tbuckley/cabot-search huggingface dataset:
Emergency Treatment of Cardiac Arrest in CHD With Coronary Bypass Graft
Authors: John E. Hutchinson
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Patients with impending myocardial infarction syndromes have been recognized, and following coronary arteriography, operations performed prior to the development of muscle necrosis.<sup>1</sup>The following case report presents an extreme example of severe proximal coronary occlusive disease, the end stage of which was averted by bypass grafting. <h3>Report of a Case.—</h3> A 47-year-old man related a history of precordial discomfort and tightness of 18 months' duration. An evaluation in June of 1970 included normal electrocardiograms and a normal x-ray film series of the upper gastrointestinal tract. On July 17, during a two-step exercise test the patient noted slight distress after the 19th trip and walked over to a cot to lie down. A seizure and ventricular fibrillation then occurred. This was successfully terminated by closed chest massage, electrical shock, and airway support. For several hours the ECGs showed ST-segment depressions, but later that day returned to normal.
Regulation of hepatic 7 alpha-hydroxylase expression by dietary psyllium in the hamster.
Authors: J D Horton, J A Cuthbert, D K Spady
Journal: Journal of Clinical Investigation (1994)

Soluble fiber consistently lowers plasma total and low density lipoprotein (LDL)-cholesterol concentrations in humans and various animal models including the hamster; however, the mechanism of this effect remains incompletely defined. We performed studies to determine the activity of dietary psyllium on hepatic 7 alpha-hydroxylase, 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase and LDL receptor expression in the hamster. In animals fed a cholesterol-free semisynthetic diet containing 7.5% cellulose (avicel) as a fiber source, substitution of psyllium for avicel increased hepatic 7 alpha-hydroxylase activity and mRNA levels by 3-4-fold. Comparable effects on 7 alpha-hydroxylase expression were observed with 1% cholestyramine. Psyllium also increased hepatic 7 alpha-hydroxylase activity and mRNA in animals fed a diet enriched with cholesterol and triglyceride. Activation of 7 alpha-hydroxylase was associated with an increase in hepatic cholesterol synthesis that was apparently not fully compensatory since the cholesterol content of the liver declined. Although dietary psyllium did not increase hepatic LDL receptor expression in animals fed the cholesterol-free, very-low-fat diet, it did increase (or at least restore) receptor expression that had been downregulated by dietary cholesterol and triglyceride. Thus, 7.5% dietary psyllium produced effects on hepatic 7 alpha-hydroxylase and LDL metabolism that were similar to those of 1% cholestyramine. Induction of hepatic 7 alpha-hydroxylase activity by dietary psyllium may account, in large part, for the hypocholesterolemic effect of this soluble fiber.
Effects of Adenine Nucleotides on the Contractility and Membrane Potentials of Rat Atrium
Authors: PHILIPS B. HOLLANDER, LEYDEN WEBB
Journal: Circulation Research (1957)

Adenine nucleotides and nucleosides depress the contractility of the rat atrium as has been shown previously for cardiac tissue of other species. It was found that this depression was accompanied by a marked shortening of the action potential, clue to a more rapid rate of repolarization, without marked effects on other atrial characteristics. The evidence points to the site of action as the cell membrane rather than the intracellular contractile systems. The purine-riboside moiety is the basic unit required for activity and combination of this group with sites in the membrane apparently leads to an increased permeability to potassium following depolarization.
Private practice and general practice
Authors: B G Wall
Journal: BMJ (1981)

<h3>Background</h3> Oliver–McFarlane syndrome is characterised by trichomegaly, congenital hypopituitarism and retinal degeneration with choroidal atrophy. Laurence–Moon syndrome presents similarly, though with progressive spinocerebellar ataxia and spastic paraplegia and without trichomegaly. Both recessively inherited disorders have no known genetic cause. <h3>Methods</h3> Whole-exome sequencing was performed to identify the genetic causes of these disorders. Mutations were functionally validated in zebrafish <i>pnpla6</i> morphants. Embryonic expression was evaluated via in situ hybridisation in human embryonic sections. Human neurohistopathology was performed to characterise cerebellar degeneration. Enzymatic activities were measured in patient-derived fibroblast cell lines. <h3>Results</h3> Eight mutations in six families with Oliver–McFarlane or Laurence–Moon syndrome were identified in the <i>PNPLA6</i> gene, which encodes neuropathy target esterase (NTE). <i>PNPLA6</i> expression was found in the developing human eye, pituitary and brain. In zebrafish, the <i>pnpla6</i> curly-tailed morphant phenotype was fully rescued by wild-type human <i>PNPLA6</i> mRNA and not by mutation-harbouring mRNAs. NTE enzymatic activity was significantly reduced in fibroblast cells derived from individuals with Oliver–McFarlane syndrome. Intriguingly, adult brain histology from a patient with highly overlapping features of Oliver–McFarlane and Laurence–Moon syndromes revealed extensive cerebellar degeneration and atrophy. <h3>Conclusions</h3> Previously, <i>PNPLA6</i> mutations have been associated with spastic paraplegia type 39, Gordon–Holmes syndrome and Boucher–Neuhäuser syndromes. Discovery of these additional <i>PNPLA6</i>-opathies further elucidates a spectrum of neurodevelopmental and neurodegenerative disorders associated with NTE impairment and suggests a unifying mechanism with diagnostic and prognostic importance.
The Glucose Receptor A DEFECTIVE MECHANISM IN DIABETES MELLITUS DISTINCT FROM THE BETA ADRENERGIC RECEPTOR
Authors: R. Paul Robertson, Daniel Porte
Journal: Journal of Clinical Investigation (1973)

Acute serum insulin responses in 10 normal subjects after rapid intravenous injection of glucose (5 g) or isoproterenol (2 μg) were of similar magnitude and timing (glucose: 431±349%; mean Δ3-5′ insulin (IRI)±SD, per cent basal and isoproterenol: 359±216%; mean Δ2-4′ IRI±SD, per cent basal). To elucidate the relationship of glucose-induced insulin secretion to pancreatic beta adrenergic receptors and the implications of this relationship with regards to abnormal insulin secretion in diabetes mellitus, two questions were studied. (a) To determine whether glucose-induced insulin secretion is dependent upon beta adrenergic activity, the effect of beta adrenergic blockade with intravenous propranolol (0.08 mg/min) upon acute insulin responses to isoproterenol and glucose were compared in normal subjects. (b) To determine whether acute insulin responses to beta adrenergic stimulation were intact in diabetes mellitus, the effect of isoproterenol upon serum insulin levels was studied in diabetic subjects. Beta adrenergic blockade in the normal subjects obliterated acute insulin responses to isoproterenol (before: 361±270%, during: - 31±15%; n = 6, P < 0.001) but did not significantly affect responses to glucose (before; 311±270%; during: 284±206%; n = 5). The mean acute insulin response after isoproterenol in the diabetic group was significantly elevated over basal levels (152±74%; n = 10, P < 0.001) but the response after glucose was not (- 11±11%). These data suggest that insulin responses to glucose in normal subjects are mediated by specific pancreatic glucose receptors which are independent from beta adrenergic receptors and that abnormal glucose-induced insulin secretion in diabetics is due to defects within glucose receptors and not beta adrenergic receptors as has been previously hypothesized.
Comparison of the antilipolytic effect of metoprolol, acebutolol, and propranolol in man.
Authors: R J Newman
Journal: BMJ (1977)

Metoprolol and acebutolol, two supposedly cardioselective beta-adrenoceptor antagonists, were tested in 11 healthy men against propranolol, a non-selective drug, for their effect on plasma free fatty acid concentrations before and after insulin. The fasting concentrations of free fatty acid were significantly reduced after acebutolol and propranolol, and their return to normal after insulin was delayed. Metoprolol had no significant effect on free fatty acid levels either before or after insulin. Although both selective and non-selective beta-blocking drugs should be expected to delay the return of free fatty acid values to normal after insulin, in contrast to propranolol and acebutolol, metoprolol had no such effect. This suggests that metoprolol may not be as effective as the other two drugs in controlling lipid metabolism during long-term treatment with beta-adrenoceptor antagonists.
Complement C3a and C4a Increased in Plasma of Patients with Aspirin-induced Asthma
Authors: Seung-Ha Lee, TaiYoun Rhim, Yun-Sung Choi, Ji-Won Min, Sung-Ho Kim, Sun-Young Cho, Young-Ki Paik, Choon-Sik Park
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Rationale: Aspirin-induced asthma (AIA) is a distinct clinical syndrome that affects up to 10% of adults with asthma. Although eicosanoid metabolites appear to play an important role in AIA, the exact pathogenic mechanism for the syndrome remains obscure. In addition, the proposed mechanism fails to explain why aspirin does not cause bronchoconstriction in all individuals.Objectives: We aimed to identify proteins that were differentially expressed in between AIA and aspirin-tolerant asthma (ATA) plasma.Methods and Main Results: By using a proteomics approach, six proteins were found to be differentially expressed in plasma between patients with AIA and patients with ATA at baseline, and eight proteins were significantly up- or down-regulated after aspirin challenge in patients with AIA. These proteins, which were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, can be classified into four groups: complement components, apolipoproteins, modified albumin, and unknown proteins. Among them, the complement component levels in plasma were validated by using ELISA. Plasma concentrations of C3a and C4a were higher in patients with AIA (n = 30) than in patients with ATA (n = 24). After the aspirin challenge, C3 decreased in both patients with AIA and those with ATA, but the C3a concentration increased in the AIA patient group (p = 0.019). Moreover, C3a and C4a levels and the ratios of C3a/C3 and C4a/C4 were correlated with the changes of FEV1 values after aspirin challenge.Conclusions: Aspirin intolerance may be related to alterations in the levels of complements, as well as those of lipoprotein and other proteins.
NHS payment system in England is "completely illogical," says national director
Authors: N. Hawkes
Journal: BMJ (2014)

Payment systems in the NHS in England will have to change if urgent and emergency care are to be successfully reformed, a senior manager from NHS England told a meeting in London on 18 November. Keith Willett, national director for acute episodes of care, said that the present system was “completely illogical.”

In the current system GPs are paid on a capitation based contract, inpatient care on an activity based formula, emergency department visits on a payment by results tariff, emergency admissions on a tariff with different rules, and community services and social care on a block contract. “We’re stuck with financial allocations that don’t work,” he said. “We have to change the payment system before the money moves the way …
On the Treatment of Hydrocele
Authors: J. Parsons
Journal: BMJ (1843)

<h3>ABSTRACT</h3> Experiments examining the social dynamics of bacterial quorum sensing (QS) have focused on mutants which do not respond to signals, and the role of QS-regulated exoproducts as public goods. The potential for QS signal molecules to themselves be social public goods has received much less attention. Here, we analyse how signal-deficient (<i>lasI</i><sup>−</sup>) mutants of the opportunistic pathogen <i>Pseudomonas aeruginosa</i> interact with wild-type cells in an environment where QS is required for growth. We show that when growth requires a ‘private’ intracellular metabolic mechanism activated by the presence of QS signal, <i>lasI</i><sup>−</sup> mutants act as social cheats and outcompete signal-producing wild-type bacteria in mixed cultures, because they can use the signals produced by wild type cells. However, reducing the ability of signal molecules to diffuse through the growth medium, results in signal molecules becoming less accessible to mutants, leading to reduced cheating. Our results indicate that QS signal molecules can be considered as social public goods in a way that has been previously described for other exoproducts, but that spatial structuring of populations reduces exploitation by non-cooperative signal cheats. <h3>Importance</h3> Bacteria communicate via signaling molecules to regulate the expression of a whole range of genes. This process, termed quorum sensing (QS), moderates bacterial metabolism in many environmental conditions, from soil and water (where QS-regulated genes influence nutrient cycling) to animal hosts (where QS-regulated genes determine pathogen virulence). Understanding the ecology of QS could therefore yield vital clues as to how we might modify bacterial behaviour for environmental or clinical gains. Here, we demonstrate that QS signals act as shareable public goods. This means that their evolution, and therefore population-level responses to interference with QS, will be constrained by population structure. Further, we show that environmental structure (constraints on signal diffusion) alters the accessibility of QS signals and demonstrates that we need to consider population and environmental structure to help us further our understanding of QS signaling systems.
Drugs in the Institutionalized Elderly: Time to Get It Right?
Authors: Don Riesenberg
Journal: JAMA (1988)

The use and misuse of medications in elderly persons who reside in long-term—care institutions have important consequences. Psychotropic drugs are among those that greatly affect the quality of life for the roughly 1.5 million institutionalized elderly persons in the United States. It is well known that some benzodiazepines, eg, diazepam, boast a much longer half-life in elderly patients.<sup>1</sup>Such antipsychotics as thioridazine, may cause significant orthostatic hypotension,<sup>2</sup>as is the case with certain tricyclic antidepressants. Additionally, the latter class of drugs includes some that produce anticholinergic side effects,<sup>3</sup>which can result in urinary retention for patients with tenuous bladder function, such as men with prostatic hypertrophy. The study by Beers et al,<sup>4</sup>in this issue ofTHE JOURNAL, inspires little confidence in prescribing practices in the long-term—care setting, specifically intermediate-care facilities (ICFs). Twelve such institutions in eastern Massachusetts, shown to be representative of those in the
TWO HUNDRED AND FIFTY BASSINI OPERATIONS FOR THE CURE OF INGUINAL HERNIA; WITHOUT MORTALITY.
Authors: W. B. DE GARMO
Journal: JAMA (1897)

The 250 operations here reported have been done upon 216 patients; 34 of the cases having been operated on on both sides. Fifty-two of the patients were females, 164 were males. I am quite sure that no one can accuse me of having selected my cases, when their ages and conditions are considered. Fifty-five of the patients were under 14 years of age, 43 were between 14 and 25, while 118 had passed their 25th year. Of the latter number, 8 were between 60 and 70, 6 between 70 and 80 and 2 were over 80 years of age. The youngest child operated on was 5 months old, and this is the first instance in my experience where I have been obliged to operate on a child less than 1 year of age. The operation was for strangulated scrotal hernia on the right side. The left was operated on at
General Surgery Residency After Graduation From US Medical Schools
Authors: Jashodeep Datta, Victor Zaydfudim, Kyla P. Terhune
Journal: JAMA Surgery (2013)

International-United States medical graduates (I-USMGs) are non-US citizen graduates of U.S. medical schools. Although academically equivalent to US-citizen peers, they are subject to the same visa requirements as non-US citizen international medical graduates. We hypothesized that visa sponsorship policies of general surgery programs (GSPs) may be discordant with the enrollment patterns of I-USMGs. A total of 196 GSPs participated in a telephone survey regarding visa sponsorship policies. Whereas GSPs preferred J-1 to H-1B sponsorship (64.2% vs. 32.6%), I-USMG enrollment favored programs supporting H-1B sponsorship (72.1% vs. 7.5%) (P = .01). University-affiliated programs were more likely to sponsor H1-Bs than independent programs (39.6% vs. 24.4%) (P = .03) and trained a greater proportion of I-USMGs than independent programs (40.6% vs. 14.0%) (P < .01). Restrictive policies against H-1B sponsorship may limit GSPs' I-USMG applicant pool and restrict I-USMGs' surgical training options.
Surgeons carry out too many operations on dying patients
Authors: A. Ferriman
Journal: BMJ (1998)

Surgeons are performing too many “inappropriate and aggressive” operations on patients who are frail or terminally ill, the latest report from the national confidential inquiry into perioperative deaths says.

“It is a surgical skill to recognise when surgery will be too adventurous, ill advised, or futile, given the condition of the patient,” says Mr Ron Hoile, consultant surgeon at the Medway NHS Trust, Kent, and the inquiry's principal clinical coordinator for surgery.

“It is difficult to resist pressure to operate, whether this comes from the patient, relatives, or medical …
Organising a practice. Problem identification, disease management, and audit.
Authors: E E Martin
Journal: BMJ (1982)

In general practice records much important information is buried among trivia even with an A4 format. Many hospital letters from follow-up clinics give little more information than the original letter does. We decided to weed and summarise the notes. All FP8 and 9 cards containing irrelevant information and all but one of the hospital letters for each episode of illness were extracted and torn up. The main items were summarised and written on a Royal College of General Practitioners (RCGP) pink summary card. The card was filed on top of the current A4 note sheet, where it can be seen first each time the notes are opened. This task was approached with trepidation on account of the amount of work it required. Elliott1 was only able to summarise 120 notes in one year. Our notes are summarised in odd moments before and after surgeries, and always by partners. The average time taken for a summary is four and a half minutes, and the average number done a day is three and a half. Certain disease entities need to be easily identified at each patient contact. We decided to mark the outside of the folders for these disease groups, and used the RCGP system with the following changes : (i) black and white squares indicate neoplasia ; (ii) a light green tag indicates bronchospasm; (iii) a puce tag indicates arteriosclerosis that limits a patient's life or needs treatment.
Organ-specific autoimmune diseases induced in mice by elimination of T cell subset. I. Evidence for the active participation of T cells in natural self-tolerance; deficit of a T cell subset as a possible cause of autoimmune disease.
Authors: S Sakaguchi, K Fukuma, K Kuribayashi, T Masuda
Journal: The Journal of Experimental Medicine (1985)

Organ-specific autoimmune diseases such as oophoritis, gastritis, thyroiditis, and orchitis were induced in female or male nude (nu/nu) mice by the transfer of nu/+spleen cells from which particular Lyt T cell subset(s) had been removed: nu/+spleen cells treated with anti-Lyt-1 plus complement (C) caused disease in recipient nude mice; anti-Lyt-2 plus C-treated spleen cells, in contrast, did not. The cells responsible for disease induction are believed to be Thy-1+, Lyt-1-, 2,3- (Thy-1, Lyt-1, 2,3), since spleen cells treated with mixed antisera, including anti-Lyt-1 and anti-Lyt-2, plus C, could induce the disease with almost the same incidence as anti-Lyt-1 plus C-treated cells (oophoritis 50%, gastritis 25%, thyroiditis 10-20%, and orchitis 40%). Cells treated with mixed antisera of anti-Thy-1, anti-Lyt-1, and anti-Lyt-2, plus C, could not induce autoimmune disease. Each induced autoimmune disease could be adoptively transferred to other nude mice via spleen cells, with resulting histological lesion of corresponding organs and development of specific circulating autoantibodies. Since anti-Thy-1 plus C treatment of donor spleen cells abrogated the capacity to transfer the disease, we conclude that T cells are required as effector cells, and that these may develop from Lyt-1-, 2,3- cells. Lyt-1+, 2,3- cells were demonstrated to have suppressive activity upon the development of the diseases; induction of autoimmunity was completely inhibited by the cotransfer of Lyt-1+, 2,3- cells with Lyt-1-, 2,3- cells. When anti-Lyt-2 plus C-treated cells (i.e., Lyt-1+, 2,3- and Lyt-1-, 2,3- cells) were mixed with anti-Lyt-1 and anti-Lyt-2 plus C-treated cells (i.e., Lyt-1-, 2,3- cells) in various ratios, then transferred to nude mice, the development of each autoimmune disease was clearly inhibited, even by small doses of Lyt-1+, 2,3- cells. The autoimmune disease we were able to induce was quite similar to human organ-specific autoimmune disease in terms of the spectrum of organs involved, histopathological features, and the development of autoantibodies to corresponding organ components (oocytes, parietal cells, thyroid colloid, including thyroglobulin, and sperm).(ABSTRACT TRUNCATED AT 400 WORDS)
Treatment of mice with EGF and orthovanadate activates cytoplasmic and nuclear MAPK, p70S6k, and p90rsk in the liver
Authors: Jerzy Ostrowski, Marek Woszczyński, Piotr Kowalczyk, Lech Trzeciak, Ewa Hennig, Karol Bomsztyk
Journal: Journal of Hepatology (2000)
Symptoms of IBS and objective measurements of large bowel function
Authors: G Lamont, D Evans, J Reynolds
Journal: Gut (1987)

within these adenomas of the duodenum.In an effort to determine the incidence of malignant degen- eration, we have commenced a further prospective study, randomising patients to annual surveillance with biopsy, or aggressive endoscopic destruction, which includes endoscopic retrograde cholangiopancreatography in the evaluation.Patients found to have malignant degeneration are subjected to surgical excision.To further confuse the picture, patients with an apparently normal appearing ampulla on random biopsy, have been shown to have histologic adenomatous change, which in some patients extends up into the bile duct.It is hoped, that with long term surveillance, and undergoing this randomisation, that we will obtain a better understanding as to the risk of cancer in the upper GI tract in patients with familial adenomatous polyposis.
Tissue transglutaminase selectively modifies gliadin peptides that are recognized by gut-derived T cells in celiac disease
Authors: Øyvind Molberg, Stephen N. Mcadam, Roman Körner, Hanne Quarsten, Christel Kristiansen, Lars Madsen, Lars Fugger, Helge Scott, Ove Norén, Peter Roepstorff, Knut E.A. Lundin, Hans Sjöström, Ludvig M. Sollid
Journal: Nature Medicine (1998)