tbuckley/cabot-search huggingface dataset:
Verbal Fluency and Naming Performance in Type I Diabetes at Different Blood Glucose Concentrations
Authors: Clarissa S Holmes, Kathleen M Koepke, Robert G Thompson, Peter W Gyves, Joy A Weydert
Journal: Diabetes Care (1984)

The effect of serum glucose alterations on selected verbal skills was examined in a group of diabetic men between 18 and 35 yr of age. An artificial insulin infusion system was used to set and maintain glucose concentrations during testing at each of three levels: hypoglycemia (55 mg/dl), euglycemia (110 mg/dl), and hyperglycemia (300 mg/dl). Subjects were used as their own controls, with performance at euglycemia serving as the comparison standard. A double-blind crossover design was employed as described in Holmes et al. (see ref. 14). Results showed significantly disrupted naming or labeling skills at hypoglycemia, with a trend toward poorer performance at hyperglycemia. During hypoglycemia, rate of responding was slowed from 6% to 18%, compared with euglycemic performance, but accuracy was not impaired. In contrast, word recognition skills were not affected by deviations in glucose. These performance effects were not correlated with duration of disease except for one of the five tests administered. This one exception, on the most difficult task, was less notable than the general finding of no relation between disease duration (from 6 mo to 17.5 yr) and test performance. Thus, in addition to considering long-term consequences of blood glucose alterations, clinicians and diabetic patients may wish to consider acute neuropsychological consequences of disrupted euglycemia.
Angina Due to Coronary Microvascular Disease in Hypertensive Patients without Left Ventricular Hypertrophy
Authors: John E. Brush, Richard O. Cannon, William H. Schenke, Robert O. Bonow, Martin B. Leon, Barry J. Maron, Stephen E. Epstein
Journal: New England Journal of Medicine (1988)

When angina occurs in patients with hypertension, it is usually attributed to coronary artery disease or left ventricular hypertrophy. To determine the contribution of coronary microvascular abnormalities to angina in patients with hypertension, we evaluated hypertensive patients without coronary artery disease or left ventricular hypertrophy by measuring the coronary responses to rapid atrial pacing before and after administration of ergonovine. We compared 12 hypertensive patients who had pacing-induced angina with 13 normotensive subjects without such angina. The two groups had similar coronary flow (in the great cardiac vein) at rest; however, pacing increased coronary flow less in hypertensive patients with angina than in normotensive subjects (48 vs. 83 percent; P = 0.05). In the hypertensive patients with angina, pacing after ergonovine increased coronary flow by only 32 percent (as compared with 48 percent before ergonovine; P less than 0.05) and decreased coronary resistance by 15 percent (as compared with 28 percent before ergonovine; P less than 0.05), indicating the presence of ergonovine-induced vasoconstriction. In normotensive subjects, in contrast, cardiac pacing after ergonovine increased coronary flow by 112 percent (P less than 0.001), and its effect on coronary resistance was not different from that of pacing before ergonovine. The hypertensive patients with angina had a significant increase in myocardial oxygen extraction during pacing after ergonovine and less of an increase in myocardial lactate consumption - a response consistent with the presence of myocardial ischemia. Thus, angina in hypertensive patients without epicardial coronary disease may be caused by myocardial ischemia, which appears to be due to an abnormally elevated resistance of the coronary microvasculature.
The Climate for the Cultivation of Clinical Research
Authors: Maurice B. Strauss
Journal: New England Journal of Medicine (1960)

The proper study of mankind is man.THIS quotation from Pope1 was not only one of John Punnett Peters' favorites: it was his medical creed. Paul Lavietes2 expressed this succinctly in his appreciation of Dr. Peters late in 1956: "To him the special province of the clinical investigator was the study of disturbances created by nature in man, usually more difficult to control and interpret than animal experimentation, but yielding information obtainable in no other way. His investigative work and his teaching were never far removed from the patient."Eighty-five years ago Jevons3 was concerned with certain trends of the . . .
Complication Rates as a Measure of Quality of Care-Reply
Authors: Jeffrey H. Silber
Journal: JAMA (1995)

In Reply.  —Dr Daley and colleagues suggest our complication rate 1 was too high, citing the prospective study by Hammermeister et al. 2 That study analyzed only 10 complications. We analyzed more types of complications (eg, we added pneumonia), hence our overall rate was higher. Comparable complications yielded similar rates in the study by Hammermeister et al and in our study (eg, the rates were 2.1% vs 1.36% for stroke, 1.6% vs 1.76% for coma, and 7.8% vs 7.18% for mechanical ventilation, respectively). Daley et al mistakenly attribute the difference in complication rates to the nature of the data collected, rather than to the different complications included for analysis. There is no indication that the difference in rates reflects any inadequacy of either the data or definitions used in our study.  We only counted events as complications if there was no notation of that same event at the time the
Biomedical research in the industrial setting. Contrasts and similarities to academia
Authors: P. Felig
Journal: JAMA (1987)

THE INVESTMENT by the US pharmaceutical insustry in biomedical research currently exceeds $4.5lion each year.<sup>1,2</sup>e 1983 the private industrialhas surpassed the Nationaltutes of Health (NIH) in the magnitude of its budget for health research and development.<sup>1</sup>physicians have some familiarity with academic-basedatively few physicians either have contact with or knowledge of the activities undertaken by the pharmaceutical industry in the discovery and development of new drugs. Having spent four years in industry after 15 years in academia, Ihave been struck by the contrasts as well as the similarities to research in the academicor. It is also clear that research in the industrial setting is undergoing change and that it may face new challenges. This article describes the content, management, and changes occurring in ibiomedical research, with particular emphasis on comparisons ware-c-based search. <h3>Drug Discovery and Development</h3> The various disciplines that constitute pharmaceutical research may be grouped under
Loss and Grief: Psychological Management in Medical Practice
Authors: Brian P. Lipton
Journal: JAMA (1971)

It was with skepticism that I started reading this book devoted to the clinical vagaries of object loss. Is it not inherently unfeeling to speak of thanatology (the study of the biological and medical phenomena of death) or to prescribe an approach to the treatment of the dying or bereaved? But I soon realized that this volume is a very effective counterbalance to the massive dehumanization and suppression of feelings implicit in a society that speaks of death in numbers and reveres a cult of youth, as if to say that dying and loss have nothing to do with the cycle of life. The book is divided into five main sections: Psychological Concepts Central to Loss and Grief, Loss and Grief in Childhood, Reaction to and Management of Partial Loss, The Dying Patient, and Humanistic and Biologic Concepts Regarding Loss and Grief. It is written from the viewpoints of such
Effects of antiviral therapy on the cellular immune response in acute hepatitis C
Authors: Fareed Rahman, Theo Heller, Yuji Sobao, Eishiro Mizukoshi, Michelina Nascimbeni, Harvey Alter, Steven Herrine, Jay Hoofnagle, Jake T. Liang, Barbara Rehermann
Journal: Hepatology (2004)

Spontaneous recovery occurs in a minority of patients with acute hepatitis C but is associated with vigorous and long-lasting cellular immune responses. Treatment-induced recovery can be achieved in the majority of patients who are treated in the acute phase, but the kinetics and mechanisms of viral clearance and immune responsiveness are not known. Both direct antiviral effects and indirect immune-mediated effects, such as immune modulation of Th2 to Th1 responses and prevention of exhaustion of cellular responses by rapid reduction of viral titer, have been proposed. To investigate how early antiviral therapy affects hepatitis C virus (HCV)-specific T cell responses, we performed detailed prospective clinical, virological, and immunological studies on 7 patients with acute hepatitis C who received antiviral therapy and were followed at 2 to 4 week intervals for 1 to 2 years. The total CD4(+) and CD8(+) cell response was analyzed with 600 overlapping HCV peptides and 6 proteins by ex vivo enzyme-linked immunospot (ELISpot), intracellular cytokine staining, and proliferation assays. In contrast to earlier studies with selected HCV epitopes, this extended analysis detected multispecific interferon gamma(+) (IFN-gamma(+)) responses in each patient, even in the absence of T-cell proliferation. After initiation of antiviral therapy (at a mean of 20 weeks after infection), all sustained responders demonstrated gradually decreasing, then nearly absent HCV-specific T-cell responses, whereas the sole patient who developed viral breakthrough after initial HCV control maintained cellular immune responses. In conclusion, a sustained response to antiviral therapy was not associated with a lasting enhancement of HCV-specific T-cell responsiveness in the blood.
The Effect of Heat Waves on Mental Health in a Temperate Australian City
Authors: Alana Hansen, Peng Bi, Monika Nitschke, Philip Ryan, Dino Pisaniello, Graeme Tucker
Journal: Environmental Health Perspectives (2008)

The goal of this study was to identify mental, behavioral, and cognitive disorders that may be triggered or exacerbated during heat waves, predisposing individuals to heat-related morbidity and mortality.Using health outcome data from Adelaide, South Australia, for 1993-2006, we estimated the effect of heat waves on hospital admissions and mortalities attributed to mental, behavioral, and cognitive disorders. We analyzed data using Poisson regression accounting for overdispersion and controlling for season and long-term trend, and we performed threshold analysis using hockey stick regression.Above a threshold of 26.7 degrees C, we observed a positive association between ambient temperature and hospital admissions for mental and behavioral disorders. Compared with non-heat-wave periods, hospital admissions increased by 7.3% during heat waves. Specific illnesses for which admissions increased included organic illnesses, including symptomatic mental disorders; dementia; mood (affective) disorders; neurotic, stress related, and somatoform disorders; disorders of psychological development; and senility. Mortalities attributed to mental and behavioral disorders increased during heat waves in the 65- to 74-year age group and in persons with schizophrenia, schizotypal, and delusional disorders. Dementia deaths increased in those up to 65 years of age.Our results suggest that episodes of extreme heat pose a salient risk to the health and well-being of the mentally ill.Improvements in the management and care of the mentally ill need to be addressed to avoid an increase in psychiatric morbidity and mortality as heat waves become more frequent.
The fibrillating atrial myocardium. What can the detection of wave breaks tell us?
Authors: A Kléber
Journal: Cardiovascular Research (2000)

See article by Chen et al. [14] (pages 220–232) in this issue. 

Ventricular and atrial fibrillation have fascinated clinical cardiologists and cardiac scientists since the beginning of the last century [1,2]. They are important determinants of cardiac mortality and morbidity, and their biophysical mechanisms share close similarities with spatio-temporal instabilities occurring in other excitable media, such as chemical and biological non-cardiac excitation–diffusion systems [3,4].

Normal cardiac electrical excitation requires propagation from a pacemaker site and extinguishes after recovery to the resting state to be reexcited only by a new pacemaker pulse. However, even the normal myocardium fibrillates relatively easily if electrically stimulated by an appropriate protocol. In diseased states, tachycardia and fibrillation may arise from a local site hosting a pathological substrate (e.g. regional ischemia) and/or be perpetuated by a more general change in the electrophysiological properties of the tissue (e.g. general shortening of the refractory period). The observation in the experimental laboratory of the sudden transition of a regularly beating heart to fibrillatory activity of cardiac muscle had already stimulated important experiments early last century. Another series of key experiments by Dr. Gordon Moe and his collaborators started in 1959 [5]. By selecting the appropriate tools, these investigators could distinguish between two types of experimentally induced atrial fibrillation (AF). In a first case, local application of aconitine [6] would produce a type of AF that terminated upon mechanical isolation of the source (aconitine deposit) that initiated rapid focal excitation. In the second case, AF was induced by vagal stimulation and created AF, which was self-sustained. In this case, re-entry, requiring a critical mass of tissue for the circulating excitations to persist, was most likely responsible for maintenance of the arrhythmia. In 1964, based on a simulation study, Moe and Abildskov formulated the classical ‘multiple-wavelet’ hypothesis to … 

* Tel.: +41-31-631-8740; fax: +41-31-631-8785 kleber{at}pyl.unibe.ch
Racial Gaps in Cancer Survival--Asking the Wrong Questions?
Authors: B. Kuska
Journal: JNCI Journal of the National Cancer Institute (1999)

A landmark 1973 study showed for the first time an “alarming increase” in the number of American blacks dying from cancer. Today, nearly 30 years later, experts say the alarm bells continue to sound unabated.

One reason the problem persists is its sheer complexity. Black healthcare topics often extend far beyond medicine, intertwining with thorny social issues, such as education, economics, culture, and racism.
Associative and sensorimotor learning for parenting involves mirror neurons under the influence of oxytocin
Authors: S. Shaun Ho, Adam MacDonald, James E. Swain
Journal: Behavioral and Brain Sciences (2014)

Mirror neuron-based associative learning may be understood according to associative learning theories, in addition to sensorimotor learning theories. This is important for a comprehensive understanding of the role of mirror neurons and related hormone modulators, such as oxytocin, in complex social interactions such as among parent-infant dyads and in examples of mirror neuron function that involve abnormal motor systems such as depression.
Our New Home-Reply
Authors: Dena Lovett-Williams
Journal: JAMA (1987)

In Reply.—  I have received 27 letters of response from doctors and their spouses across the nation. Of those, 26 were written by kind, concerned people offering advice and sharing memories. The letter from Dr Weiss-Harrison is the single exception.  I have to wonder at her suggestion that I  friendly. Six months have passed since I wrote Our New Home. I have made some good friends here during that time, and none of the people with whom I have become friendly share her attitude toward others who are reaching out for help.  As for persistence in seeking employment, I'm sure my weekly appearance at Job Service, holding a preschooler by the hand and an infant strapped to my back, might have convinced even Dr Weiss-Harrison of my determination, as would the long hours spent at the typewriter, on the telephone, and poring over the want ads. Fortunately, these efforts
Interactions of allergens and irritants in susceptible populations in producing lung dysfunction: implications for future research.
Authors: A T Hastie, S P Peters
Journal: Environmental Health Perspectives (2001)

Environmental agents, when applied in combination or sequentially, can induce a wide variety of adverse health effects in humans. To determine the effects of sequential allergen challenge and acid exposure on human bronchial epithelial cell function, we subjected normal, nonallergic control and ragweed-allergic individuals to bronchoscopic segmental ragweed challenge in vivo. We harvested bronchial epithelial cells by brush biopsy both before challenge and 24 hr after challenge and exposed cells to an acid stress in vitro (pH 5 for 3 hr), followed by a 1-hr recovery period at normal pH. In normal, nonallergic subjects, segmental allergen challenge produced no effects on ciliary activity; pH 5 exposure produced reduced ciliary activity (a decrease in the percent of the initially active area), with significant recovery after cells were returned to a normal pH. Ciliary activity from allergic subjects was also inhibited by pH 5 exposure; however, activity was not recovered when cells were placed in medium of normal pH. Ciliary activity in allergics who developed a stress response postantigen challenge, as determined by an induction of the 27 kDa stress (heat shock) protein, displayed no ciliary dysfunction when exposed to a pH 5 stress. In this case, a stress sufficient to provoke a heat shock (stress) protein (HSP) response (but not one that produced more severe lung injury and did not provoke an HSP response) protected cells from a subsequent acid stress. Because of our observations and recent findings reported in the literature, we suggest that in order to define the wide variety of health effects of environmental agents, control as well as at-risk populations should be studied and the ability to define potentially beneficial as well as detrimental effects should be built into the experimental design. Inclusion of different and novel end points also should be considered.
CULTIVATION OF THE HOG CHOLERA VIRUS
Authors: Carl Tenbroeck
Journal: The Journal of Experimental Medicine (1941)

The work of Hecke on the cultivation, of hog cholera virus was confirmed with ease. Virus was grown in the presence of fresh minced swine testicle in flasks containing Tyrode solution, on the chorioallantoic membrane of embryonated eggs, and on the surface of swine serum agar. In flasks it was grown for 14 transfers; while on eggs it was grown for 13 transfers, followed by an equal number of transfers on agar, making 26 transfers in all. Only one strain of virus was used and we do not know whether all strains can be cultivated so readily or whether we were particularly fortunate in the selection of the strain used. Neither do we know whether swine testicle is better than other tissues for growth. The cultured virus produces characteristic hog cholera when injected into swine, and its effect can be neutralized with commercial anti-hog cholera serum. No evidence of attenuation of the virus was obtained, the last culture being highly virulent when small amounts were injected. No evidence for the adaptation to the egg could be secured, since passages without swine testicle on the membrane or intravenously for 2 transfers resulted in a loss of the virus. No contaminating virus that might favor the cultivation could be detected by animal or egg inoculation. Not only has the virus been cultivated but it has been demonstrated in large amounts in the culture. Four suspensions containing slightly over 0.5 mg. of protein nitrogen produced typical hog cholera when 1 x 10(-6) cc. was injected, and one suspension made in the same way was active in one-tenth this amount. Few titrations on what is commonly known as hog cholera virus, i.e. the serum from acutely ill pigs, are available. We made one such titration and produced a delayed disease with 1 x 10(-5) cc. of infectious serum. It seems probable that the culture virus is more active than the commonly used virus and that its practical use in hog cholera vaccination and hyperimmunization would result in a considerable saving. All of the methods used yielded active cultures, but the serum agar method is the one of choice since larger amounts of suspension can be obtained with less labor.
Objective monitoring of disease activity in polyarteritis by measurement of serum C reactive protein concentration.
Authors: C R Hind, C O Savage, C G Winearls, M B Pepys
Journal: BMJ (1984)

Serial measurements of the serum concentration of C reactive protein were made in 27 patients with polyarteritis over six years. The concentration was invariably raised when the disease was active, even in patients receiving immunosuppressive treatment, and fell rapidly in association with clinical remission induced by immunosuppression. During periods of complete remission, in the absence of any intercurrent condition, the value remained within the normal range. The correlation between C reactive protein concentration and disease activity was much closer than that between erythrocyte sedimentation rate and disease activity. These results indicate that serial measurement of the serum C reactive protein concentration fills the urgent need for an objective index of the activity of polyarteritis and its response to treatment.
THE OCHSNER-SHERREN (DELAYED) TREATMENT OF ACUTE APPENDICITIS: INDICATIONS AND TECHNIQUE
Authors: H. Bailey
Journal: BMJ (1930)

RECrAL CARCINOMA.[ M DICALJOURNAA 25_90 destroyed.For the last two years the methiod has beeln to use much smlaller doses spread over a longer time.Needles containiing 2 or 3 mg. of riadium are lout in and left for seven to ten days.This miethod has given much better
Isolation of human immunodeficiency virus from synovial fluid of a patient with reactive arthritis.
Authors: R H Withrington, P Cornes, J R Harris, M H Seifert, E Berrie, D Taylor-Robinson, D J Jeffries
Journal: BMJ (1987)

Most reports of cryptosporidium enteritis have described an association with the acquired immune deficiency syndrome and a limitation to the gastrointestinal tract.Subsequently the disease has occurred in patients with a normal immune system and in other organs, suggesting possible haematogenous spread.This patient presented with typical gastroenteritis except for the severity of the abdominal pain.Cryptosporidium causes more intense abdominal pain than Giardia lamblia, and cramps are more common.5Although our patient may be an isolated example, we wonder whether some infected patients who complain of severe pain may be suffering from acute pancreatitis.We suggest therefore that cryptosporidium may be an additional aetiological factor in the cause of acute pancreatitis.