tbuckley/cabot-search huggingface dataset:
Carotid Sinus Massage
Authors: Samuel A. Levine
Journal: JAMA (1962)

IN MOST INSTANCES, the diagnosis of angina pectoris can readily be made from the clinical history. When the patient has the classical complaints, he has angina pectoris or he is a malingerer. These complaints may consist of midchest distress, a constriction or pressure or clutching pain, with radiation to the left arm, back of neck, or jaw, which comes on certain efforts ( especially walking ) or on excitement, disappears in a few minutes, and is relieved promptly by nitroglycerin. There are many variations in symptomatology, and yet the diagnosis, generally, is quite clear. However, in numerous instances of chest pain or discomfort, the diagnosis is doubtful. Other means of study are then employed. The electrocardiogram ( ECG ) may reveal definite evidence of heart muscle disease or myocardial infarction. When such evidence is found, one can at least be certain that some form of heart disease is present, even
Multi-infarct Dementia-Reply
Authors: Robert L. Rogers
Journal: JAMA (1987)

<h3>In Reply.—</h3> We wish to thank Dr Cohen for his interest in our article entitled "Improved Cognition After Control of Risk Factors for Multi-infarct Dementia." We agree that multiple bilateral cerebral embolism from cardiac disease with dysrhythmia may be a cause of MID, but it is relatively rare (2% in our series of patients). Such cases due to cardiac emboli are being investigated in our ongoing prospective studies of stroke and MID. In the series of patients we described in our article, cases of MID due to cardiac emboli were excluded. Only two of the most common forms of MID were considered in our article, those due to multiple lacunar infarctions and to watershed cerebral infarcts associated with occlusive disease of the carotid arteries. We agree that heart disease is an important risk factor associated with stroke and MID. We also agree that treatment of heart disease and cardiac dysrhythmias
Renal Cortical Blood Flow, Cortical Fraction, and Cortical Blood Volume in Hypertensive Subjects
Authors: ALEXANDER G. LOGAN, MANUEL T. VELASQUEZ, JAY N. COHN
Journal: Circulation (1973)

In 15 patients with essential hypertension total blood flow to a single kidney (TRBF) was measured by a constant infusion indicator-dilution technic which had previously been validated in dogs. Indocyanine green indicator-dilution curves then were used to calculate the fraction of renal flow traversing the rapid (cortical) circulation and the blood volume in this cortical compartment. TRBF ranged from 152 to 1033 ml/min/1.73m 2 per kidney and was closely correlated with cortical flow (r = 0.99). The cortical fraction of TRBF ranged from 46 to 93% and varied directly with total flow (r = 0.69). Noncortical flow ranged from 12 to 85 ml/min/1.73m 2 per kidney and showed no correlation with TRBF. Cortical blood volume varied from 12 to 85 ml/1.73m 2 and also was closely correlated with TRBF (r = 0.93). These data suggest that diminished TRBF in hypertensive patients is due to reduction in cortical flow with preservation of noncortical (medullary) flow and reduction in cortical blood volume. The reduced cortical fraction of TRBF could be a factor in the renal functional abnormalities which occur in hypertension.
Isolation of a nitric oxide inhibitor from mammary tumor cells and its characterization as phosphatidyl serine.
Authors: C Calderón, Z H Huang, D A Gage, E M Sotomayor, D M Lopez
Journal: The Journal of Experimental Medicine (1994)

Macrophages from mice bearing large D1-DMBA-3 mammary tumors have a decreased capacity to kill tumor targets. This effect is due to an impaired ability to produce nitric oxide (NO) in response to lipopolysaccharide (LPS) stimulation. Here we report that the DA-3 tumor cell line, derived from the in vivo adenocarcinoma D1-DMBA-3, produces a factor that inhibits both NO production/release and cytotoxicity of LPS-activated peritoneal exudate macrophages (PEM). However, other complex macrophage functions such as phagocytosis, superoxide production, mitochondrial dehydrogenase activity, and synthesis of proteins were not reduced by this factor. The NO inhibitor has been found to be lipid in nature. Lipid extracts from DA-3 cell culture supernatants were purified by repeated silica gel column chromatography. The active molecule was unambiguously characterized as phosphatidyl serine (PS) by fast atom bombardment tandem mass spectrometry. Preliminary results indicate a lack of induced NO synthase (iNOS) activity in the lysates of LPS-activated PEM pretreated with PS. The ubiquity of PS in the inner leaflet of biological membranes and its NO inhibitory property, suggest that this phospholipid may be one of the long elusive molecules responsible for regulating physiological levels of NO in the host and hence preventing cellular dysfunction and/or tissue damage. Furthermore, the possible overexpression and shedding of PS by DA-3 tumor cells may represent a novel mechanism to impair macrophage cytotoxicity, a host function that contributes to the protection against developing neoplasms.
A Smarter Strategy? — Reflections on Fecal DNA Screening for Colorectal Cancer
Authors: Steven H. Woolf
Journal: New England Journal of Medicine (2004)

Colorectal cancer, the second leading cause of death from cancer in the United States, will claim approximately 56,730 lives in 2004.1 Screening for colorectal cancer lowers both the mortality and the incidence of the disease and is widely recommended for persons 50 years of age or older. Interest in screening has increased in recent years but remains low. Only 53 percent of Americans who are 50 years of age or older have undergone screening within the recommended intervals.2 The needless deaths from and complications of colorectal cancer that occur as a consequence of this low rate of screening make correction . . .
Hazards of Echocardiographic Interpretation
Authors: Harvey Feigenbaum
Journal: New England Journal of Medicine (1973)

Echocardiography is entering a critical stage in its development. For many years the technic was considered only an interesting curiosity. However, recently the clinical usefulness of echocardiography has increased tremendously. Many new diagnostic applications, together with the prospect of obtaining direct anatomic and physiologic information in a noninvasive manner, have stimulated great enthusiasm for the technic. Unfortunately, this enthusiasm and general acceptance are creating some problems. First of all, echocardiography has frequently been described as being "simple." This statement is extremely misleading. The examination may produce no discomfort or hazard to the patient; however, one must remember that an improper . . .
487 Global hypoxia sensitizes liver to subsequent lipopolysaccharide: A new 2-hit model?
Authors: L TUCKER, A KONNO, G ARTEEL
Journal: Hepatology (2003)

Resveratrol is a natural polyphenol found in grapes and wine and has been associated with protective effects against cardiovascular diseases. In vitro, both resveratrol preconditioning (RPC) and ischemic preconditioning (IPC) require activation of sirtuin 1 (SIRT1), a nicotinamide adenine dinucleotide (NAD+)-dependent deacetylase, to induce neuroprotection against cerebral ischemia. In the present study, we tested two hypotheses: (a) that neuroprotection against cerebral ischemia can be induced by RPC in vivo; and (b) that RPC neuroprotection involves alterations in mitochondrial function via the SIRT1 target mitochondrial uncoupling protein 2 (UCP2). IPC was induced by 2 min of global ischemia (temporary bilateral carotid artery occlusion with hypotension), and RPC, by i.p. injection of resveratrol at 10, 50 and 100 mg/kg dosages. Forty-eight hours later, we compared the neuroprotective efficacy of RPC and IPC in vulnerable cornu ammonis 1 hippocampal pyramidal neurons using a rat model of asphyxial cardiac arrest (ACA). SIRT1 activity was measured using a SIRT1-specific fluorescent enzyme activity assay. In hippocampal mitochondria isolated 48 h after IPC or RPC, we measured UCP2 levels, membrane potential, respiration, and the mitochondrial ATP synthesis efficiency (ADP/O ratio). Both IPC and RPC induced tolerance against brain injury induced by cardiac arrest in this in vivo model. IPC increased SIRT1 activity at 48 h, while RPC increased SIRT1 activity at 1 h but not 48 h after treatment in hippocampus. Resveratrol significantly decreased UCP2 levels by 35% compared to sham-treated rats. The SIRT1-specific inhibitor sirtinol abolished the neuroprotection afforded by RPC and the decrease in UCP2 levels. Finally, RPC significantly increased the ADP/O ratio in hippocampal mitochondria reflecting enhanced ATP synthesis efficiency. In conclusion, in vivo resveratrol pretreatment confers neuroprotection similar to IPC via the SIRT1–UCP2 pathway.
Medicare's Declining Payments to Physicians
Authors: John K. Iglehart
Journal: New England Journal of Medicine (2002)

The promising efforts of the Bush administration and Congress to fix Medicare's troubled relationship with physicians have suffered a sharp setback. On the basis of a formula prescribed by law, the Centers for Medicare and Medicaid Services (CMS) implemented an across-the-board reduction in Medicare fee-for-service payments that averaged 4.9 percent and took effect January 1.1 The unwillingness of Congress and the Bush administration to provide a quick fix for the payment reduction was an early omen of the challenging days that lie ahead for Medicare and the 550,000 physicians who provide care to the program's 39 million disabled or elderly . . .
Immunologic Mechanisms in Allergic Disease.
Authors: Bram Rose
Journal: Annals of Internal Medicine (1967)

s1 May 1967Immunologic Mechanisms in Allergic Disease.Bram Rose, M.D., F.A.C.P.Bram Rose, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1026_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe nature and significance of immunologic A mechanisms and allergic diseases have been clarified considerably in recent years by the application of newer physicochemical methods. The ragweed system that has been the most extensively studied will be described as a model relative to the three well-defined antibody systems related to it. These are, first of all, reagin of skin sensitizing—and more recently called the homocytotropic antibody—blocking, and hemagglutinating antibodies. Of these, reagin is of prime concern in that it is capable, when combined with an allergen after having been fixed to a cell in the absence of complement, of releasing... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Bram Rose, M.D., F.A.C.P.Affiliations: Montreal, Quebec, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1026-1027KeywordsAllergensAllergic diseases ePublished: 1 December 2008 Issue Published: 1 May 1967 PDF downloadLoading ...
The case for total gastrectomy in multiple polyposis of the stomach
Authors: R. A. Roxburgh
Journal: Gut (1962)

There is a considerable risk that a patient with multiple polyposis of the stomach will develop carcinoma of the stomach and this risk is greater than that of total gastrectomy when performed for benign conditions. Total gastrectomy is therefore sound treatment for this disease, regardless of the distribution of the lesions over the gastric mucosa, and a patient successfully treated in this way is reported. Reference is also made to a patient who died untreated and was found to have both multiple polyposis and gastric carcinoma.
The Quality of Gastroenterological Reports Based on Free Text Dictation: An Evaluation in Endoscopy and Ultrasonography
Authors: K. Kuhn, W. Swobodnik, R. S. Johannes, T. Zemmler, E. F. Stange, H. Ditschuneit, M. Classen
Journal: Endoscopy (1991)

The majority of physicians consider the use of free dictation for medical reports to be essential in many domains. One of the main criticisms of structured data entry is the possible lack of flexibility and completeness. Electronic documentation systems exist for endoscopy and ultrasonography examinations which are based on structured input as well as on free dictation. Endoscopy and ultrasonography reports based on free dictation were evaluated for omissive errors. The data evaluated was drawn from a database of 18,239 gastroscopy and 3,340 colonoscopy reports dictated by 28 physicians over 74 months, and 18,834 ultrasonography reports dictated by 37 physicians over 42 months. The error rates varied from 0% to 41.8% depending upon the particular feature and the particular examination, but were usually below 15%. The results were independent of the experience of the examiner. This study provides baseline measurements of omissive error rates for selected findings in gastrointestinal endoscopy and abdominal ultrasonography which can be used as standards for the development and evaluation of systems for collection of clinical data.
Effect of Laboratory Variation in the Prothrombin-Time Ratio on the Results of Oral Anticoagulant Therapy
Authors: Mark H. Eckman, Herbert J. Levine, Stephen G. Pauker
Journal: New England Journal of Medicine (1993)

Patients receiving long-term anticoagulant therapy may be subject to unnecessary risks of bleeding or thromboembolism because of variability in the commercial thromboplastins used to determine prothrombin time and consequent uncertainty about the actual intensity of anticoagulation.
Conn's Sign or Duck?
Authors: DONALD O. CASTELL
Journal: Annals of Internal Medicine (1971)

Letters, Comments, and Corrections1 September 1971Conn's Sign or Duck?DONALD O. CASTELLDONALD O. CASTELLSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-3-482_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent brief communication by Dr. Harold Conn concerning "Sudden Scrotal Edema in Cirrhosis" which appeared in the June 1971 issue of the ANNALSbrought to mind an interesting experience. While visiting with Dr. Conn during the past year at the West Haven Veterans Hospital, I had the occasion to discuss the phenomenon described in this brief communication. Since I had not previously been aware of such a happening, Dr. Conn took me to the room of a patient with cirrhosis and ascites who had recently had a paracentesis. Upon entering the room the patient was noted... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DONALD O. CASTELLAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUnilateral Edema and Jaundice After Portacaval AnastomosisHAROLD O. CONN 1 September 1971Volume 75, Issue 3Page: 482-482KeywordsAscitesCirrhosisEdema ePublished: 1 December 2008 Issue Published: 1 September 1971 PDF downloadLoading ...
THE DIFFERENTIAL DIAGNOSIS OF TYPHOID FEVER.
Authors: WILLSON O. BRIDGES
Journal: JAMA (1902)

The combined group of symptoms which establishes the diagnosis of typhoid fever are: a gradually increasing fever with evening exacerbation and morning remission; general malaise with headache; a furred tongue with red edges and tip; nose bleed; a relatively slow pulse (possibly dicrotic); abdominal distension with tympany, gurgling and tenderness in the right iliac fossa on firm pressure; a roseolar eruption confined principally to the abdomen and chest; enlarged spleen, and the physical signs of bronchial catarrh. Should every case of typhoid fever present the foregoing symptoms, the diagnosis would be simple and mistakes would not be common, but unfortunately this is not true and I believe the classical history, as portrayed in the books, is the exception rather than the rule. Because of the great variability in the symptoms and the tardiness of the appearance of many of them, the diagnosis is often not clear until the patient is
Reversible Immortalization of Human Primary Cells by Lentivector-Mediated Transfer of Specific Genes
Authors: Patrick Salmon, José Oberholzer, Teresa Occhiodoro, Philippe Morel, Jinning Lou, Didier Trono
Journal: Molecular Therapy (2000)

We exploited the ability of lentiviral vectors to govern the stable transduction of cells irrespective of their cycling status to induce the reversible immortalization of human primary cells. First, bicistronic HIV-derived lentiviral vectors expressing GFP− and the HSV1 thymidine kinase and containing the LoxP sequence in their LTR (HLox) were used to transduce HeLa cells. Cre expression led to efficient proviral deletion, and unexcised cells could be eliminated by ganciclovir treatment. A human liver biopsy was then exposed to a combination of HLox vectors that harbored either the SV40 large T (TAg) or the human telomerase (hTERT) DNAs in place of GFP. This led to the isolation of liver sinusoidal endothelial cell (LSEC) clones that exhibited an immortalized phenotype while retaining most of the features of primary hLSEC. Complete growth arrest of these cells was observed in 2 days of Cre expression, and the resulting stationary culture could be kept for at least 2 weeks. Transduction of human adult pancreatic islets with HLox vectors coding for Tag and Bmi-1 also induced the proliferation of insulin-positive cells. These results indicate that lentivectors can be used to mediate the reversible immortalization of primary nondividing cells and should allow for the production of large supplies of a wide variety of human cells for both therapeutic and research purposes.
Limitations on dose estimation.
Authors: N A Esmen
Journal: Environmental Health Perspectives (1981)

The process of estimation of dose at a target organ from the measurements of environmental concentration of potentially hazardous agents is theoretically examined. The analysis of the estimation process suggests that the design of any study which aims to find the health effects of an agent or to construct a dose-response relationship from environmental measurements must be fully scrutinized to see whether a representative dose is tractable from such measurements made on the agent or extrapolation from a set of known effects at high dose levels is feasible and desirable.
The Order of Authorship
Authors: Gary Miranda
Journal: JAMA (1991)

To the Editor. —  Your thoughtful editorial1on the authorship of medical articles fails to take into account that the problem of authorship is related to the problem of writing style. I would suggest that both problems stem from a misguided loyalty to the concept of scientific objectivity.  As a principle of scientific procedure, objectivity reflects a respect for the facts; as a principle of writing style it obfuscates the most central fact of all— that someone chose these words in this particular order. Contrary to the oft-heard complaint that medical writing style attempts to create an impression of scientific profundity, the current function of medical writing is not to create the impression that the writer is profound or even trustworthy, but to create the impression that there is no writer at all.  The device of multiple authorship, while designed to give credit where credit is due, conveys the
Muscle Contracture Induced by Exercise
Authors: Irwin A. Brody
Journal: New England Journal of Medicine (1969)

An unusual disorder of muscle function, characterized by painless contractures occurring with exercise, was present in a patient since childhood. Muscle contraction was normal, but the relaxation phase became increasingly slow during exercise. Myotonia was ruled out by the absence of muscle action potentials during the slow relaxation. The most important biochemical finding was a marked decrease in the ability of the isolated sarcoplasmic reticulum to accumulate calcium ions. The concentration of muscle phosphorylase was normal, but the proportion of the active form was unusually high, and there was a high level of venous-blood lactate during rest. The slow relaxation of this patient's muscles may be due to the decreased uptake of calcium by the sarcoplasmic reticulum. The persistently high level of free calcium expected from such a defect may explain the persistent activation of muscle phosphorylase and hence the increased production of lactate during rest. The disease is thus attributable to a selective defect of relaxing factor.
Renal Factors Influencing Blood Pressure Threshold and Choice of Treatment for Hypertension in IDDM
Authors: Carl Erik Mogensen, Klavs W Hansen, Margrethe M Pedersen, Cramer K Christensen
Journal: Diabetes Care (1991)

In this article, we analyze the blood pressure (BP) threshold for the start of antihypertensive treatment in insulin-dependent diabetes mellitus (IDDM) patients, with particular emphasis on those with persistent microalbuminuria or proteinuria (incipient and overt nephropathy, respectively). In such individuals, there is a clear increase in the prevalence of hypertension and in actual measured BP values that is not observed in normoalbuminuric patients. In 94 young healthy adults (&amp;lt;45 yr of age), average mean ± SD arterial pressure (MAP; diastolic + 1/3 pulse pressure) was ∼90.0 ± 8.1 mmHg, closely corresponding to large population studies. In microalbuminuric IDDM patients, MAP values between ∼105 and ∼95 mmHg have been found in different studies, and the level has progressively decreased in various studies between 1984 and 1990 with similar BP-measuring techniques. Somewhat higher values are seen in patients with proteinuria, who are also consistently characterized by reduced glomerular filtration rate (GFR). A clear correlation is found between MAP plotted against the increased rate of microalbuminuria (%/yr) in incipient nephropathy and against fall rate of GFR (ml · min−1 · mo−1) in proteinuric patients. In the natural history of renal disease, different cutoff points in MAP for start of progression are observed: &amp;gt;95 mmHg for the start of progression of microalbuminuria and &amp;gt;105 mmHg for the decrease in GFR. During antihypertensive treatment, there is reduction or no progression in microalbuminuria with MAP of ∼90−95 mmHg and only a limited fall in GFR with MAP of ∼100 mmHg. However, certain antihypertensive drugs (angiotensin-converting enzyme inhibitors) may have specific renoprotective actions, reducing microalbuminuria at rather low BP levels or even independent of BP reduction. The optimal way of monitoring BP may be by 24-h ambulatory recording.
DISEASES OF THE MASTOID, THEIR COURSE AND TREATMENT.
Authors: FRANK S. MILBURY
Journal: JAMA (1898)

Before beginning the consideration of this paper, I wish to request your attention for a few moments to some of the anatomic features of the middle ear and mastoid. It is in an air-containing space, lined throughout with mucous membrane, and continuous with the covering of the naso-pharynx and adjacent parts. Its divisions are the eustachian tubes, the tympanic cavity, and the mastoid cells. The first is the channel of connection between the pharynx and the tympanum and consists of two portions, the cartilaginous and osseous, the widest opening being pharyngeal and its narrowest point at the junction of the soft and the bony part. It is from one inch to one and one-third inches long, the osseous forming about one-third of its length, and the two portions are formed at an obtuse angle. Its direction is obliquely outward, backward and slightly upward. The tubal mucous membrane contains throughout a