. In this sample, the coefficient of variation of minimum pharyngeal cross-sectional area (CSA) and mean CSA were similar to those in adults (8.0 and 11.1%, respectively). The minimum CSA, but not mean CSA, was significantly reduced in preterm children, habitual snorers, and children with SDB relative to unaffected children. Thus, minimum CSA is a useful measure for evaluating SDB risk factors in preadolescent children.
The Bactericidal Power of the Blood during Pregnancy and the Puerperium: And its Relationship to the Development and Course of Puerperal Infection
Authors: D. Miller, J. R. Whitaker
Journal: BMJ (1929)

MTDsCL JorrN 80 I hope whlat I have said about the Aberdeen report will show that, although it adds little to our knowledge of the causes -of maternal mortality, it is yet of great interest anid does a great deal to indicate the directioni along wilhieh further -inquiries may usefully proceed.We do not kniow what are the intentionis of the Ministry of Health wvitli regard to the English report; we may get a series of r-eports from different ceintres, or we may have to await tlle l)reparation of a national report.The work will occupy many years, and I am sure wre shiall be pl)e- pared to do everything we can to assist thle inivestigators in their tremiienidous task, realizing how urgently nlecessary it is in the nlational interest to reduce oul terrible wastage of miwaternal life.
437 ANRS 12202: HEPATITIS B AND DELTA HEPATITIS IN CENTRAL AFRICAN REPUBLIC (CAR): VIROLOGICAL REASSESSMENT OF A FULMINANT HEPATITIS OUTBREAK OCCURRING IN THE MID EIGHTIES
Authors: D. Samba, M. Abdou-Chekaraou, L. Gina, S. Brichler, C. Sholtés, N. Martel, J.-O. Ouavéné, A. Kay, O. Hantz, J.-L. Lesbordes, C. Trépo, E. Gordien, F. Zoulim, N.P. Komas, P. Dény
Journal: Journal of Hepatology (2012)
The Appropriateness of Tympanostomy Tubes for Children
Authors: David Grossman
Journal: JAMA (1995)

<h3>To the Editor.</h3> —In reading the article by Dr Kleinman and colleagues,<sup>1</sup>I was struck by their choice of words to describe the appropriateness or inappropriateness of the surgery for tympanostomy tubes. Specifically, their choice of the word "equivocal" to describe indications for the surgery. In my reading of their article, it seems to me that the "equivocal" indications were indications where expert panelists disagreed, where some rated the surgery as appropriate and others rated it as inappropriate. My interpretation of the word "equivocal" is that the surgery was of marginal appropriateness, and this has a very negative connotation. In their conclusion, they recommend that intervention should be made to reduce inappropriate and equivocal care to improve the quality of care being rendered to our children. Instead, I would recommend that they change the word equivocal to another, less negative word that better describes a difference of opinion among
THE PROPHYLAXIS OF INFLUENZA
Authors: Charles H. Carroll
Journal: JAMA (1918)

<h3>To the Editor:</h3> —At the end of the first week of the influenza epidemic at Newport (Sept. 15, 1918), while the disease was raging with great severity, 1,000 men were removed from the receiving barracks to the Vanderbilt farm (Camp Admiral Oman), 7 miles out of town. Here they were placed in large pyramidal tents, eight men to each tent. During the first three days, ninety-three new cases of influenza developed among the men at the camp. September 19, the fourth day at the camp, no new cases developed and the epidemic practically terminated, only an occasional sporadic case of influenza developing thereafter. The men at the camp mushroomed their tents every sunny day, ate at mess tables placed in the open, and were allowed no liberty during the first five weeks at the camp. It was noticed at the same time that the men in tents at the training
Interaction of capillary and tissue forces in the cat small intestine.
Authors: N A Mortillaro, A E Taylor
Journal: Circulation Research (1976)

We measured steady state capillary hydrostatic pressure (P c,i), plasma and lymph protein concentrations, lymph and blood flow, and capillary filtration coefficients in an in situ loop of cat small intestine at venous outflow pressures (PV) of 0, 5, 10, 15, 20, 25, and 30 mm Hg. The data were used to calculate colloid osmotic pressure of lymph and plasma, interstitial fluid pressure (Pt), pre- and postcapillary resistances, and a tissue pressure-volume curve of the intestinal interstitium. When PV was elevated from 0 to 30 mm Hg, lymph protein concentration decreased from 3.8 to 1.9 g/100 ml (representing a change in colloid osmotic pressure of 6.2 mm Hg), lymph flow increased 7-fold (or an equivalent imbalance in Starling forces of 4.3 mm Hg), and the calculated PT increased from 1.8 to +5.3. Because lymph flow draining the loop decreased during the determination of Pc, i at venous pressures between 15 and 30 mm Hg, the corresponding calculated PT may be in error by 1-2 mm Hg. The tissue pressure-volume relationship calculated from the data indicates that the intestinal interstitial volume expands nonlinearly and this expansion is characterized by two distinctly different compliant components: (1) tissue compliance is low at PV between 0 and 15 mm Hg (0.4 ml/mm Hg), and (2) at PV greater than 15 mm Hg the tissue compliance is relatively high (4 ml/mm Hg). We found that when PV was elevated from 0 to 15 mm Hg, increases in PT are the major tissue adjustments that oppose the increased filtration pressures. Furthermore, at Pv of 20-30 mm Hg, tissue protein concentration decreases, lymph flow relative to the filtration coefficient (deltaP DROP) increases and, to a much lesser extent, PT increases. Finally, the combination of these changes in tissue force at high filtration pressures represent a maximum tissue edema "safety factor" of 10 mm Hg; further increases in filtration pressures result in large volume movements into the intestinal lumen.
Some medical maxims do not age well: Andres
Authors: Donald E. Riesenberg
Journal: JAMA (1986)

Reubin Andres, MD, might be considered a gerontological iconoclast. As the chief of clinical physiology at the National Institute on Aging's Gerontology Research Center in Baltimore, he is waging an assault on several medical maxims. Andres questions whether the definition of obesity, diabetes mellitus, and even disease itself is age-dependent. This is nowhere more evident than in his reexamination of the "rocking-chair logic [that] tells you it's bad to gain weight as you get older." At the recent National Institutes of Health consensus development conference in Bethesda, Md, on health implications of obesity (<i>JAMA</i>[MEDICAL NEWS] 1985; 254:1878), Andres urged that the time-honored weight/mortality tables be adjusted according to age. These tables, initially published by Metropolitan Life Insurance Company in 1942, and updated in 1959 and 1983, are used to counsel overweight patients, calculate ideal weight for an individual, and assess health risks. The tables take into account sex and
Einfuhrung in die Balneologie und Medizinische Klimatologie
Authors: D. Preiskel
Journal: Annals of the Rheumatic Diseases (1952)

In this monograph, the author, a neurosurgeon, intends to bring the prolapse of intervertebral disks to the notice of surgeons and practitioners in Germany.His own experience appears to be very limited-only statistics taken from the predominantly American and British literature are given-and it is often not easy to discern whether he describes his own or quoted material and experience.The book takes the form of a collection of lectures, beginning with a chapter on the pathology and physiology of the disk, followed by discussions of the diagnosis, indications for, and technique of the operation, and the results as shown in the work of others.
Psychologists question "debriefing" for traumatised employees
Authors: G. Yamey
Journal: BMJ (2000)

UK employers are using a type of counselling known as debriefing for employees who have experienced psychological trauma, despite evidence that the technique is ineffective or even harmful, according to research presented at the British Psychological Society's annual occupational psychology conference last week.

The Institute for Employment Studies, an independent employment research organisation, assessed the debriefing interventions offered to employees of 18 different UK organisations. These included emergency medical services, hospital trusts, and industrial and …
Inefficacy and Proarrhythmic Effects of Flecainide and Encainide for Sustained Ventricular Tachycardia and Ventricular Fibrillation
Authors: John M. Herre
Journal: Annals of Internal Medicine (1990)

Objective: To assess the efficacy of encainide and flecainide in treating patients with sustained ventricular arrhythmias. Design: Patients were treated with encainide or flecainide. Efficacy was assessed by comparing the results of programmed ventricular stimulation while patients received therapy with the results while they were drug free. Setting: The electrophysiology laboratory of the University of California at San Francisco. Patients: Forty-nine patients with spontaneous or inducible sustained ventricular tachycardia or ventricular fibrillation for whom treatment with at least one class IA antiarrhythmic agent had failed. Interventions: Patients were treated with encainide, 35 to 50 mg three or four times daily, or flecainide, 100 to 200 mg twice daily. Results: Arrhythmia worsened early in 5 of 16 patients receiving encainide and 3 of 33 patients receiving flecainide. Patients with poor left ventricular function were more likely to exhibit proarrhythmia (P = 0.02). Nine of eleven patients receiving encainide and 23 of 28 patients receiving flecainide who had repeat programmed ventricular stimulation while receiving drug therapy still had inducible, poorly tolerated ventricular tachycardia. Conclusion: Encainide and flecainide have a low efficacy rate and a high incidence of worsening of arrhythmia in patients with sustained ventricular arrhythmias, particularly when this condition is associated with poor left ventricular function.
Authorship! Authorship! Guests, ghosts, grafters, and the two-sided coin
Authors: D. Rennie
Journal: JAMA (1994)

Authorship cannot be conferred; it may be undertaken by one who will shoulder the responsibility that goes with it. 1   Scientists who become authors display a rich variety of publication habits. Isaac Newton was famously reluctant to publish and, when he did, to attach his name to the work. 2 More recently, and less famously, Yury Struchkov published one paper every 3.9 days for 10 years, while 20 researchers worldwide each published at least once every 11.3 days throughout the decade of the 1980s. 3   See also p 438.  Whichever strategy is employed, the product of research is embodied in a manuscript that, once published, allows others to try to replicate and extend the work. Scientists believe they invest their lives in their research and in each manuscript. The published paper, though ostensibly merely a means of communication, is tangible evidence of this intellectual effort. Research workers, expecting to see
Inhibition of Autophagy Enhances Anticancer Effects of Atorvastatin in Digestive Malignancies
Authors: Pei-Ming Yang, Yuan-Ling Liu, Yi-Chu Lin, Chia-Tung Shun, Ming-Shiang Wu, Ching-Chow Chen
Journal: Cancer Research (2010)

Abstract Preclinical and clinical studies have shown that statins, the 3-hydroxy-3-methylglutaryl–CoA reductase inhibitors with cholesterol-lowering properties, exhibited anticancer effects. However, the underlying mechanisms remain ill defined. In this study, we showed that atorvastatin could inhibit the growth of hepatocellular carcinoma (HCC) and colorectal carcinoma (CRC) cells via induction of apoptosis. Atorvastatin also induced autophagy that is a physiologic process involved in the turnover of intracellular organelles. Atorvastatin-induced autophagy was found to be inhibited by AMP-activated protein kinase (AMPK) small interfering RNA. Examination of HCC patients showed the positive correlation between AMPK activity and autophagic marker (beclin-1). Atorvastatin-induced AMPK activation could induce p21 expression, which was also positively correlated with beclin-1 expression in CRC patients. AMPK/p21 signaling caused endoplasmic reticulum (ER) stress response leading to the induction of autophagy. Inhibition of autophagy by an autophagic inhibitor bafilomycin A1 or genetic knockout of autophagy-related gene 5 enhanced atorvastatin-induced cytotoxicity and apoptosis. In summary, activation of AMPK by atorvastatin enhances p21 expression and ER stress response, leading to autophagy, which promotes survival of cancer cells. Combinations of atorvastatin with bafilomycin A1 provide a novel and promising strategy to improve the treatment of digestive malignancies. Cancer Res; 70(19); 7699–709. ©2010 AACR.
Projections of Type 1 and Type 2 Diabetes Burden in the U.S. Population Aged &amp;lt;20 Years Through 2050
Authors: Giuseppina Imperatore, James P. Boyle, Theodore J. Thompson, Doug Case, Dana Dabelea, Richard F. Hamman, Jean M. Lawrence, Angela D. Liese, Lenna L. Liu, Elizabeth J. Mayer-Davis, Beatriz L. Rodriguez, Debra Standiford
Journal: Diabetes Care (2012)

OBJECTIVE To forecast the number of U.S. individuals aged &amp;lt;20 years with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) through 2050, accounting for changing demography and diabetes incidence. RESEARCH DESIGN AND METHODS We used Markov modeling framework to generate yearly forecasts of the number of individuals in each of three states (diabetes, no diabetes, and death). We used 2001 prevalence and 2002 incidence of T1DM and T2DM from the SEARCH for Diabetes in Youth study and U.S. Census Bureau population demographic projections. Two scenarios were considered for T1DM and T2DM incidence: 1) constant incidence over time; 2) for T1DM yearly percentage increases of 3.5, 2.2, 1.8, and 2.1% by age-groups 0–4 years, 5–9 years, 10–14 years, and 15–19 years, respectively, and for T2DM a yearly 2.3% increase across all ages. RESULTS Under scenario 1, the projected number of youth with T1DM rises from 166,018 to 203,382 and with T2DM from 20,203 to 30,111, respectively, in 2010 and 2050. Under scenario 2, the number of youth with T1DM nearly triples from 179,388 in 2010 to 587,488 in 2050 (prevalence 2.13/1,000 and 5.20/1,000 [+144% increase]), with the greatest increase in youth of minority racial/ethnic groups. The number of youth with T2DM almost quadruples from 22,820 in 2010 to 84,131 in 2050; prevalence increases from 0.27/1,000 to 0.75/1,000 (+178% increase). CONCLUSIONS A linear increase in diabetes incidence could result in a substantial increase in the number of youth with T1DM and T2DM over the next 40 years, especially those of minority race/ethnicity.
Risk factors and 25 year risk of coronary heart disease in a male population with a high incidence of the disease: the Finnish cohorts of the seven countries study.
Authors: J. Pekkanen, A. Nissinen, P. Puska, S. Punsar, M. J. Karvonen
Journal: BMJ (1989)

To assess the efficacy of high serum cholesterol concentration, raised blood pressure, and smoking as predictors of coronary heart disease.Prospective cohort study of middle aged men conducted over 25 years.Finish components of an ongoing international study (seven countries study).1520 Men who at age 40-59 in 1959 were free of clinically evident heart disease.At each follow up visit a detailed medical examination including resting electrocardiography was performed, blood pressure and serum total cholesterol concentration were measured, and smoking was assessed.825 Deaths (54% of participants) occurred during follow up, of which 335 were due to coronary heart disease. The hazard ratio for death from coronary heart disease with respect to risk factors at entry were: for serum cholesterol concentrations above 8.4 mmol/l v below 5.2 mmol/l, 2.68 (95% confidence interval 1.62 to 4.42); for systolic blood pressure in the highest quintile v that in the lowest quintile, 2.46 (1.72 to 3.50); and for smoking 10 or more cigarettes daily v never smoking, 1.95 (1.36 to 2.79). The hazard ratios with respect to cholesterol concentrations and blood pressure remained constant during follow up but the ratio with respect to smoking diminished, mainly owing to men giving up the habit. The estimated conditional probability of a 50 year old man dying of coronary heart disease in the next 25 years ranged from 12% among those with the most favourable risk factor profile to 75% among those with the least favourable profile.High risk factor levels (as determined in this study) in middle aged men may greatly increase the absolute probability of death from coronary heart disease when the period of study is relevant to the human life span.
Internet use is associated with utilization of genetic counseling for BRCA 1/2 mutations in women with a family history of breast or ovarian cancer
Authors: K. Armstrong, S. Gray, S. Domchek
Journal: Journal of Clinical Oncology (2006)

10654 Background: Women obtain breast cancer risk information from a variety of sources including mass media, the internet and personal and professional sources. Little is know about how internet use for health information influences choices about breast cancer risk evaluation and decision making. Methods: Case control study of 408 women with a family history of breast or ovarian cancer, of whom 217 underwent genetic counseling for BRCA 1/2 testing (cases) and 191 women who did not (controls). Participants received primary care within a large health system in greater Philadelphia, PA. Results: Women with a family history of breast or ovarian cancer who reported frequent use of the internet for health information (&gt;1–2 times a month) were significantly more likely to undergo genetic counseling for BRCA 1/2 testing than women that rarely used the internet to obtain health information (&lt;2 times a year) (odds ratio 2.6; 95% CI 1.7–4.0). This association persisted after adjustment for age, race, education and Gail risk (adjusted odds ratio 2.1; 95% CI 1.05–4.2) Conclusions: Frequent use of the internet for health care information is associated with higher use of genetic counseling for BRCA 1/2 mutations in women with a family history of breast or ovarian cancer. The association can not be explained by differences in education, cancer risk, age or race. A possible hypothesis for this association is that internet use exposes women to more information about genetic testing, BRCA testing opportunities and the experiences of other women who have utilized BRCA counseling services. No significant financial relationships to disclose.
Safety profile of a divided dose of propranolol for heart rate in children with infantile haemangioma during 16 weeks of treatment
Authors: H. Song, H. Shi, X. Zhang, J. Wang, Y. Yu, W. Chen, H. Zhou
Journal: British Journal of Dermatology (2014)

Although propranolol has been accepted as a first-line drug for infantile haemangioma (IH), no study has systematically characterized changes in heart rates during long-term propranolol treatment.To evaluate the influence of a divided dose of propranolol on heart rates in patients with IH.A prospective study was conducted from January 2009 to December 2013. All patients with IH were administered propranolol at 0·67 mg kg(-1) per day as a single dose on days 1 and 2, gradually increased to the full dose (2 mg kg(-1) per day) on day 5, which was given in three divided doses. Heart rates were recorded before treatment and were closely monitored during treatment. Heart rates in controls were monitored once a week.All heart rates monitored during treatment were found to be within the normal range. Fluctuations in heart rates were observed after every dose from the first day to the first dose of the sixth day; however, from the second dose of the sixth day onwards, no significant differences in heart rates were observed after each dose on successive days. During the second week of drug therapy, no significant differences in heart rates were observed at 1 h after the first dose (P = 1·00). Also, no significant differences (P = 0·73) in heart rates were observed between patients and controls at 1 h after the first dose on Mondays from week 1 to 16 of treatment.A three-times-daily dosing regimen of propranolol had no significant sustained effects on heart rates in subjects with IH.