tbuckley/cabot-search huggingface dataset:
Effect of Live Measles Vaccine on the Platelet Count
Authors: Frank A. Oski, J. Lawrence Naiman
Journal: New England Journal of Medicine (1966)

THROMBOCYTOPENIA may accompany or follow a variety of viral infections.1 Thrombocytopenic purpura is a well recognized but apparently uncommon complication of measles.2 , 3 The availability of an attenuated live measles vaccine allowed a study of the effects of a controlled viral infection on the platelet count. This study demonstrates that a prompt, transient, mild depression of the platelet count occurs in many cases after inoculation with live measles virus.Materials and MethodsSubjectsSubjects, both males and females, ranged in age from six weeks to thirty-nine years. All were afebrile and in good health at the time of vaccination. Twenty-nine were . . .
Mortality among oral contraceptive users: 20 year follow up of women in a cohort study.
Authors: M. P. Vessey, L. Villard-Mackintosh, K. McPherson, D. Yeates
Journal: BMJ (1989)

OBJECTIVE--To see whether the use of oral contraceptives influences mortality. DESIGN--Non-randomised cohort study of 17,032 women followed up on an annual basis for an average of nearly 16 years. SETTING--17 Family planning clinics in England and Scotland. SUBJECTS--Women recruited during 1968-74. At the time of recruitment each woman was aged 25-39, married, a white British subject, willing to participate, and either a current user of oral contraceptives or a current user of a diaphragm or intrauterine device (without previous exposure to the pill). MAIN OUTCOME MEASURES--Overall mortality and cause specific mortality. RESULTS--238 Deaths occurred during the follow up period. The main analyses concerned women entering the study while using either oral contraceptives or a diaphragm or intrauterine device. The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use. Death rates from breast cancer (relative risk 0.9; 95% confidence interval 0.5 to 1.4) and suicide and probable suicide (relative risk 1.1; 95% confidence interval 0.3 to 3.6) were much the same in the two contraceptive groups. In 1981 the relative risk of death in oral contraceptive users from circulatory diseases as a group was reported to be 4.2 (95% confidence interval 2.3 to 7.7) in the Royal College of General Practitioners oral contraception study. The corresponding relative risk in this study was only 1.5 (95% confidence interval 0.7 to 3.0). CONCLUSIONS--These findings contain no significant evidence of any overall effect of oral contraceptive use on mortality. None the less, only small numbers of deaths occurred during the study period and a significant adverse (or beneficial) overall effect might emerge in the future. Interestingly, the mortality from circulatory disease associated with oral contraceptive use was substantially less than that found in the Royal College of General Practitioners study.
Spinal (subarachnoid) block. A review of 11,574 cases
Authors: D. C. Moore
Journal: JAMA (1966)

A computer study of 11,574 cases revealed spinal block to be a safe procedure provided (1) equipment is carefully cleaned, (2) both the equipment and drugs are heat sterilized together in a tray, and (3) the spinal block is administered with meticulous asepsis. In 8,852 patients, vasoconstrictor drugs were injected into the subarachnoid space along with the local anesthetic solution and they resulted in safe, consistent prolongation of anesthesia—epinephrine extended the duration by 50% and phenylephrine by 100%. Of the complications, hypotension was the most frequent. It occurred in 4,454 patients—1,225 prior to surgery and 3,229 during surgery. Headache resulted in 163 patients, backache in 48, postoperative vomiting in 233, peripheral nerve palsy in 17, but none were permanent. Prolonged spinal block occurred in two patients, and cardiac arrest occurred in four with three deaths. Since 1898 when August Bier produced spinal anesthesia by injecting cocaine into the subarachnoid space,
Genes, Enzymes, and Inherited Diseases: Biological Studies
Authors: Robert Druyan
Journal: JAMA (1962)

Perhaps in no discipline of biology is the movement toward a molecular basis for understanding clearer than in genetics. From the descriptive studies of genotype and phenotype, genetics has evolved to its present concern with nucleic acids, proteins, and enzymes in a fruitful effort to understand the mechanisms of heredity. In a brief, clearly illustrated text, the author presents a lucid summary of recent trends in genetics. The scope of subjects covered is extremely broad, ranging from desoxyribose nucleic acid (DNA) to therapy of inherited disease. Despite the combination of ambitious scope, brevity, and an assumption of a minimal biochemistry background, the book is clear, accurate, and understandable. No topic is covered in depth, but a good selection of recent references is given. The orientation of this book is not clinical; a variety of texts treat the problems of inherited disease more thoroughly. But, increasingly, the concepts developed in terms
Effects of Nuclear War on Health and Health Services
Authors: Abraham Verghese
Journal: JAMA (1988)

This book is an updated report by an international committee of experts in medical sciences and public health commissioned by the World Health Organization to report on the consequences of nuclear war on health and health services. If you consider yourself knowledgeable and appropriately alarmed about the danger of nuclear war, and even if you are involved (as are many physicians) in the effort to prevent nuclear war, this book will still disturb you. There is the obligatory recitation of the magnitude of arms buildup (more than 15 000 megatons, the destructive power of this mass being such that if only 1% of it were utilized in urban areas, more people would be killed in a few hours than during the whole of the Second World War) followed by a very detailed but quite readable accounting of physical characteristics of nuclear explosions. In addition to the blast wave (containing half
Why Do Patients Choose Chemotherapy Near the End of Life? A Review of the Perspective of Those Facing Death From Cancer
Authors: Robin Matsuyama, Sashidhar Reddy, Thomas J. Smith
Journal: Journal of Clinical Oncology (2006)

The number of patients receiving chemotherapy near the end of life is increasing, as are concerns about goals of treatment, toxicity, and costs. We sought to determine the available sources of knowledge, the choices, and concerns of actual patients, and how patients balanced competing issues.We used a literature search from 1980 to present.Available patient sources provide little information about prognosis, choices, alternatives, consequences, or how to choose. Many patients would choose chemotherapy for a small benefit in health outcomes, and for a smaller benefit than perceived by their health care providers for their own treatment. Adverse effects are less a concern for patients than for their well health care providers. There are no decision aids to assist patients with metastatic disease in making their choices, such as there are for adjuvant breast therapy.The perspective of the patient is different from that of a well person. Patients are willing to undergo treatments that have small benefits with major toxicity. Receiving realistic information about the different options of care and the likelihood of successful treatment or adverse effects is difficult. These factors may explain some of the increased use of chemotherapy near the end of life. Decision aids and honest, unbiased sources to inform patients of their prognosis, choices, consequences, typical outcomes, and ways to make decisions are needed. More prospective information about how patients make their choices, and what they would consider a good choice, would assist informed decision making.
Regulation of glibenclamide-sensitive K+ current by nucleotide phosphates in isolated rabbit pulmonary myocytes
Authors: L. H. Clapp
Journal: Cardiovascular Research (1995)

Although the existence of ATP-sensitive K+ (KATP) channels in vascular muscle is widely accepted, there appears to be little consensus as to what the primary regulator of these channels is under physiological or pathophysiological conditions. Recent evidence has suggested that nucleotide diphosphates (NDPs) may play a more important role than ATP. However, since the properties of vascular KATP channels are quite diverse, and the effects of these nucleotides are poorly understood, the aim of this study was to test the hypothesis that intracellular ATP can regulate whole-cell KATP current (IK,ATP) in the absence of NDPs.Single cells were isolated from rabbit main pulmonary artery by enzymatic treatment with papain. Whole-cell patch clamp experiments were performed in cells dialysed with different nucleotides. The effect of the KATP channel activator, levcromakalim (10 microM), was investigated at a holding potential of -60 mV. The contribution of IK,ATP to the holding current was defined as the current which was blocked by glibenclamide following washout of levcromakalim.Lowering the intracellular ATP concentration ([ATP]i) from 1 to 0.1 mM, in the presence or absence of GTP, enhanced the levcromakalim-induced current (Ilev) by approximately 2.5 fold and increased a glibenclamide-sensitive background K+ current (Iglib). However, Iglib was larger with GTP and the total glibenclamide-sensitive current (Ilev+Iglib) increased with time. Significant activation of Iglib failed to occur when the pipette contained no nucleotides and the responses to levcromakalim were generally much smaller than seen with ATP. GDP (0.5 mM), in the absence of pipette ATP, activated a large background K+ current which had similar properties to Ilev. Consistent with this was the observation that Ilev became substantially reduced in the presence of GDP, presumably because a significant amount of IK,ATP was already activated.The response to levcromakalim in isolated cells from pulmonary artery was, as expected for an agent activating KATP channels, modulated by changes in the pipette [ATP]. This effect was not dependent on the presence of other pipette nucleotides, although the possibility cannot be excluded that metabolites from the cellular breakdown of ATP are essential for normal channel regulation. GDP could also activate IK,ATP under conditions where the channel is probably in a low phosphorylation state. The time-dependent effects of GTP require further work to determine the precise mechanism, but may suggest that GTP and/or G-proteins are involved in the regulation of KATP channels.
Returning streets to the people
Authors: G. Tiwari
Journal: BMJ (2002)

Walking and non-motorised vehicles are the major means of transport for most poor people in Asian cities. They provide access to economic opportunities, health services, and other social services essential for survival. For many people, walking is the only way of getting to work, even over long distances. Even subsidised public transport and low cost bicycles are out of reach. These people are “captive pedestrians.” Those who use public transport systems also become pedestrians at least four times a day when they access those systems.

These two groups form the largest group of road users. Yet their needs for a safe and convenient infrastructure are ignored as cities continue to invest in an infrastructure that makes the environment even more hostile for pedestrians.

State authorities plan for the …
HIGH SENSITIVITY TROPONIN IS ASSOCIATED WITH MORTALITY, CORONARY HEART DISEASE AND HEART FAILURE IN INDIVIDUALS WITH PREVALENT CARDIOVASCULAR DISEASE IN THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY
Authors: Vijay Nambi, Justin Saunders, Lloyd Chambless, James A. de Lemos, Xiaoxi Liu, Salim Virani, Eric Boerwinkle, Ron C. Hoogeveen, Brad C. Astor, Thomas Mosley, Aaron R. Folsom, Josef Coresh, Christie Ballantyne
Journal: Journal of the American College of Cardiology (2011)
Abscess and fistulae in Crohn's disease
Authors: D. M. Steinberg, W. T. Cooke, J. Alexander-Williams
Journal: Gut (1973)

In a series of 360 patients with Crohn's disease 18% have developed a complication of abscess and/or fistula. Both complications can be spontaneous but more commonly occur in patients who have had a previous operation. There is a high incidence of fistula after laparotomy without resection of diseased bowel. Simple drainage of an abscess is usually followed by a fistula and fistulae do not close spontaneously. The optimal surgical treatment for fistula and for deep abscess is excision in continuity with the diseased segment of intestine.
ST. LOUIS ENCEPHALITIS
Authors: Margaret G. Smith, Russell J. Blattner, Florence M. Heys
Journal: The Journal of Experimental Medicine (1946)

A colony of chicken mites (Dermanyssus gallinae) was established from a single adult female mite and her offspring. This colony of mites was shown to be free of the virus of St. Louis encephalitis. Infection of mites from this homogeneous colony with the virus of St. Louis encephalitis was accomplished by feeding on chickens having viremia. The virus was recovered as readily from mites which had not been allowed to feed for 8 days as from mites freshly engorged, showing that the demonstration of virus in the mites does not depend on the presence of fresh infective chicken blood. Transovarian passage of the St. Louis virus into the second generation has been demonstrated in mites infected experimentally. The female mite infected as an adult can pass the St. Louis virus through eggs laid after additional feeding on normal blood. Persistence of the virus for a period of 6 months has been shown in a colony of mites infected experimentally in the laboratory.
Multiple Combination Bactericidal Antibiotic Testing for Patients with Cystic Fibrosis Infected with Multiresistant Strains of <i>Pseudomonas aeruginosa</i>
Authors: BIANCA J. LANG, SHAWN D. AARON, WENDY FERRIS, PAUL C. HEBERT, NONI E. MacDONALD
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

We developed a rapid in vitro antibiotic susceptibility test to screen double- and triple-antibiotic combinations for bactericidal activity against 75 multiresistant Pseudomonas aeruginosa isolates referred from 44 cystic fibrosis (CF) patients. When used alone, the most effective intravenous antibiotic, meropenem, was bactericidal against only 44% of the isolates. High-dose tobramycin (200 μ g/ml; concentrations achievable by aerosol administration) was bactericidal against 72% of isolates. Adding a second antibiotic significantly improved bactericidal activity. The most effective double-antibiotic combinations contained high-dose tobramycin plus meropenem, piperacillin/tazobactam, or ciprofloxacin, and were bactericidal against 88 to 94% of the isolates. Excluding high-dose tobramycin, the most effective intravenous double-antibiotic combinations contained meropenem plus ciprofloxacin, tobramycin (4 μ g/ml), or cefipime, and were bactericidal against 85%, 71%, and 70% of isolates, respectively. Adding a third antibiotic did not significantly improve inhibition in vitro. We conclude that double-antibiotic combinations containing meropenem or high-dose tobramycin show the best bactericidal activity in vitro against multiresistant strains of P. aeruginosa. Addition of a third antibiotic to these double-antibiotic combinations may be unnecessary.
Endocytosis Is Required for Synaptic Activity-Dependent Release of Amyloid-β In Vivo
Authors: John R. Cirrito, Jae-Eun Kang, Jiyeon Lee, Floy R. Stewart, Deborah K. Verges, Luz M. Silverio, Guojun Bu, Steven Mennerick, David M. Holtzman
Journal: Neuron (2008)
Accuracy of Diagnostic Tests Read With and Without Clinical Information
Authors: Clement T. Loy, Les Irwig
Journal: JAMA (2004)

ContextAlthough it is common practice to read tests with clinical information, whether this improves or decreases the accuracy of test reading is uncertain.ObjectiveTo determine whether diagnostic tests are more accurate when read with clinical information or without it.Data SourcesMEDLINE search (1966-December 2003) extended by search of reference lists and articles citing the articles retrieved (Web of Science, 1985-December 2003).Study SelectionAll articles comparing the accuracy of tests read twice by the same readers, once without and once with clinical information, but otherwise under identical conditions. Only articles that reported sensitivity and specificity or receiver operating characteristic (ROC) curves were included.Data ExtractionData were extracted by one author and reviewed independently by the other. When the data were difficult to interpret, differences were resolved by discussion.Data SynthesisSixteen articles met the inclusion criteria. Eleven articles compared areas under ROC curves for tests read with and without clinical information, and 5 compared only sensitivity and specificity. Ten articles used actual clinical information; 6 used constructed clinical information that was plausible. Overall, clinical information improved test reading accuracy although the effect was smaller in the articles using actual clinical information when compared with those using constructed clinical information. There were no instances in which clinical information resulted in significant reduction in test reading accuracy. In some instances, improved test reading accuracy came from improved sensitivity without loss of specificity.ConclusionsAt least for the tests examined, the common practice of reading diagnostic tests with clinical information seems justified. Future studies should be designed to investigate the best way of providing clinical information. These studies should also give an estimate of the accuracy of clinical information used, display ROC curves with identified data points, and include a wider range of diagnostic tests.
Restoration of the Unfolded Protein Response in Pancreatic β Cells Protects Mice Against Type 1 Diabetes
Authors: Feyza Engin, Alena Yermalovich, Truc Nguyen, Sarah Hummasti, Wenxian Fu, Decio L. Eizirik, Diane Mathis, Gökhan S. Hotamisligil
Journal: Science Translational Medicine (2013)

Preservation of insulin-producing pancreatic β cells in type 1 diabetes requires an intact UPR, and treatment with tauroursodeoxycholic acid can restore UPR defects.
Histamine potentiation of nerve- and drug-induced responses of a rabbit cerebral artery.
Authors: J A Bevan, S P Duckles, T J Lee
Journal: Circulation Research (1975)

Rabbit basilar artery rings are normally relatively unresponsive to transmural stimulation of their sympathetic nerve supply. However, in the presence of histamine (0.55 muM), contractile responses to nerve stimulation were markedly increased. Norepinephrine and serotonin concentrations that produce 50% of a maximum contractile response (ED50) were considerably decreased in the presence of histamine; maximum responses to both norepinephrine and serotonin were increased. Although a prejunctional effecto of histamine has not been eliminated, potentiation of responses to transmural nerve stimulation is probably due to an increase in smooth muscle responsiveness to norepinephrine. In rabbit saphenous artery rings, histamine produced a qualitatively similar potentiation of responses to nerve stimulation, norepinephrine, and serotonin except that maximum responses were not increased. Serotonin (0.084 muM) did nog potentiate contractile responses of the basilar artery to transmural nerve stimulation or norepinephrine. Since histamine and serotonin are released from rabbit platelets in response to tissue injury the synergistic effect of these agents on vascular smooth muscle contraction might be advantageous in minimizing hemorrhage. But such a response could also be deleterious if the effects of these vasoconstrictors were prolonged.
Court-Ordered Obstetrical Interventions
Authors: Veronika E.B. Kolder, Janet Gallagher, Michael T. Parsons
Journal: New England Journal of Medicine (1987)

In a national survey, we investigated the scope and circumstances of court-ordered obstetrical procedures in cases in which the women had refused therapy deemed necessary for the fetus. We also solicited the opinions of leading obstetricians regarding such cases. Court orders have been obtained for cesarean sections in 11 states, for hospital detentions in 2 states, and for intrauterine transfusions in 1 state. Among 21 cases in which court orders were sought, the orders were obtained in 86 percent; in 88 percent of those cases, the orders were received within six hours. Eighty-one percent of the women involved were black, Asian, or Hispanic, 44 percent were unmarried, and 24 percent did not speak English as their primary language. All the women were treated in a teaching-hospital clinic or were receiving public assistance. No important maternal morbidity or mortality was reported. Forty-six percent of the heads of fellowship programs in maternal-fetal medicine thought that women who refused medical advice and thereby endangered the life of the fetus should be detained. Forty-seven percent supported court orders for procedures such as intrauterine transfusions. We conclude from these data that court-ordered obstetrical procedures represent an important and growing problem that evokes sharply divided responses from faculty members in obstetrics. Such procedures are based on dubious legal grounds, and they may have far-reaching implications for obstetrical practice and maternal and infant health.