tbuckley/cabot-search huggingface dataset:
Methadone Program Problems
Authors: Edward A. Nol
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Just as the alarming increase in the use of habituating drugs and especially of heroin is a symptom of many social ills, such as alienation among the young, individual degradation in various guises, and desocialization by political and administrative hypocrisy, so are some of the ways society deals with this symptom a testimonial of ineptness, unpreparedness, and denial of reality. Specifically, I bring to your attention the ingenious ways in which the establishment is utilized to thwart attempts at handling the heroin addiction problem. The individual practitioner of medicine more than organized medicine is involved here, and since relatively few of us experience the problem, however painfully, there is ostensibly no reason why the mammoth American Medical Association should concern itself with it. In distancing itself from the rehabilitative efforts made, and by issuing careful, very general statements with regard to the issue, preferably in conjunction with
A Glucagon-Like Peptide-1 Analog Reverses the Molecular Pathology and Cardiac Dysfunction of a Mouse Model of Obesity
Authors: Mohammad Hossein Noyan-Ashraf, Eric Akihiko Shikatani, Irmgard Schuiki, Ilya Mukovozov, Jun Wu, Ren-Ke Li, Allen Volchuk, Lisa Annette Robinson, Filio Billia, Daniel J. Drucker, Mansoor Husain
Journal: Circulation (2012)

Background— Cardiac consequences of obesity include inflammation, hypertrophy, and compromised energy metabolism. Glucagon-like peptide-1 is an incretin hormone capable of cytoprotective actions that reduces inflammation and endoplasmic reticulum stress in other tissues. Here we examine the cardiac effects of the glucagon-like peptide-1 analog liraglutide in a model of obesity, independent of changes in body weight. Methods and Results— C57Bl6 mice were placed on a 45% high-fat diet (HFD) or a regular chow diet. Mice on HFD developed 46±2% and 60±2% greater body weight relative to regular chow diet–fed mice at 16 and 32 weeks, respectively (both P &lt;0.0001), manifesting impaired glucose tolerance, insulin resistance, and cardiac ceramide accumulation by 16 weeks. One-week treatment with liraglutide (30 µg/kg twice daily) did not reduce body weight, but reversed insulin resistance, cardiac tumor necrosis factor-α expression, nuclear factor kappa B translocation, obesity-induced perturbations in cardiac endothelial nitric oxide synthase, connexin-43, and markers of hypertrophy and fibrosis, in comparison with placebo-treated HFD controls. Liraglutide improved the cardiac endoplasmic reticulum stress response and also improved cardiac function in animals on HFD by an AMP-activated protein kinase–dependent mechanism. Supporting a direct mechanism of action, liraglutide (100 nmol/L) prevented palmitate-induced lipotoxicity in isolated mouse cardiomyocytes and primary human coronary smooth muscle cells and prevented adhesion of human monocytes to tumor necrosis factor-α–activated human endothelial cells in vitro. Conclusions— Weight-neutral treatment with a glucagon-like peptide-1 analog activates several cardioprotective pathways, prevents HFD-induced insulin resistance and inflammation, reduces monocyte vascular adhesion, and improves cardiac function in vivo by activating AMP-activated protein kinase. These data support a role for glucagon-like peptide-1 analogs in limiting the cardiovascular risks of obesity.
Effect of Intravenous Glucose on Concentration of Insulin in Maternal and Umbilical-cord Plasma
Authors: R. D. G. Milner, C. N. Hales
Journal: BMJ (1965)

using a ferricyanide method (Hoffman, 1937), within 36 hours.This period of storage was accepted, since, when the same sample was estimated repeatedly at different times (0-36 hours), any change in blood-sugar concentration was less than the error of the method.
A STUDY OF THE ANTISEPTIC PROPERTIES OF CERTAIN ORGANIC COMPOUNDS
Authors: I. J. Kligler
Journal: The Journal of Experimental Medicine (1918)

THIS STUDY OF THE INHIBITIVE EFFECT OF ANILINE AND SOME OF ITS DERIVATIVES AND OF THE TRIPHENYLMETHANE DYES ON CERTAIN BACTERIA WARRANTS THE FOLLOWING TENTATIVE CONCLUSIONS: 1. The composition and reaction of the medium exert a marked influence on the behavior of the antiseptic. The higher the concentration of organic nitrogenous compounds (peptone) in the medium, the lower is the effective concentration of the dye. The reaction of the medium modifies the specific action of the antiseptic, owing probably to an alteration in the bacterial cell. 2. The germicidal action of the compounds is a function of the benzene nucleus, the added elements or radicals, their number, and, in the case of the dyes, probably the quinoid structure of the nucleus. 3. As far as tested, the increase in the number of alkyl radicals increases the antiseptic power. Methyl green is an interesting exception to this rule, for the change of one of the nitrogens to the quaternary salt is accompanied by an almost complete loss in inhibitive action. 4. The antiseptic power is enhanced to a greater extent by an ethyl than a methyl group, and the second alkyl produces a proportionately greater increase than the first. It appears that the relative position of the introduced group may be a factor in determining the relative improvement in the effectiveness of the compound. 5. The introduction of a methyl group in the nucleus consistently enhances the inhibitive action of the compound and its alkyl derivatives. This is evident from a comparison of the action of aniline and its derivatives with that of toluidine and its corresponding derivatives. 6. The simple aniline derivatives, as well as the dyes, are more toxic for the Gram-positive than the Gram-negative bacteria. Of the former, Bacillus subtilis is more sensitive to the dyes than Staphylococcus aureus, while the reverse is true in the case of the aniline compounds. 7. The most marked specific selective effect is manifested by the triphenylmethane dyes. Bacillus aerogenes and Bacillus typhosus possess a higher resistance to these substances than Bacillus coli or Bacfflus dysenterice. The last is exceedingly sensitive. This partial specificity is apparently a function of the molecule as a whole.
The FDA's Critique of the Anturane Reinfarction Trial
Authors: Robert Temple, Gordon W. Pledger
Journal: New England Journal of Medicine (1980)

The Food and Drug Administration recently refused to approve a claim that sulfinpyrazone (Anturane) was effective in the prevention of sudden death during the first six months after myocardial infarction. The Ciba—Geigy company based this claim entirely on the results of a controlled multicenter trial, the Anturane Reinfarction Trial, which was reported and discussed in the Journal.1 2 3—4 This paper summarizes the problems with the trial that were identified during FDA staff review and the reasons for the FDA decision.We are aware that it is unusual for an FDA critique of a clinical trial to be published in the medical . . .
Reading of Capsule Endoscopy Images Significantly Improved
Authors: U. Seitz, Y. M. Naga, S. Bohnacker, S. Seewald, N. Soehendra
Journal: Endoscopy (2005)

Capsule endoscopy (Given Imaging, Yoqneam, Israel) allows for small-bowel assessment with little discomfort for the patient. However, evaluation is still a challenge for the investigator. Unlike flexible endoscopy where the examiner is actively involved in maneuvering the instruments, browsing more than 50 000 images in capsule endoscopy can be a monotonous procedure. We added a “jog/shuttle” control, which is a well-established tool in professional video editing, to the Given Imaging capsule endoscopy reading system.
Oregon's Bold Medicaid Initiative
Authors: William B. Stason
Journal: JAMA (1991)

Oregon's plan to prioritize health care services for coverage under its Medicaid program offers a unique opportunity to focus national debate on health insurance reform. There is little question that our present system is a patchwork with many serious failings: (1) continued escalation of costs despite managed care initiatives, utilization management, and prospective payment for hospital care; (2) inequities in physician reimbursement; (3) the large number (&gt;37 million) of Americans who have no insurance and the many more who are underinsured; and (4) the dramatic geographic variations in the use of health services, without corresponding evidence of differences in health. The Oregon plan is a bold attempt to maximize health care benefits for Medicaid recipients within severe budgetary limitations. This ambitious experiment should be encouraged. The value of lessons to be learned— positive and negative—far outweighs the potential risks. The essence of this plan, as ably described by Hadorn<sup>1</sup>
Protein Kinase A (PKA) Inhibition Renders Interleukin-1 Beta (IL-1β) Pro-mitogenic to Human Airway Smooth Muscle (ASM) Cells: Role of Induced GPCR Ligands
Authors: A MISIOR, H YAN, R PASCUAL, D DESHPANDE, R PENN
Journal: Journal of Allergy and Clinical Immunology (2008)
Ethical Issues in the Design and Conduct of Clinical Trials in Developing Countries
Authors: Harold T. Shapiro, Eric M. Meslin
Journal: New England Journal of Medicine (2001)

There has been considerable controversy about the ethics of clinical trials that are sponsored or conducted by groups in industrialized countries but carried out in developing countries.18 The National Bioethics Advisory Commission, of which we serve as chairman and executive director, respectively, has recently addressed these and related issues.9 International collaborative research covers a broad spectrum of methods, topics, and research strategies. In this essay, we discuss ethical issues in the design and conduct of clinical trials in developing countries. In particular, we focus on phase 3 and other drug trials that, if successful, can lead to the use . . .
The Epstein-Barr Virus and Chronic Fatigue Syndrome
Authors: George R. Reiss
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Hellinger et al<sup>1</sup>state that "the validity of the chronic mononucleosis syndrome and the appropriate means for its diagnosis have not been established." I would like to add a proviso. Since there were no data presented in this study that either prove or disprove the "validity" of the syndrome itself, the authors should refrain from drawing such a conclusion. This article only addresses the value of Epstein-Barr virus serology in the diagnosis of chronic mononucleosis, also known as chronic fatigue syndrome. Others have reached similar conclusions in the past.<sup>2</sup> These results could be interpreted to show that the testing available today is simply not sensitive enough to help diagnose this illness. They also suggest that laboratory testing for chronic fatigue syndrome, in itself, is no substitute for careful history taking, examination, and differential diagnosis.
Influence of indomethacin and l-cysteine on histamine and peptidoleukotriene release from superfused tracheas taken from guinea pigs passively sensitized with IgG1 and IgE antibodies
Authors: Jai Y. Ro, Carl K. Buckner, John K. Brendel, Rand I. Fishleder, Frank M. Graziano
Journal: Journal of Allergy and Clinical Immunology (1991)
Bioenergetic Consequences of Left Ventricular Remodeling
Authors: Jianyi Zhang, Kenneth M. McDonald
Journal: Circulation (1995)

Background Left ventricular (LV) remodeling is associated with LV dysfunction and decrease of coronary flow reserve. The underlying mechanisms responsible for these alterations are unclear. Changes in myocardial high-energy phosphate levels may be associated with these alterations. Methods and Results Twelve dogs with LV remodeling secondary to discrete necrosis produced by transmyocardial DC shock were compared with 8 normal dogs. LV mass and end-diastolic volume were measured by magnetic resonance imaging 7 days before and 12.9±1.3 months after DC shock. Transmurally localized 31 P nuclear magnetic resonance spectra from five layers across the LV wall were obtained simultaneously with transmural blood flow measurements (microspheres) under basal conditions and during pacing at 200 and 240 beats per minute. LV mass and end-diastolic volume were significantly increased after DC shock (33% and 26%, respectively, each P &lt;.01). Under basal conditions, the subendocardial creatine phosphate (CP)/ATP ratio was significantly lower in remodeled LV compared with the control group (1.71±0.09 versus 2.04±0.09, P &lt;.05). The subendocardial CP/ATP ratio was inversely correlated with both the increase in LV mass and LV end-diastolic volume ( r =−.77 and r =−.70, P &lt;.01 and P &lt;.05, respectively). In remodeled myocardium, pacing induced a significant increase in LV end-diastolic pressure (from 8±1 to 20±3 mm Hg, P &lt;.05), which was accompanied by a significant decrease of subendocardial/subepicardial (Endo/Epi) blood flow ratio (from 1.01±0.10 to 0.63±0.11, P &lt;.05) and a significant decrease in subendocardial CP/ATP ratio (from 1.78±0.07 to 1.61±0.10, P &lt;.05) and increase of ΔP i /ATP ratio (from 0 to 0.24±0.05, P &lt;.01). The decrease in subendocardial CP/ATP ratio was correlated with the decrease in Endo/Epi blood flow ratio ( r =.79, P &lt;.05). Conclusions These results demonstrate that alterations in myocardial high-energy phosphate levels are correlated with the extent of LV remodeling. In remodeled hearts, pacing-induced tachycardia produces further changes of myocardial high-energy phosphate levels in the subendocardium that appear to be related to ventricular dysfunction and redistribution of blood flow away from the subendocardium.
Combined factor V/VIII deficiency: A case report including levels of factor V and factor VIII coagulant and antigen as well as protein C inhibitor
Authors: Janet M. Brown, Nancy R. Selik, Mary Jo Voelpel, Eberhard F. Mammen
Journal: American Journal of Hematology (1985)

Abstract Comprehensive coagulation studies were performed on members of a family with combined factor V/VIII deficiency. The purpose of these studies was to investigate the hypothesis that combined factor V/VIII deficiency is due to a lack of the inhibitor to activated protein C. The analyses performed included routine APTT and PT, factor V and VIII coagulant activity and antigen levels, van Willebrand factor levels, protein C antigen assay, and both protein C inhibitor activity and antigen levels. Three of the 19 family members studied were found to have a deficiency of both factors V and VIII. These three individuals showed prolonged APTTs and PTs and decreased levels of factor V and factor VIII coagulant activity and antigen. Factor VIII related antigen and ristocetin cofactor (von Willebrand factor) levels were normal. Protein C and both protein C inhibitor activity and antigen levels were also found to be normal. These findings confirm the results of other recent investigators and indicate that the autosomal, inherited combined factor V/VIII deficiency is not due to a protein C inhibitor deficiency. The real defect in this combined deficiency remains to be determined.
The gender agenda
Authors: D. Spence
Journal: BMJ (2011)

I like listening to the radio. There are always recurring stories. A common complaint is the lack of women on company boards. A great quote was “only when we have as many incompetent women executives as incompetent men will there be true equality.” But these vaulted arguments about sex equality are largely meaningless to ordinary people. Change at the top sees pearls replacing pinky rings, sisters replacing brothers. This is still a closed, privileged group—from a narrow number of schools and universities—that dominates society. So is this real change? …
THE PULMONIC SECOND SOUND, IN HEALTH AND DISEASE.
Authors: IRVIN HARDY
Journal: JAMA (1906)

While due attention has been given to the difference existing between the pulmonic and systemic circulations, as a result of pulmonary consolidation, there seems to be a scarcity of comment regarding a comparative lessening of intra-aortic blood pressure. By experiment and observation I have found in healthy individuals what appeared to be an accentuated pulmonic second sound which would disappear on having the patient walk briskly for a few minutes. The point I wish to make is that healthy people who are inactive, engaged in sedentary occupations, have an apparent accentuated pulmonic second when in reality it is only a relative one, due to lessened intra-aortic pressure, the result of deficient exercise. Use is made of exercise to bring out signs of disease of the valve segments, but I have seen no literature bearing on this subject. What theory one may have, the fact remains, or at least is constant
Streptococcal Pneumonia in Neonatal Respiratory Distress
Authors: Michael L. Wyman
Journal: JAMA (1980)

To the Editor.—  We refer to the article by Miller et al (243:1176, 1980) concerning neonatal respiratory distress. We would like to add a note regarding the importance of streptococcal pneumonia.  As greater strides have been made in the prevention and treatment of both respiratory distress syndrome (RDS) and meconium aspiration syndrome, we and others have found that streptococcal pneumonia persists and thus is becoming the most notable killer among the various causes of respiratory distress in the newborn. 1,2 It is treatable with penicillin early in its course but tragically is not often treated until too late, because the chest roentgenogram is interpreted as uncomplicated RDS. 1,3,4 We believe it is crucial that the roentgenographic appearance of neonatal streptococcal pneumonia is often indistinguishable from uncomplicated RDS, (ie, diffuse granular appearance with or without air bronchograms) and that trying to make the distinction can result in a lethal delay in
City of Birmingham Vacancies
Authors: H. R. Pomson
Journal: BMJ (1965)

MEIALSOAL 49 ferences or in one's own.case list, and even when we consider the origins of the malady we find that these, too, are not unspecific.Typically the hysterical individual is some- one who suffers from severe headache, has a distressing pain in some part of the body, constantly demands sympathy, or tends to complain of not being understood.She is self-centred, constantly feels people are not good enough to her, and is so preoccupied with her own problems that she has little or no time to consider the needs of anyone else.It is this chronically complaining attitude with perpetual sense of injury that is charac- teristic.Occasionally there exists some other disability such as paralysis, lameness, or blindness, without there being an organic basis for such symptoms, which can, there- fore, disappear or interchange with each other.Hysterical patients often are frigid.The treatment of such patients can be wearing, as they make such pathetic demands for sympathy or help, but at the same time they are selfish to a degree.These patients from a very early age have suffered from a sense of not being loved, and the origins of this quality have become so deeply unconscious by the time adult life is reaphed that they are seldom accessible to therapy, with correspondingly disappointing prognosis.Male hysterics are in a small minority.-Iam, etc., Barnt Green, DAVID T. MACLAY.Birmingham.Electrocardiography with Music SIR,.-
Academic medicine: a faltering engine
Authors: P. M Stewart
Journal: BMJ (2002)

News p 446 

> “Oh let me lead an academicke life”
> 
> B Hall, Virgidem 1599;IV:83

Arecent report for the council of heads of medical schools for the United Kingdom has concluded that 1000 more clinical academic posts will be needed by 2006 to train 2500 more medical students—a 60% increase in the number of students since 1998.1 Clinical research is also under threat: the number of clinical academics active in research in British universities fell by 12% between the 1996 and 2001 research assessment exercises (from 2813 to 2469 full time equivalents).2 Despite this, there is a crisis in recruitment and retention of clinical academics within the United Kingdom such that over 10% of posts are unfilled.1 This is not a new problem. In 1995 a House of Lords select committee drew attention to recruitment problems in academic medicine. In 1997 the Richards report made 35 recommendations to prevent a threat to academic medicine, yet few of these were acted on.3 Why has this crisis occurred and what can be done about it?

Unfortunately there is no single culprit. The uncertain career structure for clinical academics remains a major disincentive. Although the specialist registrar training programme provides a structured and accelerated approach to training junior doctors, it lacks flexibility in accommodating the training of academics, which involves a postdoctoral research fellowship. Undertaking a period of protected research …
Topical PUVA treatment increases epidermal beta-adrenergic adenylate cyclase responsiveness
Authors: S. KAJITA, H. IIZUKA, Y. HASHIMOTO, A. OHKAWARA
Journal: British Journal of Dermatology (1986)

The effects of topical PUVA treatment on the epidermal cyclic AMP system were investigated. 8‐methoxypsoralen (8‐MOP), 0.3% in ethanol was applied to the backs of pigs which were then irradiated with UVA. A significant increase in the epidermal beta‐adrenergic adenylate cyclase response was observed 24 h after low (1.1 J/cm2) and moderate (2.1 J/cm2) dose irradiation. There was no significant change in the adenosine‐ or histamine‐mediated adenylate cyclase responses. 8‐MOP application or UVA irradiation alone had no effect on the beta‐adrenergic adenylate cyclase response. PUVA treatment with a higher irradiation dose (4.2 J/cm2) produced no increase in the beta‐adrenergic response and adenosine‐ and histamine‐mediated adenylate cyclase responses were decreased. Cyclic AMP phosphodiesterase activity was decreased by PUVA treatments using UVA doses of 1.1 and 2.1 J/cm2; however, the change was not statistically significant. The increased beta‐adrenergic response was also observed in the presence of the cyclic AMP phosphodiesterase inhibitor, isobutylmethylxanthine. These results indicate that epidermal adenylate cyclase responsiveness is affected by topical PUVA treatment in vivo.
Effect of Erythropoietin on Exercise Capacity in Patients With Moderate to Severe Chronic Heart Failure
Authors: Donna M. Mancini, Stuart D. Katz, Chim C. Lang, John LaManca, Alhakam Hudaihed, Ana-Silvia Androne
Journal: Circulation (2003)

Background— Patients with chronic heart failure (CHF) are frequently anemic. An increase in hemoglobin could enhance exercise performance by increasing oxygen delivery. We investigated the effect of erythropoietin (EPO) on exercise performance in anemic patients with CHF. Methods and Results— Twenty-six anemic patients aged 57±11 years were randomized to receive EPO (15 000 to 30 000 IU per week) or placebo for 3 months. Parameters measured at baseline and end therapy included blood parameters (hemoglobin, hematocrit, plasma volume), exercise parameters (peak oxygen consumption [V̇ o 2 ], exercise duration, 6-minute walk), muscle aerobic metabolism (half-time of V̇ o 2 and near infrared recovery), and forearm vasodilatory function. EPO was well tolerated by all patients. Twelve patients in the EPO group felt improvement versus 1 in the placebo group ( P &lt;0.05). There were significant increases in hemoglobin (11.0±0.5 to 14.3±1.0 g/dL, P &lt;0.05), peak V̇ o 2 (11.0±1.8 to 12.7±2.8 mL · min −1 · kg −1 , P &lt;0.05) and exercise duration (590±107 to 657±119 s, P &lt;0.004) in the EPO group but no significant changes in the control group. Resting and hyperemic forearm vascular resistance and indices of the rate of muscle oxidative capacity were unchanged in both groups. Conclusion— EPO significantly enhances exercise capacity in patients with CHF. One mechanism of improvement in V̇ o 2 is increased oxygen delivery from increased hemoglobin concentration.