tbuckley/cabot-search huggingface dataset:
Elastance of the Pleural Space: A Predictor for the Outcome of Pleurodesis in Patients with Malignant Pleural Effusion
Authors: Ray-Shee Lan
Journal: Annals of Internal Medicine (1997)

Background: In patients who have malignant pleural effusion, it is difficult to diagnose trapped lung before thoracoscopy, thoracostomy, and drainage of the effusion. Predicting the outcome of pleurodesis in patients who have malignant pleural effusion without trapped lung is also difficult. Objective: To investigate the factors that may be useful in diagnosing trapped lung and predicting the outcome of pleurodesis. Design: Prospective cohort study. Setting: University medical center. Patients: 65 patients with symptomatic malignant pleural effusion. Intervention: A chest tube was inserted for drainage of the effusion, and pleurodesis was done using bleomycin as the sclerosant. Measurements: The pH and glucose levels of the effusion and the elastance of the pleural space (defined as the decline in pleural fluid pressure in cm H2O after removal of 500 mL of effusion) were measured. The outcome of pleurodesis was evaluated 1 month after the chest tube was removed. Results: Patients with an elastance of 19 cm H2O or more had a higher incidence of trapped lung (11 of 14 patients) than did those with an elastance less than 19 cm H2O (3 of 51 patients) (P < 0.001). None of the 14 patients with an elastance of 19 cm H2O or more and none of the 14 patients with a trapped lung had successful pleurodesis. Forty-two of 43 patients with an elastance less than 19 cm H2O who did not have a trapped lung had successful pleurodesis. Elastance seemed to be the best predictor for trapped lung and outcome of pleurodesis, although outcome was also correlated with pH and glucose levels of the effusion. Low-dose bleomycin (30 mg) is as effective as the usual dose of bleomycin (60 mg) for pleurodesis. Conclusion: In patients with symptomatic malignant pleural effusion, measurement of the elastance of the pleural space is a simple and effective method for the diagnosis of trapped lung and prediction of the outcome of chemical pleurodesis with bleomycin.
Is ACE Gene Polymorphism a Useful Marker for Diabetic Albuminuria in Japanese NIDDM Patients?
Authors: Shinichi Nakajima, Tsuneharu Baba, Yoshitada Yajima
Journal: Diabetes Care (1996)

We studied the relationship between an insertion/deletion (I/D) polymorphism in the ACE gene and albuminuria/proteinuria in Japanese NIDDM patients.A total of 142 Japanese NIDDM patients (89 men, 53 women) with a known diabetes duration of 14 +/- 5 (mean +/- SD) years and an age of 56 +/- 6 years were divided into three groups according to the stage of nephropathy: 41 patients with normoalbuminuria, 47 patients with microalbuminuria, and 54 with overt proteinuria. The three groups were similar in age, diabetes duration, and recent HbAic level.The distribution of DD, ID, and II genotypes of the ACE gene did not differ among the three groups (10, 46, and 44% in the normoalbuminuric patients; 13, 53, and 34% in the microalbuminuric patients; and 15, 46, and 39% in the proteinuric patients, respectively). Meanwhile, the frequency of the D allele in the proteinuric male patients was slightly higher than in the normoalbuminuric male patients (45 vs. 27%, chi 2 = 3.9, P < 0.05), while the D allele frequency was nonsignificantly lower in the proteinuric female patients than in the normoalbuminuric female patients.These results did not support the hypothesis that the genotype of the ACE gene would be a clinically useful genetic marker for predicting the development of nephropathy in Japanese NIDDM patients. However, the role of D allele of ACE gene in the progression of nephropathy in male patients remains to be seen.
A FEW LIVING ISSUES AFFECTING THE HISTORY OF MEDICINE, AND WHAT CAME OF THEM.
Authors: DONALD MACLEAN
Journal: JAMA (1895)

The patriot poet of Scotland, Robert Burns, recalling the aspirations of his ardent young manhood, immortalized one of them in these simple but eloquent lines: "A wish (I mind its power), A wish that to my latest hour Shall strongly heave my breast; That I for poor auld Scotland's sake Some usefu' plan or book could make, Or sing a song at least." By simply substituting the larger term, Humanity, for the poetical and romantic one, Scotland, in this stanza, we have a sentiment appropriately expressive of the motive which brings us together to-day. The annual meeting of theAmerican Medical Associationoccurs at the brightest and sweetest season of the year and in most congenial surroundings. It never, as far as my recollection of its meetings extends, has failed to prove an occasion of delightful interchange of fraternal relations between its members, as well as season of practical advantage
External Cardiac Massage
Authors: J. Richard Baringer, Edwin W. Salzman, Wallace A. Jones, Allan L. Friedlich
Journal: New England Journal of Medicine (1961)

THORACOTOMY and open-chest cardiac massage have been used for some time in the management of sudden circulatory arrest. Although useful, the procedure is a formidable undertaking, particularly when not done in the operating room.Recently, Kouwenhoven, Jude and Knickerbocker∥ described a technic for cardiac massage without opening the chest. Their report, and the early gratifying experience with this technic at the Massachusetts General Hospital, prompted a review of the 84 cases in which it has been used here by many members of the staff during the past six months. Every case has been included in which external cardiac massage was . . .
TCT-694 Early Outcomes With Direct Flow Medical Versus 1°-Generation Transcatheter Aortic Valve Devices: A Single-Center Propensity-Matched Analysis
Authors: Gennaro Giustino, Azeem Latib, Vasileios F. Panoulas, Matteo Montorfano, Alaide Chieffo, Paola Spatuzza, Claudia Montanaro, Maurizio Taramasso, Filippo Figini, Katsumasa Sato, Eustachio Agricola, Pietro Spagnolo, Fabrizio Monaco, Ottavio Alfieri, Antonio Colombo
Journal: Journal of the American College of Cardiology (2014)
Nonvariceal Upper Gastrointestinal Bleeding
Authors: L. Aabakken
Journal: Endoscopy (2005)

This topic was elegantly reviewed a year ago by Rollhauser and Fleischer [1]. The conclusions at the time are largely echoed this year, with no major changes in either treatment algorithms or outcomes. The incidence of peptic ulcer bleeding appears to be declining slowly, more so in the duodenum, with a slight rise in the incidence of gastric ulcer. The value of early endoscopy appears to be clear, while second-look endoscopy remains controversial. Intensive-care monitoring appears to be of value, as well as proton-pump inhibitor (PPI) treatment, although protection against stress ulcers is still inadequate.
Complementary DNA cloning of the major allergenPhl p I from timothy grass (Phleum pratense); recombinantPhl p I inhibits IgE binding to group I allergens from eight different grass species
Authors: Sylvia Laffer, Rudolf Valenta, Susanne Vrtala, Markus Susani, Ronald van Ree, Dietrich Kraft, Otto Scheiner, Michael Ducheˆne
Journal: Journal of Allergy and Clinical Immunology (1994)
Immunostimulators induce granulocyte/macrophage colony-stimulating activity and block proliferation in a monocyte tumor cell line.
Authors: P Ralph, H E Broxmeyer, I Nakoinz
Journal: The Journal of Experimental Medicine (1977)

Monocyte tumor cell line PU5-1.8 does not normally produce colony-stimulating activity (CSA) required by granulocyte and macrophage progenitors to proliferate and mature in agar. However, CSA is induced in the culture line by as little as 10 ng/ml endotoxic lipopolysaccharide (LPS), with maximum CSA production and release to the medium between 2 and 3 days of incubation. Derived lipid A, but not alkali-treated LPS, is also active. Induction requires RNA and protein synthesis, but is not blocked by mitomycin C or Colcemid. Other inducers of CSA include Mycobacterium Bacillus Calmette-Guérin, tuberculin protein preparation purified protein derivative, zymosan, and phorbol myristate. All inducing agents are specific inhibitors of the monocyte tumor cell proliferation in vitro. Latex beads, another macrophage-activating agent, are rapidly phagocytosed by PU5-1.8 cells, but neither inhibit growth nor induce CSA.
Touching: The Human Significance of the Skin
Authors: Philip C. Anderson
Journal: JAMA (1978)

The personal wit, curiosity, and other literary skills of Ashley Montagu are presented to the reader, while the almost incidental topic is skin. The author, a famous anthropological journalist, shows such great enthusiasm and imagination when he presents information that he can give importance to the most trivial data. He has a thoroughly developed and fascinating opinion on almost everything, especially on matters so complex that experts would not venture any conclusions or on recondite matters about which almost nothing is known. If this skill is accepted as a journalistic technique aimed mostly at entertainment but also at teaching about general social viewpoints and far-reaching hypotheses, then both author and reader can enjoy the book. Knowledge of actual sciences or burdensome tests of truth or evidence should not disturb the spell; good fun is intended. Once the reader is in the proper spirit, he can learn whether men or women
Report on the Oxford Accident Service after 25 years.
Authors: J. C. Scott
Journal: BMJ (1967)

The comprehensive Accident Service in a teaching hospital dealing with all types of injury and under the general direction of an orthopaedic surgeon was pioneered in Oxford and opened in 1941. Twenty-five years in such an enterprise seems to afford an opportunity and a responsibility to take stock. The Accident Service was planned in 1940 and established in July 1941. The purpose was to provide a unified service for treatment of fractures and all other injuries. At first some justifiable misgivings were felt among general surgeons who had been accustomed to treating accidents, but once the decision was taken there was generous co-operation, and before long it was clear to all that the Accident Service had been an important advance in the hospital scheme. The aim was to ensure direc tion and supervision for the  department, and an important implication of this aim was that that department should be incorporated in the Accident Service to ensure a uniformly high standard of treatment. The casualty department of British hospitals is often the point of major public impact, providing an important service, and at the same time being most vulnerable to criticism and censure.
Action and Reaction: The Biological Response to siRNA and Its Delivery Vehicles
Authors: Rosemary L Kanasty, Kathryn A Whitehead, Arturo J Vegas, Daniel G Anderson
Journal: Molecular Therapy (2012)

RNA interference (RNAi)-based therapeutics have significant potential for the treatment of human disease. Safe and effective delivery of RNA to target tissues remains a major barrier to realizing its clinical potential. Several factors can affect the in vivo performance of short interfering RNA (siRNA) delivery formulations, including siRNA sequence, structure, chemical modification, and delivery formulation. This review provides an introduction to the principles underlying the pharmacokinetics and pharmacodynamics of systemically administered siRNA and its delivery formulations, including the factors that lead to its degradation, clearance, and tissue uptake, as well as its potential for immunogenicity, toxicity, and off-target effects within the body.
Breast Cancer and Thyroid Therapy
Authors: Colum A. Gorman
Journal: JAMA (1977)

IT HAS recently been reported<sup>1</sup>that, among patients undergoing mammography at a hospital in Detroit, the prevalence of breast cancer was higher in women receiving thyroid hormone therapy than in those who were not. Prevalence of breast cancer was said to increase with increasing duration of thyroid hormone treatment, particularly in nulliparous women. Since the time that this report appeared and was widely publicized by the news media, many patients have expressed concern that the thyroid hormone they are taking may be dangerous, and they have inquired as to whether such treatment should be stopped. The American Thyroid Association, whose membership comprises physicians and basic scientists interested in the thyroid and its diseases, views the aforementioned article with concern, both because of its implication of a possible basic relationship between thyroid therapy and breast cancer and because of its potential impact on the treatment of patients who require thyroid
The Evaluation of Efficacy and Adverse Effect in Intralymphatic Allergen-Specific Immunotherapy Against House Dust Mite, Cat, and Dog Allergens in Allergic Rhinitis
Authors: Sang Min Lee, Joo Hyun Jung, Seung Joon Choi, Eugene Joe, Shin Myung Kang, Yu Jin Kim, Sung Young Kyung, Jeong-Woong Park, Sung Hwan Jeong, Sang Pyo Lee
Journal: Journal of Allergy and Clinical Immunology (2015)
Think Globally Act Locally: The Case for Symphysiotomy
Authors: Douwe Arie Anne Verkuyl
Journal: PLoS Medicine (2007)

When expatriate doctors from developed countries working in sub-Saharan Africa suggest to the local doctors and midwives that symphysiotomies should sometimes be done, they are silenced neither with quotations from the medical literature nor with tales of patients seen, but with: "If symphysiotomies are such good operations why don't you perform them at home?" Here is why.
Comparative Study of KL-6, Surfactant Protein-A, Surfactant Protein-D, and Monocyte Chemoattractant Protein-1 as Serum Markers for Interstitial Lung Diseases
Authors: HIROSHI OHNISHI, AKIHITO YOKOYAMA, KEIICHI KONDO, HIRONOBU HAMADA, MASAHIRO ABE, KAZUTAKA NISHIMURA, KUNIO HIWADA, NOBUOKI KOHNO
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

KL-6, surfactant protein (SP)-A, SP-D, and monocyte chemoattractant protein-1 (MCP-1) are reported to be sensitive markers for interstitial lung diseases (ILD). However, each marker has been studied independently. The aim of this study was a comparative analysis of the diagnostic values of these markers. Subjects consisted of 33 patients with ILD (21 cases of idiopathic pulmonary fibrosis and 12 associated with collagen vascular diseases) and 82 control subjects (12 cases of bacterial pneumonia and 70 healthy volunteers). Receiver operating characteristic curves revealed that KL-6 was superior to the other markers. The cut-off levels for these markers that resulted in the highest diagnostic accuracy were determined to be 465 U/ml for KL-6, 48.2 ng/ml for SP-A, 116 ng/ml for SP-D, and 1080 pg/ml for MCP-1. The sensitivity, specificity, and diagnostic accuracy were 93.9%, 96.3%, and 95.7% for KL-6; 81.8%, 86.6%, and 85.2% for SP-A; 69.7%, 95.1%, and 87.8% for SP-D; and 51.5%, 92.7%, and 80.9% for MCP-1; respectively. The serum levels of SP-A and SP-D, but not of KL-6, were significantly higher in patients with bacterial pneumonia than in healthy volunteers. These results suggest that of the markers studied, KL-6 is the best serum marker for ILD.
Long-Term Therapy with Adefovir Dipivoxil for HBeAg-Negative Chronic Hepatitis B
Authors: Stephanos J. Hadziyannis, Nicolaos C. Tassopoulos, E. Jenny Heathcote, Ting-Tsung Chang, George Kitis, Mario Rizzetto, Patrick Marcellin, Seng Gee Lim, Zachary Goodman, Jia Ma, Sarah Arterburn, Shelly Xiong, Graeme Currie, Carol L. Brosgart
Journal: New England Journal of Medicine (2005)

Treatment with adefovir dipivoxil for 48 weeks resulted in histologic, virologic, and biochemical improvement in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B. We evaluated the effect of continued therapy as compared with cessation of therapy.One hundred eighty-five HBeAg-negative patients with chronic hepatitis B were assigned to receive 10 mg of adefovir dipivoxil or placebo once daily for 48 weeks (ratio, 2:1). After week 48, patients receiving adefovir dipivoxil were again randomly assigned either to receive an additional 48 weeks of the drug or to switch to placebo. Patients originally assigned to placebo were switched to adefovir dipivoxil. Patients treated with adefovir dipivoxil during weeks 49 through 96 were subsequently offered continued therapy. The primary end points were changes in hepatitis B virus (HBV) DNA and alanine aminotransferase levels.Treatment with adefovir dipivoxil resulted in a median decrease in serum HBV DNA of 3.47 log copies per milliliter (on a base-10 scale) at 96 weeks and 3.63 log copies per milliliter at 144 weeks. HBV DNA levels were less than 1000 copies per milliliter in 71 percent of patients at week 96 and 79 percent at week 144. In the majority of patients who were switched from adefovir dipivoxil to placebo, the benefit of treatment was lost (median change in HBV DNA levels from baseline, -1.09 log copies per milliliter; only 8 percent of patients had levels below 1000 copies per milliliter at week 96). Side effects during weeks 49 through 144 were similar to those during the initial 48 weeks. Resistance mutations rtN236T and rtA181V were identified in 5.9 percent of patients after 144 weeks.In patients with HBeAg-negative chronic hepatitis B, the benefits achieved from 48 weeks of adefovir dipivoxil were lost when treatment was discontinued. In patients treated for 144 weeks, benefits were maintained, with infrequent emergence of viral resistance.
Native C-Reactive Protein Increases Whereas Modified C-Reactive Protein Reduces Atherosclerosis in Apolipoprotein E–Knockout Mice
Authors: Susanne B. Schwedler, Kerstin Amann, Konstanze Wernicke, Alexander Krebs, Matthias Nauck, Christoph Wanner, Lawrence A. Potempa, Jan Galle
Journal: Circulation (2005)

C-reactive protein (CRP) may have proatherogenic but also vasoprotective properties. We tested the hypothesis that the configuration of CRP (pentameric, or native [nCRP], versus monomeric, or modified [mCRP]) determines these different characteristics in an in vivo model.We investigated the effects of human nCRP and mCRP on the development of atherosclerosis in apolipoprotein E-knockout (ApoE(-/-)) mice. Treatment with nCRP for 8 weeks (2.5 mg/kg SC weekly) resulted in a 4-fold-higher mean aortic plaque area in 14-week-old female ApoE(-/-) mice compared with the saline controls. In contrast, mean plaque size was decreased by approximately 50% in mCRP-treated ApoE(-/-) mice (2.5 mg/kg SC weekly). Using immunohistochemistry, we report the natural presence of the mCRP antigen in saline controls. mCRP antigen was expressed in smooth muscle cells and extracellularly in the vicinity of the plaques to a similar level in both CRP-treated groups and saline controls. mCRP and ApoB colocalized with macrophages and were equally upregulated in all aortic plaques. Vascular cell adhesion molecule expression was increased, and CD154 and intercellular adhesion molecule showed a trend for higher expression in nCRP-treated compared with mCRP-treated mice. CD154 expression in the vessel wall and plaque size correlated significantly. mCRP-treated ApoE(-/-) exhibited higher serum levels of the antiinflammatory interleukin-10 compared with the other 2 groups.Here, we show that mCRP and nCRP have opposite effects on atherosclerosis in ApoE(-/-) mice. These data may explain in part the conflicting activities previously reported for CRP in models of atherogenesis.
Serum and glucocorticoid inducible kinases in the regulation of the cardiac sodium channel SCN5A
Authors: C Boehmer
Journal: Cardiovascular Research (2003)

The serum and glucocorticoid inducible kinase SGK1 and its isoform SGK3 are both expressed in cardiac tissue. One of the functions of SGK1 is the phosphorylation and inactivation of the ubiquitin ligase Nedd4-2, which in turn could be shown to downregulate the voltage-gated Na+ channel SCN5A (hH1). The present study has been performed to test for a role of SGK1 and SGK3 in the regulation of SCN5A. To this end cRNA encoding the human Na+ channel SCN5A was injected into Xenopus laevis oocytes with or without cRNA encoding the wild-type kinases SGK1, the constitutively active kinase S422DSGK1, the inactive form K127NSGK1 or the wild-type SGK3. SCN5A currents were activated by coexpression of either wild-type SGK1 or SGK3 or the constitutively active S422DSGK1. In contrast, the inactive mutant K127NSGK1 significantly decreased the currents. Moreover, coexpression of SGK3 significantly altered SCN5A gating, i.e. it hyperpolarized the activation threshold and depolarized the prepotential required for 50% availability of the channel. Opposite shifts of gating properties were elicited by mutation of serine to alanine (S483ASCN5A and S663ASCN5A) in the SGK consensus sequences of SCN5A. The present observations disclose a role of the kinases SGK1 and SGK3 in the regulation of cardiac Na+ channels. As SGK1 is upregulated by glucocorticoids, mineralocorticoids and a variety of inflammatory mediators and both kinases are activated by insulin and IGF1, the kinases could mediate effects of those hormones and mediators on cardiac function.
Gamma-interferon production in atopic dermatitis shows differential modification by phosphodiesterase and prostaglandin inhibition
Authors: L. S. OSTLERE, R. B. MALLETT, A. KAMINSKI, E. R. KAMINSKI, R. S. PEREIRA, C. A. HOLDEN
Journal: British Journal of Dermatology (2006)

Interferon-gamma (IFN-gamma) production by peripheral blood mononuclear leucocytes (MNL) is reduced in atopic dermatitis (AD) patients. This may be related to abnormalities in second messenger systems, and increased prostaglandin E2 (PGE2) release from monocytes. We compared the effects of manipulating the second messenger activity using the phosphodiesterase (PDE) inhibitor Ro 20-1724, dibutyryl cyclic adenosine monophosphate (cAMP), and cyclooxygenase inhibition of PGE2, on IFN-gamma production by cultured MNL from AD patients (n = 9) and normal controls (n = 10). Ficoll-Hypaque-separated MNL were cultured for 48 h with OKT3 stimulation, and cAMP, Ro 20-1724, or indomethacin. Supernatants were analysed for IFN-gamma by ELISA. Basal IFN-gamma was lower in AD patients, and the increase in IFN-gamma production with OKT3 was 6.5-fold greater in control subjects than patients with AD. Culture with indomethacin significantly enhanced OKT3-stimulated IFN-gamma production in both groups, whereas OKT3-stimulated IFN-gamma production was abolished with dibutyryl cAMP. IFN-gamma production was significantly lower with Ro 20-1742 in AD than in normal controls. We have shown reduced IFN-gamma release from unstimulated and stimulated MNL in AD patients compared with normal controls. The addition of indomethacin increased IFN-gamma production in both groups, although the increase was less in AD patients, suggesting an intrinsic cellular defect. IFN-gamma release from AD MNL was more sensitive to the inhibitory effects of PDE, and this may be due to increased PDE activity, or the hyperdynamic cAMP system present in atopics.
Foundation trust regulator calls for less government interference
Authors: Andrew Cole
Journal: BMJ (2005)

The chairman of the Independent Regulator of NHS Foundation Trusts, Bill Moyes, has called for less government interference in the NHS and greater private sector involvement to help extend patient choice and “make failure real.”

Speaking at the sixth annual health care conference, organised by healthcare analysts LCS International Consulting, Dr Moyes said that determining whether a trust was failing was “gloriously ill defined.” At the moment trusts were either deemed to be financially viable or on “the cliff edge of insolvency.” He suggested a similar arrangement to that used for utilities such as gas and electricity, which offers an …