tbuckley/cabot-search huggingface dataset:
Do emergency tests help in the management of acute medical admissions?
Authors: A D S Smith
Journal: BMJ (1984)

dstress Metabolic ackiosis Hyperpyrexia Hyperglycoeamia R if nmpicin Bright red skin pigmentation Red discoloumtion d plasma and urine Liver damage Ethambutol Nausea Abdominal pain Fever Mental confusion Visual hallucinations Optic neuropathyCompound cough mixtures and cold remedies may contain a variety of opioids, antihistamines, and sympathomimetic and mucolytic agents.The management of opioid and antihistamine overdose is covered elsewhere.The various sympathomimetic agents cause acute behavioural disturbances including visual and auditory hallucinations as well as features of cc and i overactivity.These may require specific treatment in the form of sedation or sympathomimetic blocking agents, or both.Chronic use of these drugs may cause behavioural disorders and hallucinations which remit on withdrawal of the drug.Anticholinergic drugs-Agents such as ipratropium bromide are being used increasingly in the treatment of asthma.When administered by inhalation these have a wide safety margin, but accidental or deliberate self-poisoning with nebuliser fluid may cause pronounced anticholinergic poisoning.There have been a few reports of paradoxical bronchoconstriction after both aerosol or high dose nebulised anticholinergic compounds.The reaction to the aerosol is thought to be an allergic response, but the reaction to the nebulised solution may be due to inhalation of a non-isotonic solution.Corticosteroids are occasionally taken in acute overdose but toxic effects are unlikely.Sodium cromoglycate is of low toxicity and overdose needs no specific
An Offshore Haven for Human Embryonic Stem-Cell Research?
Authors: Susan Okie
Journal: New England Journal of Medicine (2005)

U.S. scientists studying human embryonic stem cells face unprecedented political, regulatory, and financial barriers created by the Bush administration's restrictive policies and by the ongoing national debate over the ethics of such research. The most promising method of making patient-specific and disease-specific embryonic stem-cell lines — somatic-cell nuclear transfer — is also the most ethically troubling for many people, because it requires both the creation of embryos for research purposes and the recruitment of women as egg donors. The procedure, in which the nucleus of a somatic cell is inserted into an oocyte, providing the genes for the development of . . .
Moving Boundaries — The Nightingale Twins and Transplantation Science
Authors: Stefan G. Tullius, Julia A. Rudolf, Sayeed K. Malek
Journal: New England Journal of Medicine (2012)

In 1960, a kidney from 12-year-old Lana Nightingale was transplanted into her twin sister Johanna — now the longest surviving kidney-transplant recipient. Their story reminds us that, like the physicians who care for them, patients help in advancing medicine.
Simultaneous detection of hepatitis C virus and interferon stimulated gene expression in infected human liver
Authors: Stefan Wieland, Zuzanna Makowska, Benedetta Campana, Diego Calabrese, Michael T. Dill, Josan Chung, Francis V. Chisari, Markus H. Heim
Journal: Hepatology (2013)

Approximately 50% of patients with chronic hepatitis C (CHC) have ongoing expression of interferon stimulated genes (ISGs) in the liver. It is unclear why this endogenous antiviral response is inefficient in eradicating the infection. Several viral escape strategies have been identified in vitro, including inhibition of interferon (IFN) induction and ISG messenger RNA (mRNA) translation. The in vivo relevance of these mechanisms is unknown, because reliable methods to identify hepatitis C virus (HCV)-infected cells in human liver are lacking. We developed a highly sensitive in situ hybridization (ISH) system capable of HCV RNA and ISG mRNA detection in human liver biopsies and applied it to study the interaction of HCV with the endogenous IFN system. We simultaneously monitored HCV RNA and ISG mRNA using HCV isolate- and ISG mRNA-specific probes in liver biopsy sections from 18 CHC patients. The signals were quantified at the single-cell resolution in a series of random high-power fields. The proportion of infected hepatocytes ranged from 1%-54% and correlated with viral load, but not with HCV genotype or ISG expression. Infected cells occurred in clusters, pointing to cell-to-cell spread as the predominant mode of HCV transmission. ISG mRNAs were readily detected in HCV-infected cells, challenging previously proposed mechanisms of viral interference with the immune system. Conversely, infected cells and neighboring cells showed increased ISG mRNA levels, demonstrating that the stimulus driving ISG expression originates from HCV-infected hepatocytes. HCV infection in human hepatocytes during CHC does not efficiently interfere with IFN induction, IFN signaling, or transcription of ISG mRNA.
Incremental cost-effectiveness of early and long-term clopidogrel in patients undergoing percutaneous coronary infarction in the CURE trial: The PCI-CURE economic analysis
Authors: Shamir R. Mehta, William S. Weintraub, Bengt Jonsson, Andre Lamy, Elizabeth Mahoney, Peter Lindgren, Marcus Flather, Michel E. Bertrand, Feng Zhao, Susan Chrolavicius, Keith A. Fox, Salim Yusuf
Journal: Journal of the American College of Cardiology (2003)
The Syk inhibitor fostamatinib disodium (R788) inhibits tumor growth in the Eμ- TCL1 transgenic mouse model of CLL by blocking antigen-dependent B-cell receptor signaling
Authors: Mirza Suljagic, Pablo G. Longo, Sara Bennardo, Emerald Perlas, Giuseppe Leone, Luca Laurenti, Dimitar G. Efremov
Journal: Blood (2010)
STUDIES OF BLOOD VOLUME IN THE TETRALOGY OF FALLOT AND IN OTHER TYPES OF CONGENITAL HEART DISEASE 1
Authors: Woodrow Nelson, H. S. Mayerson, John H. Clark, Champ Lyons
Journal: Journal of Clinical Investigation (1947)

The recent introduction by Blalock (1) of an operative procedure for the successful treatment of the tetralogy of Fallot has focused considerable at- tention on the various manifestations of this con- dition.It has also indicated the need of more in- formation to aid in the diagnosis and prognosis, as well as in the preoperative and postoperative treatment of the patients with this disease.The pres- ent study is concerned particularly with the measurement of blood volume, hemoglobin, and plasma protein in 7 cases of tetralogy of Fallot, 4 cases of isolated septal defect, and 1 case each of Eisen- menger complex, isolated pulmonic stenosis, coarctation of the aorta, congenital mitral stenosis, and patent ductus arteriosus.Fallot (2), in 1888, described the complex of combined congenital cardiac defects of pulmonic stenosis, right ventricular hypertrophy, patent in- terventricular septal defects, and dextroposition of the aorta which is commonly referred to as the "Tetralogy of Fallot."It is a common congenital defect of the heart.It constitutes 77 per cent of the 110 cases of pulmonary stenosis and 66 per cent of 40 cases of pulmonary atresia in Abbott's (3) series of 1,000 cases.The Eisenmenger com- plex is much less common.It differs from Fal- lot's tetralogy by having no pulmonary stenosis or atresia.The prognosis is somewhat better, the average life span being 16 years compared to 12.5 years in Fallot's type (4).The oldest age of sur- vival recorded in either type is 60 years (5).The principal extracardiac pathology of Fallot's tetralogy is a generalized vascular distention, cap- illary hyperplasia (3), and increased tortuosity.This is accompanied by polycythemia and in- creased blood viscosity.Blood arteriovenous-oxygen difference is increased, and its per cent oxygen 1One of series of studies being conducted under a grant from the Research and Development Division, Office of the Surgeon General, United States Army.saturation is decreased.Cyanosis, usually present at rest, is increased on exertion, when dyspnea also appears.4
Relationship Between Adrenergic Activity and Cardiac Actions of Quinidine
Authors: Jay Roberts, Richard P. Stadter, Vincent Cairoli, Walter Madell
Journal: Circulation Research (1962)

Unanesthetized dogs with complete heart block were used to explore the relationship between adrenergic activity and quinidine action on the heart. After vagolysis, quinidine still increased both the atrial and ventricular rates. Following reduction in adrenergic activity by reserpine, hexamethonium, or surgical sympathectomy, the atrial and ventricular pacemakers were depressed. After sympathetic activity had been reduced by a combination of hexamethonium and reserpine, quinidine caused profound pacemaker depression and sometimes ventricular asystole. Quinidine produced coupling and occasionally runs of ventricular tachycardia independent of the level of sympathetic activity. There was no significant prolongation of the QRS time by quinidine in doses of 5 and 10 mg./Kg. Both the development of ectopic pacemakers and the depression of pacemaker activity of quinidine were dose dependent.
Ten-year follow-up of quality of life in patients randomized to receive medical therapy or coronary artery bypass graft surgery. The Coronary Artery Surgery Study (CASS)
Authors: W J Rogers, C J Coggin, B J Gersh, L D Fisher, W O Myers, A Oberman, L T Sheffield
Journal: Circulation (1990)

Quality of life indexes were assessed in 780 patients 10 years after randomization to medical therapy (n = 390) or coronary artery bypass graft surgery (n = 390) in the Coronary Artery Surgery Study. At 10 years, mortality was 21.8% in the medical group and 19.2% in the surgical group (p = NS), and 144 (37%) of the medical group had undergone surgery because of increasing chest pain. At study entry, 22% of medical and surgical patients were angina free; at 1 and 5 years after entry, the frequency of asymptomatic patients was 66% and 63% in the surgical group and 30% and 38% in the medical group. However, by 10 years after entry, the proportion of patients free of angina had fallen to 47% in the surgical group and to 42% in the medical group. Activity limitation and use of beta-blockers and long-acting nitrates were less in the surgical than the medical group at 1 and 5 years after entry but little different from the medical group at 10 years after entry. Throughout follow-up, recreational status, employment status, frequency of heart failure, use of other medications, and hospitalization frequency were similar between the two groups. Thus, indexes of quality of life such as angina relief, increased activity, and reduction in use of antianginal medications initially appear superior in patients with stable manifestations of ischemic heart disease assigned to surgery, but by 10 years after entry, these advantages are much less apparent. Although the observed similarities of the medically and surgically assigned groups at 10 years reflect return of symptoms in the surgical group to some extent, a more important explanation is the performance of late surgery in a large proportion of the medically assigned patients, rendering them asymptomatic.
Views of doctors and managers on the doctor-manager relationship in the NHS
Authors: H. T O Davies
Journal: BMJ (2003)

A well functioning relationship between doctors and managers is crucial if government plans for “modernising” the NHS are to deliver real service improvements. 1 2 We aimed to shed some light on current perceptions of the doctor-manager relationship by examining areas of convergence or divergence of views among a large sample of doctors and managers in the NHS.

We conducted a postal questionnaire survey in NHS acute trusts across Great Britain during the summer of 2002. The survey included a census of chief executives and medical directors (from 197 trusts), together with a stratified cluster sample of both medical and non-medical managers at directorate level (clinical directors or their equivalent and non-medical directorate managers or their equivalent) randomly selected from 75 trusts. Comparisons between these different role groups form the central part of the analysis; we assessed variations across all four groups …
Prevalence and Progression of Subclinical Atherosclerosis in Younger Adults With Low Short-Term but High Lifetime Estimated Risk For Cardiovascular Disease
Authors: Jarett D. Berry, Kiang Liu, Aaron R. Folsom, Cora E. Lewis, J. Jeffrey Carr, Joseph F. Polak, Steven Shea, Stephen Sidney, Daniel H. O'Leary, Cheeling Chan, Donald M. Lloyd-Jones
Journal: Circulation (2009)

Background— We hypothesized that individuals with low 10-year but high lifetime cardiovascular disease risk would have a greater burden of subclinical atherosclerosis than those with low 10-year but low lifetime risk. Methods and Results— We included 2988 individuals ≤50 years of age at examination year 15 from the Coronary Artery Risk Development in Young Adults (CARDIA) study and 1076 individuals ≤50 of age at study entry from the Multi-Ethnic Study of Atherosclerosis (MESA). The 10-year risk and lifetime risk for cardiovascular disease were estimated for each participant, permitting stratification into 3 groups: low 10-year (&lt;10%)/low lifetime (&lt;39%) risk, low 10-year (&lt;10%)/high lifetime risk (≥39%), and high 10-year risk (≥10%) or diagnosed diabetes mellitus. Baseline levels and change in levels of subclinical atherosclerosis (coronary artery calcium or carotid intima-media thickness) were compared across risk strata. Among participants with low 10-year risk (91% of all participants) in CARDIA, those with a high lifetime risk compared with low lifetime risk had significantly greater common (0.83 versus 0.80 mm in men; 0.79 versus 0.75 mm in women) and internal (0.85 versus 0.80 mm in men; 0.80 versus 0.76 mm in women) carotid intima-media thickness, higher coronary artery calcium prevalence (16.6% versus 9.8% in men; 7.1% versus 2.3% in women), and significantly greater incidence of coronary artery calcium progression (22.3% versus 15.4% in men; 8.7% versus 5.3% in women). Similar results were observed in MESA. Conclusions— Individuals with low 10-year but high lifetime risk have a greater subclinical disease burden and greater incidence of atherosclerotic progression compared with individuals with low 10-year and low lifetime risk, even at younger ages.
The stratum granulosum: a contractile system
Authors: WALTER B. SHELLEY, LENNART JUHLIN
Journal: British Journal of Dermatology (1980)

Sheets of stratum granulosum of glycerinated cow hoof epidermis showed immediate contraction on exposure to ATP in the presence of calcium. Other layers of the epidermis were unresponsive. Contraction of the stratum granulosum could be induced also by dopamine, but not by a variety of other pharmacological agents. It could be blocked by EGTA, lidocaine, or high concentrations of potassium. It is postulated that the keratohyalin granule is a contractile protein uniquely responsible for the changes observed.
Nasal histamine release following hyperosmolar and allergen challenge
Authors: M. C. Krayenbuhl, B. N. Hudspith, J. Brostoff, G. K. Scadding, J. L. Guesdon, Y. Latchman
Journal: Allergy (1989)

Allergic rhinitis is characterised by symptoms of sneezing, itching of the nose with watery secretions, and nasal obstruction. We have previously shown that patients can have the diagnosis of allergic rhinitis confirmed by nasal provocation tests and assessment of nasal inspiratory peak flow (NIPF) after specific allergen or hyperosmolar challenge. We now show that histamine is released into the nasal lavage fluid in response to such challenges. Saline lavage alone results in detectable histamine levels in the order of 5 ng/ml, but in the presence of allergen (HDM) there is a significant increase in histamine release in atopies but not in control subjects. With hyperosmolar challenge, atopies showed a biphasic response in that histamine release was increased with 1.8% and 3.6% saline but returned to baseline with 5.4% and 7.2% saline, then showing a further increase with 9.0% saline. This raises the possibility of two populations of responsive mast cells. Hyperosmolar challenge leads to symptoms of nasal itch and sneezing as well as histamine release in atopics but not in controls. This suggests that hyperosmolar challenge can be used as a simple diagnostic test for allergic rhinitis and may provide a model for nasal hyper‐reactivity.
Developing world needs access to low cost pharmaceutical information from reliable sources
Authors: N. Pakenham-Walsh, M. Eddleston, M. Kaur
Journal: BMJ (1999)

EDITOR—Hafeez and Mirza have assessed how seriously (or not) pharmaceutical companies take their responsibility to provide information on request to prescribers in Pakistan.1 Two of their conclusions are that “providing information on drugs is not a priority for companies in Pakistan” and that “the decision to respond to a request for more information therefore seems to depend on how …
Training More Generalists
Authors: Christopher M. Lowther
Journal: Annals of Internal Medicine (1994)

Letters1 January 1994Training More GeneralistsChristopher M. Lowther, MDChristopher M. Lowther, MDP.O. Box 3017; Cheyenne, WA 82003Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-1-199401010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:“Who are these guys?” said Butch Cassidy to the Sundance Kid as Pinkerton's detectives chased the outlaws across the West. That was my question as I read Dr. Rivo's review [1] of factions that intend to force young people into internal medicine. Are they the stodgy academic types who are never on call, who rarely see a patient at night or on weekends, and who are protected by the residents they are finding increasingly difficult to hire? Whoever they are, they are not addressing the real issues. Recent surveys by the American College of Physicians suggest that ...REFERENCE1. Rivo M. Internal medicine and the journey to medical generalism. Ann Intern Med. 1993; 119:146-52. Google Scholar Author, Article, and Disclosure InformationAffiliations: P.O. Box 3017; Cheyenne, WA 82003 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1994Volume 120, Issue 1Page: 92-93KeywordsHealth careMedical servicesPrimary care physicians Issue Published: 1 January 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Can patients with cystic fibrosis have a career in the health service?
Authors: T J David
Journal: Journal of the Royal Society of Medicine (2002)

Patients with cystic fibrosis (CF) grow up in contact with a wide variety of health professionals, so it is hardly surprising that some wish to have a career in the health service. In an attempt to answer the question posed by the title, this editorial looks at three issues—the infection risks to the CF healthcare worker; the infection risks to the CF healthcare worker's patients; and the challenges of a health service career for an individual who already has to cope with the considerable demands of a CF therapy regimen.
Editor of the <i>BMJ</i> to take up new post
Authors: Zosia Kmietowicz
Journal: BMJ (2004)

The editor of the BMJ , Dr Richard Smith, is to leave the journal after 25 years to become the chief executive of a new European arm of a US healthcare company.

UnitedHealth Group is the largest healthcare company in the United States—with revenue last year of $28.8bn (£16.1bn;€24bn).

Commenting on his decisions to leave the BMJ , Dr Smith said in an email to staff: “I've spent long hours considering the many pluses and minuses of leaving, but ultimately I have two reasons for going. Firstly, …
Minimal Genetic Findings and Their Cancer Control Implications
Authors: Henry T. Lynch
Journal: JAMA (1978)

A kindred in which five first-degree relatives were initially known to exhibit colorectal, endometrial, and unspecified carcinoma for two generations, occurring at an early age and including three cases of multiple primary cancer, is consistent with criteria for the cancer family syndrome. Follow-up included a diligent surveillance program that led to the early diagnosis of colon cancer in a young member of the third generation who had been considered at high risk for this lesion. Manifestly, hereditary cancer syndrome identification may be expedited through longitudinal study of apparently cancer-prone kindreds, given limited historical information about tumor expression. However, cancer surveillance measures can and should be instituted early and predicated on clues that suggest, but need not be diagnostic of, such a hereditary cancer predisposing disorder. (<i>JAMA</i>240:535-538, 1978)
Intracardiac Injections During Resuscitation
Authors: Ronald W. Yakaitis
Journal: JAMA (1981)

To the Editor.—  Davison and his colleagues have performed a muchneeded service in reporting their experience with ICIs during resuscitation. Nevertheless, I still have difficulty accepting ICI as a customary route of drug administration, and I fear that their article may be construed as a blanket recommendation of ICI as an arbitrary option to IV drug administration. In an effort to counter this possibility, there are several points concerning ICI and this report that should be discussed.  First, the authors observed hemopericardium to be a relatively common but clinically insignificant complication of ICI. I submit that it would be difficult, in the heat of initial resuscitative attempts, to assess whether tamponade is either present or exerting any appreciable detrimental effect. Moreover, figures derived from living subjects regarding the relationship between tamponade and the rate of pericardial sac fluid accumulation may bear little, if any, resemblance to the hemodynamic situation in
Platelet-Derived Growth Factor–Stimulated Superoxide Anion Production Modulates Activation of Transcription Factor NF-κB and Expression of Monocyte Chemoattractant Protein 1 in Human Aortic Smooth Muscle Cells
Authors: Takeshi Marumo, Valérie B. Schini-Kerth, Beate Fisslthaler, Rudi Busse
Journal: Circulation (1997)

Background Platelet-derived growth factor (PDGF) and superoxide anion (O 2 ·− ) have been implicated in vascular diseases. We investigated whether PDGF stimulates the production of O 2 ·− in human aortic smooth muscle cells (HSMCs) and whether O 2 ·− leads in this way to the activation of nuclear factor–κB (NF-κB) and induction of monocyte chemoattractant protein 1 (MCP-1) in PDGF-stimulated HSMCs. Methods and Results PDGF-AB concentration- and time-dependently stimulated O 2 ·− generation from HSMCs. The stimulatory effect of PDGF-AB was mimicked by PDGF-BB but not by PDGF-AA. The generation of O 2 ·− by PDGF-AB was attenuated by the NAD(P)H oxidase inhibitor iodonium diphenyl, the specific protein kinase C (PKC) inhibitor Ro 31-8220, and the phosphatidylinositol 3-kinase inhibitor wortmannin. Allopurinol and nifedipine had no effect on PDGF-AB–induced O 2 ·− release, whereas indomethacin potentiated this response. Gel mobility shift assay revealed that PDGF-AB increased the binding activity of NF-κB, which contained predominantly the p50/p65 heterodimer in nuclear extracts from HSMCs. Superoxide dismutase as well as iodonium diphenyl, Ro 31-8220, and wortmannin attenuated PDGF-AB–induced activation of NF-κB and expression of MCP-1 mRNA. In contrast, superoxide dismutase did not inhibit the interleukin-1β–induced NF-κB activation. Conclusions The results demonstrate that PDGF stimulates O 2 ·− generation in HSMCs via PKC-dependent and wortmannin-sensitive pathways involving flavoenzyme(s). This PDGF-induced O 2 ·− production may be involved in vascular lesion formation by mediating, at least in part, NF-κB activation and MCP-1 induction.