tbuckley/cabot-search huggingface dataset:
The "British System" of Heroin Maintenance
Authors: Carl Weber
Journal: JAMA (1973)

<h3>To the Editor.—</h3> The system of opium prohibition produces exorbitant prices, intolerable crime, and frustrating and expensive attempts at criminal control. In England, the pharmacy cost of heroin is 4 cents a grain. The street price in the United States is $30 to $90 a grain or about a 1,000-fold increase over the legal price.<sup>1(p28-29)</sup>This astronomical profit margin provides incentive for continued smuggling, and accounts for the fact that addicts commit 75% to 80% of the crime in New York City.<sup>2</sup>It is estimated on the basis of 350,000 addicts (which is a conservative figure) that the annual cost of heroin purchases is about $1.5 billion. About $100 million is obtained by legal activity, about $500 million by prostitution, and about $900 million by property crimes. About $2.60 worth of property is required to yield $1 in cash. So the cost to victims of property crimes is
THE MAINTENANCE OF BLOOD COLLOID: PASSAGE OF STORED GUM ACACIA FROM THE CELLS TO THE CIRCULATION AFTER PLASMAPHERESIS
Authors: R. E. Knutti, R. A. Warrick, J. B. Goetsch
Journal: The Journal of Experimental Medicine (1950)

Removal of blood plasma by plasmapheresis from dogs made hypoproteinemic by injections of gum acacia over long periods of time, has resulted in the removal of more gum acacia than was originally present in the plasma. Gum acacia injections had been discontinued previous to the start of the experiments, and hence it must be concluded that the excess amounts of acacia were derived from deposits in the various organs. These observations verify the previous suggestion that the increase in blood acacia in the hypoproteinemic dog on a low protein diet is due to the transfer of acacia to the blood from its sites of deposit in the body. The experiments further suggest that the colloid content of the blood stream is maintained at the expense of tissue colloids, and support the idea that colloidal substances may pass in and out of cells.
Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation.
Authors: K B Kern, A B Sanders, S F Badylak, W Janas, A B Carter, W A Tacker, G A Ewy
Journal: Circulation (1987)

The ultimate goal of cardiopulmonary resuscitation (CPR) is long-term, neurologically intact survival. This study examined whether open-chest cardiac massage could improve 7 day survival and neurologic function when instituted after the failure of standard closed-chest compression CPR. Twenty-nine mongrel dogs were anesthetized and then instrumented with catheters to monitor right atrial and ascending aortic pressures. Ventricular fibrillation was induced and after 3 min standard CPR was begun. Standard CPR was performed with a Thumper programmed for 2 inch chest compressions at 60/min with a 50% duty cycle. External defibrillation was attempted twice after 15 min of ventricular fibrillation. Unsuccessfully defibrillated animals were randomly assigned to either an additional 2 min of continued closed-chest compressions, or 2 min of open-chest cardiac massage. All animals underwent a period of advanced cardiac life support and were followed until they were resuscitated or died. Follow-up care, including scoring of neurologic deficit, was performed for 7 days. In dogs receiving open-chest cardiac massage there was significantly more immediate resuscitation success (14/14 vs 5/14; p less than .005), 24 hr survival (12/14 vs 4/14; p less than .005), and 7 day survival (11/14 vs 4/14; p less than .02) than in those receiving continued closed-chest compression. Open-chest cardiac massage significantly improved long-term outcome when instituted after 15 min of ineffective closed-chest compression.
Impact of a Medical Journal Club on House-Staff Reading Habits, Knowledge, and Critical Appraisal Skills
Authors: M Linzer, J T Brown, L M Frazier, E R DeLong, W C Siegel
Journal: JAMA (1988)

The journal club is an established teaching modality in many house-staff training programs. To determine if a journal club improves house-staff reading habits, knowledge of epidemiology and biostatistics, and critical appraisal skills, we randomized 44 medical interns to receive either a journal club or a control seminar series. A test instrument developed by the Delphi method was administered before and after the interventions (mean, five journal club sessions). By self-report, 86% of the house staff in the journal club group improved their reading habits vs 0% in the control group. Knowledge scores increased more in the journal club group than in the control group, and a trend was found toward more knowledge gained as more sessions were attended. Ability to appraise critically a test article increased slightly in each group, but there was no significant difference between the groups. We conclude that a journal club is a powerful motivator of critical house-staff reading behavior and can help teach epidemiology and biostatistics to physicians-in-training. (<i>JAMA</i>1988;260:2537-2541)
Tuberculosis diagnostics: which target product profiles should be prioritised?
Authors: Sandra V. Kik, Claudia M. Denkinger, Martina Casenghi, Caroline Vadnais, Madhukar Pai
Journal: European Respiratory Journal (2014)

To the Editor: 

Globally, a third of all tuberculosis (TB) cases are not notified and many patients do not receive drug susceptibility testing (DST) [1]. New diagnostics can contribute to increased case detection, shorter diagnostic delay and reduced TB transmission. While the Xpert MTB/RIF assay (Cepheid Inc., Sunnyvale, CA, USA) is a much needed breakthrough [2], it may not reach lower tiers of the healthcare system [3] and doesn’t meet all needs ( e.g. cannot detect resistance against multiple drugs).

Several promising diagnostics are under development and companies are showing interest in TB products, inspired by the success of Xpert MTB/RIF [4]. But which new TB diagnostics should they invest in, and what is the potential market size for these products? Stakeholders have expressed a need for different products, including a test for childhood TB [5], a simple point-of-care-test for active pulmonary TB [6], a molecular smear replacement test [7], DST for expected new drug regimens [8], predictive biomarkers for latent TB infection (LTBI) [9], and treatment monitoring [10].

Given the variety of these needs, it is important for product developers to have access to: 1) a clearly identified list of diagnostics that are considered high priority by the TB community; 2) well developed, detailed target product profiles (TPPs) for priority diagnostics; and 3) up-to-date market size estimates for the priority TPPs. These issues are being addressed by ongoing activities, supported by the Bill and Melinda Gates Foundation (Seattle, WA, USA) and other partners [3, 7, 11].

TPPs are useful to align the end-users needs …
Smoking and Abnormalities in Renal Function
Authors: Sara-Joan Pinto-Sietsma, Wilbert M.T. Janssen, Paul E. de Jong
Journal: Annals of Internal Medicine (2001)

Letters3 July 2001Smoking and Abnormalities in Renal FunctionSara-Joan Pinto-Sietsma, MD, Wilbert M.T. Janssen, MD, PhD, and Paul E. de Jong, MD, PhDSara-Joan Pinto-Sietsma, MDUniversity Hospital Groningen; 9713 GZ Groningen, the Netherlands (Pinto-Sietsma, Janssen, de Jong)Search for more papers by this author, Wilbert M.T. Janssen, MD, PhDUniversity Hospital Groningen; 9713 GZ Groningen, the Netherlands (Pinto-Sietsma, Janssen, de Jong)Search for more papers by this author, and Paul E. de Jong, MD, PhDUniversity Hospital Groningen; 9713 GZ Groningen, the Netherlands (Pinto-Sietsma, Janssen, de Jong)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-1-200107030-00035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the interest in our recent article on smoking and renal abnormalities in nondiabetic persons. As Drs. Mehler and Estacio point out, smoking has been found to have adverse effects on renal function not only in patients with type 1 diabetes mellitus but also in those with type 2 diabetes mellitus (1). We agree with their plea that physicians should strongly encourage cessation of smoking in patients with type 2 diabetes mellitus. Our finding that smoking is also associated with both albuminuria and renal function changes in patients without diabetes argues that smoking has renal effects independent ...References1. Mehler P, Jeffers B, Biggerstaff S, Schrier R. Smoking as a risk factor for nephropathy in non–insulin-dependent diabetics. J Gen Intern Med. 1998;13:842-5. [PMID: 9844083] CrossrefMedlineGoogle Scholar2. Monster TBM, Janssen WMT, de Jong PE, de Jong-den Berg LTW. Oral contraceptives and hormone replacement therapy are associated with microalbuminuria. Arch Intern Med. [In press] Google Scholar3. Kellogg JH. Tobaccoism. Battle Creek, MI: Modern Medicine Publishing; 1922. Google Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital Groningen; 9713 GZ Groningen, the Netherlands (Pinto-Sietsma, Janssen, de Jong) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSmoking Is Related to Albuminuria and Abnormal Renal Function in Nondiabetic Persons Sara-Joan Pinto-Sietsma , Jaap Mulder , Wilbert M.T. Janssen , Hans L. Hillege , Dick de Zeeuw , and Paul E. de Jong Smoking and Abnormalities in Renal Function Philip S. Mehler and Raymond Estacio Smoking and Abnormalities in Renal Function Stephen J. Jay Metrics 3 July 2001Volume 135, Issue 1Page: 68KeywordsHormone replacement therapyHypertensionKidneysMicroalbuminuriaObesityOral contraceptive therapyRenal diseasesSmoking cessationType 1 diabetesType 2 diabetes ePublished: 3 July 2001 Issue Published: 3 July 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Superior Vena Caval Syndrome
Authors: Hugh H. Hussey
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Concerning the excellent report by Shimm et al (1981; 245:951), three comments merit consideration. First, the authors' initial reference citation carries the name, Kate S. I fear that Sol Katz, renowned expert in pulmonary diseases, may not take kindly to being called "Kate." Second, the change in etiology of superior vena caval syndrome has been remarkable since I reported 52 cases in 1939.<sup>1</sup>In the 1930s, syphilitic aneurysm of the aorta was the dominant cause, and in two such cases the aneurysm ruptured into the vena cava, thereby provoking a truly startling episode. Third, Shimm and his colleagues might have mentioned that mediastinal carcinoma (usually lung cancer) readily invades the vena cava, veins being susceptible to such encroachment whereas arteries are not. Also, when the vena cava is invaded, its lumen may be completely occluded or narrowed to a small slit (see Fig 17 in the first
TCT-482 Effect of Cangrelor on Ischemic Endpoints: Further Analyses from CHAMPION PHOENIX
Authors: Deepak L. Bhatt, Gregg W. Stone, Kenneth Mahaffey, C. Michael Gibson, Philippe G. Steg, Christian Hamm, Matthew J. Price, Tiepu Liu, Efthymios N. Deliargyris, Simona Skerjanec, Jayne Prats, Harvey D. White, Robert Harrington
Journal: Journal of the American College of Cardiology (2014)
Dual Endothelin Receptor Blockade Acutely Improves Insulin Sensitivity in Obese Patients With Insulin Resistance and Coronary Artery Disease
Authors: Gunvor Ahlborg, Alexey Shemyakin, Felix Böhm, Adrian Gonon, John Pernow
Journal: Diabetes Care (2007)

Endothelin (ET)-1 is a vasoconstrictor and proinflammatory peptide that may inhibit glucose uptake. The objective of the study was to investigate if ET (selective ET(A) and dual ET(A)+ET(B)) receptor blockade improves insulin sensitivity in patients with insulin resistance and coronary artery disease.Seven patients (aged 58 +/- 2 years) with insulin resistance and coronary artery disease completed three hyperinsulinemic-euglycemic clamp protocols: a control clamp (saline infusion), during ET(A) receptor blockade (BQ123), and during combined ET(A) (BQ123) and ET(B) receptor blockade (BQ788). Splanchnic blood flow (SBF) and renal blood flow (RBF) were determined by infusions of cardiogreen and p-aminohippurate.Total-body glucose uptake (M) differed between the clamp protocols with the highest value in the BQ123+BQ788 clamp (P < 0.05). The M value corrected by insulin was higher in the BQ123+BQ788 than in the control clamp (P < 0.01) or the BQ123 clamp (P < 0.05). There was no difference between the control clamp and the BQ123 clamp. Mean arterial pressure did not change during the control clamp, whereas it decreased during both the BQ123 (P < 0.01) and BQ123+BQ788 (P < 0.05) clamps. RBF increased and renal vascular resistance decreased in the BQ123+BQ788 clamp (P < 0.05) but not in the BQ123 clamp. There was no change in SBF in either clamp.Dual ET(A)+ET(B) receptor blockade acutely enhances insulin sensitivity in patients with insulin resistance and coronary artery disease, indicating an important role for endogenous ET-1.
Experimental Coxsackievirus Endocarditis
Authors: George E. Burch
Journal: JAMA (1966)

Although occasional references to viral endocarditis have appeared in the literature,<sup>1,2</sup>neither cardiologists nor pathologists generally consider endocarditis or valvulitis to be a complication of viral infection. However, it has been suggested that subendocardial fibroelastosis may be viral in etiology and it has recently been observed that children with subendocardial fibroelastosis have significant skin reactivity to mumps antigen.<sup>3</sup>In a previous report from this laboratory, it was postulated that some instances of acute and chronic valvulitis in man may be viral in This opinion was based on the following considerations: (1) a relatively large number of patients considered to have rheumatic valvular disease give no history of rheumatic fever, (2) chronic valvular disease may occur without Aschoff bodies or other pathological stigmata of rheumatic valvulitis, (3) acute valvulitis has been reported in experimental animals following viral infection,<sup>5-7</sup>and (4) there is no basis for assuming that the
Community-acquired pneumonia: impact of immune status.
Authors: L M Mundy, P G Auwaerter, D Oldach, M L Warner, A Burton, E Vance, C A Gaydos, J M Joseph, R Gopalan, R D Moore
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

This cross-sectional and prospective one year study evaluated adults admitted to an inner city hospital with community-acquired pneumonia. The study used extensive diagnostic methods to evaluate the etiologies of community-acquired pneumonia in hospitalized patients with differing immunologic status. Of 385 study patients, concurrent problems associated with immunosuppression were noted in 221 (57%) patients, 180 of whom were human immunodeficiency virus (HIV)-infected. The five most common causes of community-acquired pneumonia were: Streptococcus pneumoniae, Pneumocystis carinii, aspiration, Hemophilus influenzae, and gram-negative bacilli. Only 8.3% of patients had either Legionella, Chlamydia pneumoniae or Mycoplasma pneumoniae. Despite use of state-of-the-art diagnostic techniques, no diagnosis was made in 46 of 180 (25.6%) HIV-infected patients, 56 of 164 (34.1%) immunocompetent patients, and 20 of 41 (48.8%) non-HIV-infected immunosuppressed patients. The diagnostic yield of pre-antibiotic sputum culture for conventional bacteria was 99/155 (63.9%) compared to 52 of 169 patients (32.7%) with adequate post-antibiotic sputum culture (p < 0.0001). Although S. pneumonia continues to be the most commonly identified etiologic agent of community-acquired pneumonia, it is surpassed by P. carinii in the HIV-infected patient population. The apparent decline in the frequency of S. pneumoniae in our series presumably reflects administration of antibiotics prior to procurement of sputum culture. The paucity of atypical agents in this study support the current American Thoracic Society guidelines for selective use of macrolide therapy in immunocompetent adults hospitalized with community-acquired pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)
Tackling community-acquired methicillin-resistant<i>Staphylococcus aureus</i>in collegiate football players following implementation of an anti-MRSA programme
Authors: S Scott Sutton, Jason J Stacy, James Mensch, Toni Torres-McGehee, Charles L Bennett
Journal: British Journal of Sports Medicine (2013)

Competitive football players’ safety has become an important concern at the high school, collegiate and professional level and warrants attention.1–4 From 2003 to 2008, five players at our institution developed clinically significant community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections requiring hospitalisation and intravenous antibiotics. In 2008, the University of South Carolina team instituted anti-MRSA precautions based on recommendations made by the Centers for Disease Prevention and Control (CDC) (box 1). In an attempt to understand if guidelines recommended by the CDC resulted in low MRSA colonisation rates, we randomly selected players on a Division I collegiate football programme to evaluate colonisation for MRSA obtained from nares, helmets and shoulder pads. Inclusion criteria were age 18 or older and current team member. Exclusion criteria were presence of skin infection, receiving antibiotics or hospitalisation in the prior month. The study received IRB approval and informed consent was obtained from study participants. A research assistant or team physician obtained specimens from the nares, helmet and shoulder pads with a cotton-tipped swab from …
Abstract 4652: Urinary levels of the tobacco-specific carcinogen N′-nitrosonornicotine and its glucuronide are strongly associated with esophageal cancer risk in smokers in the Shanghai Cohort Study
Authors: Jian-Min Yuan, Aleksandar D. Knezevich, Renwei Wang, Yu-Tang Gao, Stephen S. Hecht, Irina Stepanov
Journal: Cancer Research (2011)

Abstract Background: Experimental studies have shown that the tobacco-specific nitrosamine N′-nitrosonornicotine (NNN) can induce esophageal cancer in rats. However, epidemiological data that directly link NNN to esophageal cancer in humans have been lacking. Methods: A nested case-control study of esophageal cancer including 77 cases and 223 individually matched control subjects within the Shanghai Cohort Study was conducted to examine the association between urinary NNN and risk of developing esophageal cancer among male current smokers. Besides urinary creatinine (Cr) and total cotinine, urinary free NNN and its pyridine-N-glucuronide (NNN-N-Gluc) were quantified separately for each study sample by liquid chromatography- tandem mass spectrometry. A conditional logistic regression method was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for esophageal cancer associated with elevated urinary NNN. All P values reported were two-sided. Results: Esophageal cancer patients had significantly higher urinary levels of free NNN (geometric mean 58.2 fmol/mg Cr), NNN-N-Gluc (49.8 fmol/mg Cr) and the sum of the two, referred to as total NNN (117.9 fmol/mg Cr), than control subjects (geometric means 18.2, 24.4, and 45.1 fmol/mg Cr, respectively) whereas the ratio of NNN-N-Gluc to total NNN was significantly lower in cancer patients (46.7%) than controls (56.4%) (all P's &amp;lt; 0.0001). Compared with the lowest quartile, ORs (95% CIs) for esophageal cancer for the 2nd, 3rd, and 4th quartiles of free NNN were 2.61 (0.80-8.55), 5.74 (1.67-19.75), and 30.64 (7.70-121.93), respectively, after adjustment for smoking intensity and duration (Ptrend &amp;lt; 0.0001). Additional adjustment for urinary cotinine strengthened the association, and ORs (95% CIs) became 4.46 (1.14-17.41), 13.83 (3.21-59.53) and 128.22 (19.9-826.7) (Ptrend &amp;lt; 0.0001). In contrast, the ratio of NNN-N-Gluc to total NNN was inversely associated with esophageal cancer risk. The smoking-adjusted ORs (95% CIs) for the 2nd, 3rd, and 4th quartiles were 0.43 (0.20-0.96), 0.23 (0.09-0.56) and 0.20 (0.08-0.50), respectively, compared with the lowest quartile (Ptrend =0.0002). Additional adjustment for urinary total cotinine did not materially alter the observed ORs. Conclusion: The findings of the present study indicate that the tobacco-specific nitrosamine NNN plays a significant role as a cause of esophageal cancer in smokers. In contrast, the glucuronidation of NNN may protect against the development of tobacco-related esophageal cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4652. doi:10.1158/1538-7445.AM2011-4652
Ige Responses To Chlamydia Pneumoniae (cpn) In Allergic Asthma
Authors: A. Shulman, S. Kohlhoff, E. Estrella, K. Kalra, T. Smith-Norowitz, H. Durkin, M. Hammerschlag, R. Joks, D. Weaver
Journal: Journal of Allergy and Clinical Immunology (2010)
Highly selective vagotomy and duodenal ulcers that fail to respond to H2 receptor antagonists
Authors: J N Primrose, A T R Axon, D Johnston
Journal: BMJ (1988)

A study was conducted to see whether patients with duodenal ulcers that failed to heal in response to H2 receptor antagonists had a higher incidence of recurrent ulceration after highly selective vagotomy than patients whose ulcers healed with these drugs. Between 1977 and 1983, 157 patients had a highly selective vagotomy for uncomplicated duodenal ulcer; in 57 patients the ulcer had failed to heal despite treatment with H2 receptor antagonists (refractory group), 19 patients had developed recurrent ulceration while receiving maintenance treatment, 67 patients had remained healed while taking H2 receptor antagonists but suffered frequent relapses when treatment was stopped, and 14 patients had not been given these drugs before operation. The overall incidence of recurrent ulceration was 6% after two years and 11% after five years of follow up. In the refractory group, however, the incidence of recurrent ulceration was 18% at two years and 34% after five years, whereas the incidence of recurrence was only 1.5% at two years and 3% after five years in patients whose ulcers had healed with H2 receptor antagonists. Resistance to H2 receptor antagonists was not related to preoperative basal or peak acid output but was related to cigarette smoking. Factors associated with recurrent ulceration after highly selective vagotomy were basal acid outputs before and after operation, cigarette smoking, and the surgeon who performed the operation. Duodenal ulcers that fail to respond to H2 receptor antagonists represent a more severe ulcer diathesis, for which highly selective vagotomy is less effective.