tbuckley/cabot-search huggingface dataset:
Enhanced In Vivo Antithrombotic Effects of Endothelial Cells Expressing Recombinant Plasminogen Activators Transduced With Retroviral Vectors
Authors: David A. Dichek, Johanna Anderson, Andrew B. Kelly, Stephen R. Hanson, Laurence A. Harker
Journal: Circulation (1996)

The effects of regulating endothelial cell (EC) plasminogen activator production on thrombus accumulation in vivo are incompletely understood. By overexpressing plasminogen activators in ECs via gene transfer, the hypothesis was tested that increased levels of plasminogen activators inhibit the accumulation of thrombus in vivo.Cultured baboon ECs transduced with human cDNAs for wild-type tissue plasminogen activator (TPA) or for glycosylphosphatidylinositol-anchored urokinase-type plasminogen activator (a-UPA) were seeded onto collagen-coated segments of vascular graft (collagen segments) and exposed overnight to flow using an in vitro perfusion circuit. The antigenic levels of TPA and UPA each increased 10-fold in the media perfusing the corresponding transduced ECs compared with untransduced ECs (P < or = .05 in both cases). In baboons the antithrombotic effects of TPA-transduced or a-UPA-transduced ECs were measured as 111In-platelet deposition and 125I-fibrin accumulation on collagen segments bearing sparsely attached ECs (tarnsduced versus untransduced) interposed in exteriorized arteriovenous femoral shunts. Platelet-rich thrombus formed on the collagen segments with fibrin-rich thrombus propagated distally. The presence of TPA-transduced or a-UPA-transduced ECs on collagen segments at a density of 25,000 ECs/cm2 decreased 111AIn-platelet deposition and 125I-fibrin accumulation on collagen surfaces compared with untransduced ECs present at equivalent density (P < .05 for platelet deposition with TPA-transduced ECs and P < .05 for platelet deposition on the propagated tail, as well as fibrin accumulation on the graft with a-UPA-transduced ECs). The systemic levels of fibrinopeptide A, thrombin-antithrombin complex, D-dimer, and both local and systemic levels of TPA and UPA were not increased by transduced ECs compared with untransduced ECs. The focal antithrombotic effects of transduced ECs appear to be due to local enhancement of thrombolysis.ECs transduced with recombinant TPA and a-UPA enhance local antithrombotic activity in vivo. This strategy of attaching transduced ECs overexpressing plasminogen activators may be therapeutically useful by preventing thrombo-occlusive failure of implanted cardiovascular devices or mechanically denuded vessels.
Herpes gestationis and bullous pemphigoid: a disease spectrum
Authors: R. HOLMES, M.M. BLACK, D.M. WILLIAMSON, R.W.B. SCUTT
Journal: British Journal of Dermatology (1980)

A patient with herpes gestationis has persisted with clinically active disease for 8 years post‐partum. She also had Graves' disease, alopecia totalis and ulcerative colitis. The case demonstrates the close overlap between herpes gestationis and bullous pemphigoid.
The essence of EBM
Authors: Brendan M Reilly
Journal: BMJ (2004)

Practising what we teach remains a big challenge 

> Two roads diverged in a yellow wood, And sorry I could not travel both.… 

Robert Frost

W hen Frost pondered these two roads, he did not call for a randomised controlled trial. Life is about chance, and that goes for medicine too. Clinicians know that sometimes the best we can do is make our decision, hope it will have made all the difference, and not pine away about the road not taken. Today, as medicine lurches down the road to an evidence based world view, do we know where we are going? Should we turn back?

Even well intentioned supporters ask what's the “E” for evidence based medicine (EBM)?1 Its most basic assumptions are unproved, indeed largely untested. For example, we do not know whether “convincing information leads to optimal decision making.”2 Nor do we know whether most healthcare professionals “base their decisions on the best evidence.” As Frost wrote about another wood, EBM has miles to go, and promises to keep.

One problem is the lack of consensus and clarity about what EBM is. Experts have explained well what EBM is not.3 It is not a clearing house for cookbooks. Nor is it something we have been doing all along, repackaged to …
Improvement in Adenoviral Gene Transfer Efficiency after Preincubation at +37°C in Vitro and in Vivo
Authors: Maija Kossila, Suvi Jauhiainen, Mikko O. Laukkanen, Pauliina Lehtolainen, Maiju Jääskeläinen, Päivi Turunen, Sami Loimas, Jarmo Wahlfors, Seppo Ylä-Herttuala
Journal: Molecular Therapy (2002)

Adenovirus is a widely used vector in gene transfer experiments because it produces high transduction efficiency in vitro and in vivo by means of the coxsackie-adenovirus receptor (CAR) and major histocompatibility complex (MHC) class I α-2 domain. Adenoviral gene transfer efficiency has been reported to correlate with cellular CAR expression. We report here a simple method to increase adenoviral gene transfer efficiency in cells that do not express high levels of CAR: preincubation of adenovirus for 30–40 minutes at +37°C significantly increased the transduction efficiency in vitro in CHO and BALB/3T3 cells, in which CAR is expressed at very low levels. Increased transduction efficiency of preincubated adenovirus was also detected in vivo in rat brain tissue. In addition, we found that adenoviruses were rapidly inactivated in human serum in a complement-independent manner, whereas fetal bovine serum (FBS) had hardly any effects on the viral infectivity. We conclude that preincubation of adenoviral vectors at +37°C may substantially increase gene transfer efficiency in applications in which target cells do not express high levels of CAR.
Blood Pressure Survey of Physicians
Authors: Rose E. London
Journal: JAMA (1966)

A blood pressure survey was made of 400 physicians attending the 1965 American Medical Association annual convention. A double-blind technique was used to compare the usual clinical measurement with the electronic blood pressure monitor. The average age was 55.2 years. Mean blood pressure values by both methods were essentially identical and in the normal range. The electronic blood pressure monitor provides an efficient method of determining systolic and diastolic values.
Expression of homeobox genes in a proximal tubular cell line derived from adult mice
Authors: Gunter Wolf, Gerald S. Kuncio, Mae Jane Sun, Eric G. Neilson
Journal: Kidney International (1991)

We have been studying the expression of several homeobox genes in cultures of proximal tubular epithelium (MCT cells) harvested from adult mus musculus. Hox genes 2.1, 2.3, and 3.3, in particular, are all expressed at low levels in resting MCT cells. The expression of Hox 2.1 and 3.3 were not influenced by mitogenic (epidermal growth factor: EGF, and platelet-derived growth factor: PDGF) nor by hypertrophogenic cytokines (angiotensin II: Ang II) in serum-free media. Transcripts for Hox 2.3, however, were elevated in MCT cells by Ang II. EGF, and serum treatment, as early as 30 minutes after their addition, whereas no change, or slight reductions were observed with transforming growth factor beta (TGF beta), PDGF, and gamma-interferon (gamma IFN). Hox 2.3 was also super-induced by serum, in the presence of cycloheximide, in cells rested previously in serum-free media, suggesting that new protein synthesis was not required for expressive augmentation. The induction of Hox 2.3, moreover, was not specific for tubular epithelium, since the gene could be activated in tubulointerstitial fibroblasts after treatment with EGF. These experiments collectively represent a first report regarding the characterization of transcripts encoding homeoboxes in adult cells derived from renal tissue. The putative DNA-binding properties of homeobox proteins in general, the prompt and rapid induction of Hox 2.3 by morphogenic cytokines in tubulointerstitial cells, and the observed effect of cycloheximide on this gene, all indicate that Hox 2.3 might have a role in the general activation of mature somatic cells, as an immediate early event. probably in the capacity of a nuclear trans-acting factor.
Council of Europe launches investigation into H1N1 pandemic
Authors: R. Watson
Journal: BMJ (2010)

A Europe wide investigation will begin this week into the World Health Organization’s decision to label the outbreak of swine flu a “pandemic,” amid allegations that it did so under pressure from drug companies looking to boost demand for their vaccines.

The inquiry, launched by the Council of Europe’s parliamentary assembly, will be led by the British Labour MP Paul Flynn and could be concluded as early as June.

Speaking after being appointed to the role, Mr Flynn said that he wanted to establish how WHO had assessed the risks from …
Foregone Health Care Among Adolescents
Authors: Carol A. Ford
Journal: JAMA (1999)

ContextNo annual national population estimates exist of the numbers of adolescents who think they need but do not receive health care or their risk of health problems.ObjectiveTo describe the proportion of adolescents who report foregone health care each year and the influence of sociodemographic factors, insurance status, past health care, and health risks/behaviors on foregone care.DesignCross-sectional analyses of data from wave 1 of the National Longitudinal Study of Adolescent Health, conducted during 1995.SettingIn-home interviews conducted throughout the United States.ParticipantsOf 27,000 adolescents in grades 7 through 12 who were invited to participate, 20,746 (76.8%) completed the in-home interview.Main Outcome MeasureReported foregone health care in the preceding year by individual and family characteristics, insurance status, past health care, health/behavior risk factors, and symptoms.ResultsOn average, 2268 (18.7%) of 12,079 adolescents reported foregone health care within the past year. Factors associated with decreased risk of foregone care included continuous private or public insurance (adjusted relative risk [95% confidence interval], 0.64 [0.50-0.82] to 0.82 [0.70-0.96]), and having a physical examination within the past year (0.87 [0.78-0.97] for male and 0.79 [0.70-0.88] for female adolescents). Factors associated with increased risk of foregone care included older age (1.12 [1.06-1.15] for male), minority race/ethnicity (1.25 [1.06-1.46] to 1.50 [1.30-1.73]), single-parent home (1.31 [1.18-1.46] for female), and disability (2.03 [1.61-2.52] for male and 1.66 [1.20-2.10] for female). Adolescents participating in the following behaviors were more likely to report foregone care than those who did not: daily cigarette use (26.0% vs 16.8%; 1.34 [1.16-1.55]), frequent alcohol use (30.3% vs 18.1%; 1.34 [1.11-1.62] for male), and sexual intercourse (25.1% vs 15.1%; 1.23 [1.09-1.39] for male and 1.39 [1.23-1.56] for female). From 32.4% to 38.2% of adolescents with symptoms suggesting health problems reported foregone care (1.61 [1.13-2.26] to 2.03 [1.81-2.28]).ConclusionsOur study suggests that adolescents who forego care are at increased risk of physical and mental health problems. Efforts to improve adolescent health through health care should address factors influencing foregone care.
Doctor jailed for “culpable homicide” and possessing child pornography
Authors: Tony Sheldon
Journal: BMJ (2004)

A Dutch paediatric cardiologist has been found guilty of “culpable homicide” after a 7 month old baby girl died following heart catheterisation. He was also found guilty of possessing a large quantity of child pornography and has been banned from practising medicine for six years and jailed for 18 months, with six months suspended.

Dr Paul H, 45, had, the court accepts, intended to help Charlotte Floor, who had been born with a severe heart abnormality. But his “gross carelessness” and “irresponsible decisions” meant he is to blame for her death.

In 2001, Dr H had operated at Utrecht's Wilhelmina Children's Hospital, …
Immigrant Women's Health: Problems and Solutions
Authors: Sarita Verma
Journal: Annals of Internal Medicine (1999)

Medical Writings: Book Notes18 May 1999Immigrant Women's Health: Problems and SolutionsSarita Verma, LLB, MDSarita Verma, LLB, MDQueen's University, Kingston, Ontario, Canada. (Verma)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-10-199905180-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Kramer EJ, Ivey SL, Ying YW; eds. 438 pages. San Francisco: Jossey-Bass; 1999. $47.95. ISBN 0787942944. Order phone 415-433-1767.Field of medicine: Public health and policy.Format: Hardcover book.Audience: Primary care physicians, including general internists, obstetricians and gynecologists, family physicians, epidemiologists, psychiatrists, and medical students.Purpose: To provide information about health issues pertinent to immigrant women and to review the current state of scientific knowledge about immigrant women's attitudes, beliefs, practices, and behaviors.Content: The 20 chapters of this book are divided into four parts. The first part provides background on demographic characteristics, barriers to health care, behaviors that ... Author, Article, and Disclosure InformationAffiliations: Queen's University, Kingston, Ontario, Canada. (Verma) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 18 May 1999Volume 130, Issue 10Page: 865-866KeywordsBehaviorHealth careHealth care utilizationHealth information technologyObstetrics and gynecologyPosttraumatic stress disorderPrevention, policy, and public healthPrimary care physiciansPsychiatry and mental healthPublic policy ePublished: 15 August 2000 Issue Published: 18 May 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Twelve-Dose Drug Regimen Now Also an Option for Preventing Tuberculosis in Children and Adolescents
Authors: Ben J. Marais
Journal: JAMA Pediatrics (2015)

Preventive therapy serves 2 important functions: first toprotectvulnerableindividuals,includingyoungchildren,fromactivediseasefollowingtuberculosisexposureorinfection,andsecondtoreducethereservoiroflatentinfectionfromwhichfuturereactivationofdiseasemaydevelop.Eradicationofthepooloflatentinfectionismostrelevantinsettingswithgoodepidemic control such as the United States, where the risk offuturereinfectionislow.Multiplebarrierslimittheuptakeofpreventivetherapy,includingthelongtreatmentdurationandpoor adherence reported with 9 months of daily unsuper-visedisoniazidmonotherapy.Demonstratedequivalenceof3to 4 months of daily isoniazid and rifampin offered someimprovement,
Progression of salivary gland dysfunction in patients with Sjogren's syndrome
Authors: J Pijpe, W W I Kalk, H Bootsma, F K L Spijkervet, C G M Kallenberg, A Vissink
Journal: Annals of the Rheumatic Diseases (2006)

<b>Background:</b> Salivary gland dysfunction is one of the key manifestations of Sjögren's syndrome. <b>Objectives:</b> (1) To assess prospectively loss of function of individual salivary glands in patients with primary and secondary Sjögren's syndrome in relation to disease duration and use of immunomodulatory drugs. (2) To study changes in sialochemical and laboratory values and subjective complaints over time. <b>Methods:</b> 60 patients with Sjögren's syndrome were included in this study. Whole and gland-specific saliva (parotid and submandibular/sublingual (SM/SL)), samples were collected at baseline and after a mean of 3.6 (SD 2.3) years of follow-up. Disease duration was recorded for all patients. <b>Results:</b> Patients with Sjögren's syndrome with short disease duration had significantly higher stimulated flow rates at baseline than those with longer disease duration (p&lt;0.05). When compared with healthy controls, the decrease in SM/SL flow rates at baseline was more prominent than that in parotid flow rates (p&lt;0.05). Over time, there was a significant further decrease of stimulated flow rates, especially of the parotid gland, accompanied by increasing problems with swallowing dry food (p&lt;0.05). The decrease was independent of the use of corticosteroids or disease-modifying antirheumatic drugs (DMARDs). Sialochemical variables remained stable. <b>Conclusions:</b> Early Sjögren's syndrome is characterised by a decreased salivary gland function (parotis&gt;SM/SL), which shows a further decrease over time, regardless of the use of DMARDs or steroids. Patients with Sjögren's syndrome with longer disease duration are characterised by severely reduced secretions of both the parotid and SM/SL glands. These observations are relevant for identifying patients who would most likely benefit from intervention treatment.
The Tutorial Process
Authors: Andrew D. Hunt
Journal: JAMA (1990)

A prominent feature of the current interest in improvement of medical education has been recognition of the inadequacy of passive student learning, rote memorization of facts, and regurgitation of such memorized knowledge via subject-specific examinations. Relevance of the basic sciences to clinical situations, active student self-learning, and the catalytic effect on learning indigenous to the small-group problem-solving process are some of the main features of what has come to be known as "problem-based learning." This method has been used in an increasing number of medical schools over the past two decades, received a sort of unofficial sanction via the General Professional Education of the Physician (GPEP) report, and now, with the American Association of Medical Colleges supporting workshops to assist schools to adopt this pedadogical methodology, would seem to be generally recognized as an important and intriguing alternative to traditional lecture-based teaching. Dr Barrows has been a prominent contributor to
General practitioners' access to x ray services
Authors: N E Early
Journal: BMJ (1991)

11) mm Hg; (p<OOOl), and the median difference was 5 mm Hg (interquartile range 2-8 mm Hg; range 0-15 mm Hg).Muffling was recorded in 78% of the group and blood pressure was not heard to zero in any subject.These findings are similar to those of Perry et al,' though the distribution of differences between phase IV and phase V readings was shifted towards the right in our study (table ).Distribution (%) ofdifferences between diastolic pressures measured at phase I 'and at phase l in those with auidible muffling ofsounds Difference (mm Hg): 0-2 3-5 6-10 >10Brown and Adsett
Maternal Hormone Measurements-Reply
Authors: Johann H. Duenhoelter
Journal: JAMA (1983)

<h3>In Reply.—</h3> I appreciate the opportunity to respond to Dr Clepper, who commented on the use of maternal hormone measurements, specifically estrogens, in the management of high-risk pregnancies. The topic has been discussed with him previously.<sup>1</sup>Since that time, no great breakthrough has been made in this field; as a matter of fact, many clinicians have abandoned estrogen measurements as a result of their often disappointing experiences and based on the results of our prospective controlled study.<sup>2</sup>Nevertheless, there are institutions in which estrogens are still used in the management of high-risk pregnancies. Dr Clepper agrees with us about a high incidence of low estrogen values in healthy fetuses. However, he insists that the incidence of falsenegative results, ie, normal values in the presence of fetal jeopardy, is low. The accuracy of this statement depends on the definition of<i>fetal jeopardy</i>. There is no doubt that with a dying
Nomenclature of Voltage-Gated Sodium Channels
Authors: Alan L. Goldin, Robert L. Barchi, John H. Caldwell, Franz Hofmann, James R. Howe, John C. Hunter, Roland G. Kallen, Gail Mandel, Miriam H. Meisler, Yoheved Berwald Netter, Masahara Noda, Michael M. Tamkun, Steven G. Waxman, John N. Wood, William A. Catterall
Journal: Neuron (2000)
Eye Symptoms in Brain Tumors
Authors: Donald D. Matson
Journal: JAMA (1962)

In dissemination of medical knowledge it is often useful and interesting, rather than to discuss disease entities from an etiological or pathological point of view, to consider instead a single symptom or sign, or a group of symptoms and signs, along with the various problems they may provoke, much in the manner an individual physician might approach a new patient. This method of presentation is the one used by Alfred Huber, the Swiss ophthalmologist, in his scholarly new monograph entitled "Eye Symptoms in Brain Tumors." The author states, on the basis of his experience in examining and following 1,600 cases of brain tumor in the Clinic of Prof. H. Kravenbühl in Zurich, that in about 60% of the series, ocular abnormalities were among the initial clinical findings. He further feels that "the majority of eye signs in brain tumors actually are of diagnostic and even localizing significance." Emphasis is placed
Effect of histamine on proliferation of normal human adult lung fibroblasts.
Authors: M Jordana, A D Befus, M T Newhouse, J Bienenstock, J Gauldie
Journal: Thorax (1988)

Fibrotic lung tissue shows increased connective tissue deposition and fibroblast proliferation and in addition a substantial increase in mast cell numbers in and around the fibrotic area. To elucidate the question of whether products of mast cells affect the proliferative behaviour of structural cells in the lung and thereby contribute to fibrogenesis, the effect of histamine, a prominent mast cell derived mediator, on the in vitro proliferation of primary cultures of normal adult human lung fibroblasts was studied. Histamine enhanced fibroblast proliferation in a dose dependent manner, with an optimum effect at a physiological concentration of 10(-7) mol/l. This effect occurred when cells were exposed to histamine at restricted times during cell growth and was shown to depend in part on the stage of the cell cycle reached by the fibroblasts. The histamine induced proliferation was mediated through an H2 histamine receptor on the fibroblast, being inhibited by cimetidine, an H2 antagonist, and not by pyrilamine maleate, an antagonist of the H1 receptor. Mast cell products such as histamine may interact with and promote the increased fibroblast proliferation found in pulmonary fibrosis.