tbuckley/cabot-search huggingface dataset:
Increased Restenosis in Diabetes Mellitus After Coronary Interventions Is Due to Exaggerated Intimal Hyperplasia
Authors: Ran Kornowski, Gary S. Mintz, Kenneth M. Kent, Augusto D. Pichard, Lowell F. Satler, Theresa A. Bucher, Mun K. Hong, Jeffrey J. Popma, Martin B. Leon
Journal: Circulation (1997)

Background The increased risk of restenosis after catheter-based coronary interventions in diabetic patients has not been determined. Intravascular ultrasound (IVUS) has shown that the decrease in arterial area is responsible for most of the late lumen loss in nonstented lesions and that intimal hyperplasia is responsible for all of the late lumen loss in stented lesions. Methods and Results Serial (postintervention and follow-up at 5.6±3.3 months) IVUS was used to study 251 native coronary lesions in 241 patients; 63 patients had treated diabetes mellitus (oral hypoglycemic drugs or insulin). Interventional procedures included percutaneous transluminal coronary angioplasty, directional or rotational atherectomy, excimer laser angioplasty, or Palmaz-Schatz stents. The external elastic membrane (EEM), stent, and lumen areas were measured. The plaque+media (P+M) area in nonstented lesions was calculated as EEM minus lumen area, and the intimal hyperplasia (IH) area in stented lesions was calculated as stent minus lumen area. The anatomic slice selected for serial analysis had an axial location within the target lesion at the smallest follow-up lumen area. Nonstented lesions in diabetics and nondiabetics had a similar decrease in EEM cross-sectional area (CSA; 1.9±2.8 versus 1.8±4.2 mm 2 ; P =.6350). However, nonstented lesions in diabetics had a greater increase in P=M CSA (1.3±2.8 versus 0.6±2.5 mm 2 , P =.0720), and the increase in P=M CSA contributed a greater percentage to the decrease in lumen CSA. In stented lesions, the decrease in lumen CSA (5.2±2.5 versus 2.0±2.3 mm 2 ) and the increase in IH CSA (5.0±2.8 versus 1.8±2.0 mm 2 ) were greater in diabetics than nondiabetics ( P =.0009 and P =.0007, respectively). These findings were even more striking in (nonstented and stented) restenotic lesions. Conclusions Serial IVUS analysis showed that the main reason for increased restenosis in diabetes mellitus was exaggerated intimal hyperplasia in both stented and nonstented lesions.
Severe, Reversible Neutropenia During High-Dose Mebendazole Therapy for Echinococcosis
Authors: Mark H. Levin
Journal: JAMA (1983)

Two patients receiving oral high-dose mebendazole therapy for echinococcosis were found to have severe, reversible neutropenia, apparently due to marrow suppression; platelets and RBCs were also reversibly suppressed in one. High blood levels of mebendazole (239 ng/mL in one patient may have resulted in the neutropenia and several toxic side effects, as well as a striking shrinkage of the patient's pulmonary and liver cysts. Neutropenia with high-dose mebendazole therapy may occur in up to 5% of patients and may be much more common than previously recognized. The WBC count should be monitored frequently during the first several weeks of therapy. Further experience will be needed to determine whether neutropenia is related to mebendazole levels. (<i>JAMA</i>1983;249:2929-2931)
US health system is not meeting patients' needs at end of life, says expert committee
Authors: M. McCarthy
Journal: BMJ (2014)

The US health system needs to undergo major changes if it is to meet the needs of patients nearing the end of life, a new report from the US Institute of Medicine has said.

The report1 was written by a 21 member expert committee convened by the institute. It found that, although the fields of palliative and hospice care had become established in the United States, access to good end of life care remained limited by the small number of palliative care specialists, a lack of primary and specialty care providers who were proficient in basic palliative care, and a health system whose incentives promoted medical interventions ahead of compassionate end of life care.

“Often clinicians …
Escherichia coli rpoB Mutants Have Increased Evolvability in Proportion to Their Fitness Defects
Authors: J. E. Barrick, M. R. Kauth, C. C. Strelioff, R. E. Lenski
Journal: Molecular Biology and Evolution (2010)

Evolvability is the capacity of an organism or population for generating descendants with increased fitness. Simulations and comparative studies have shown that evolvability can vary among individuals and identified characteristics of genetic architectures that can promote evolvability. However, little is known about how the evolvability of biological organisms typically varies along a lineage at each mutational step in its history. Evolvability might increase upon sustaining a deleterious mutation because there are many compensatory paths in the fitness landscape to reascend the same fitness peak or because shifts to new peaks become possible. We use genetic marker divergence trajectories to parameterize and compare the evolvability--defined as the fitness increase realized by an evolving population initiated from a test genotype--of a series of Escherichia coli mutants on multiple timescales. Each mutant differs from a common progenitor strain by a mutation in the rpoB gene, which encodes the beta subunit of RNA polymerase. Strains with larger fitness defects are proportionally more evolvable in terms of both the beneficial mutations accessible in their immediate mutational neighborhoods and integrated over evolutionary paths that traverse multiple beneficial mutations. Our results establish quantitative expectations for how a mutation with a given deleterious fitness effect should influence evolvability, and they will thus inform future studies of how deleterious, neutral, and beneficial mutations targeting other cellular processes impact the evolutionary potential of microorganisms.
Medical Communication in Alaska by Satellite
Authors: Heather E. Hudson, Edwin B. Parker
Journal: New England Journal of Medicine (1973)

Abstract An experimental communication satellite has been used since late summer of 1971 to provide daily two way radio contact between native health aides in remote Alaska communities and a Public Health Service doctor. Health aides, who after 16 weeks of training provide all the primary health care in their communities, are now able to consult with a doctor concerning treatment of most of their cases where formerly radio contact was impossible six days out of seven. Doctors and health aides have accepted the experimental communication service as an integral part of the Alaska health-care delivery system. The Public Health Service now has the problem of how to terminate or replace the experimental service without lowering the quality of health care that the native people have learned to expect. (N Engl J Med 289:1351–1356, 1973)
Endoscopic Ultrasonography of an Arteriovenous Malformation in a Gastric Polyp
Authors: T.L. Tio, G.N.J. Tytgat
Journal: Endoscopy (1986)

A case of arteriovenous malformation in a gastric polyp in a 60-year-old male complicated by profuse bleeding after endoscopic polypectomy, and treated successfully by emergency surgery, is presented. The vascular abnormality was clearly visualized by endoscopic ultrasonography (EUS) prior to endoscopic removal of the polyp. Although endoscopic coagulation of the pedicle proceeded slowly and with the utmost care causing apparently adequate coagulation of the stalk, the depth, of coagulation appeared insufficient to prevent major haemorrhage. From this experience we would be inclined to recommend EUS examination of the pedicle of large polypoid lesions to document the size of the vascular structure before endoscopic transection is carried out.
Cardiovascular response to static exercise during selective autonomic blockade in the conscious cat.
Authors: G Diepstra, W Gonyea, J H Mitchell
Journal: Circulation Research (1980)

Selective autonomic blockade with propranolol, atropine, and combined atropine and propranolol was used to elucidate the role of the autonomic nervous system in the cardiovascular responses that occur during voluntary static exercise in conscious cats. Seven animals were operantly conditioned to hold a bar against a fixed resistance for a constant time of 15 seconds and were then placed on an exercise regimen which consisted of small weekly increments in resistance. With a resistance of 100 g. heart rate (HR) increased by 7%. With exercise at a resistance of 200 g, HR (10%), left ventricle systolic pressure (LVSP, 16%), and LV max dp/dt (18%) increased, and significant changes in these parameters persisted throughout the remainder of the training period. beta-Adrenergic receptor blockade with propranolol abolished the increase in LV max dp/dt, whereas HR and LVSP increased. After atropine, the increase in HR was abolished at the early training stages, whereas LVSP and LV max dp/dt increased. Administration of atropine and propranolol blocked the increase in HR and LV max dp/dt responses, whereas LVSP increased. In this study, the increased HR in response to exercise was mediated primarily by the parasympathetic nervous system, whereas the increases in LV max dp/dt were mediated by the sympathetic nervous system. Furthermore, the bradycardia accompanying chronic performance of isometric exercise resulted from both an increase in vagal tone and a decrease in sympathetic tone.
Changing Patterns of PCP Infection After Prophylactic Treatment in AIDS Patients
Authors: H. El-Zeftawy, H. Abujudeh, M. Azia, S. Naddaf, W. Omar, S. Atay, M. Kumar, L. Difabrizio, V. LaBombardi, J. Gillooly, H. M. Abdel-Dayem
Journal: Clinical Nuclear Medicine (1998)

El-Zeftawy, H.; Abujudeh, H.; Azia, M.; Naddaf, S.; Omar, W.; Atay, S.; Kumar, M.; Difabrizio, L.; LaBombardi, V.; Gillooly, J.; Abdel-Dayem, H. M. Author Information
Peerage of Science: will it work?
Authors: Attila Hettyey, Matteo Griggio, Marlene Mann, Shirley Raveh, Franziska C. Schaedelin, Kerstin E. Thonhauser, Michaela Thoß, Wouter F.D. van Dongen, Joël White, Sarah M. Zala, Dustin J. Penn
Journal: Trends in Ecology & Evolution (2012)
SOME REMARKS ON THE FEEDING OF SCHOOL CHILDREN.
Authors: LOUIS W. ATLEE
Journal: JAMA (1884)

Read in Section on the Diseases of Children of the American Medical Association, May, 1884. From the beginning of all things the weak have been subservient to the strong, both mentally and physically. That the vigor of its people goes to make the greatness of a state is well illustrated in the history of the Roman people, who lost their supremacy in proportion as they destroyed their once famous physical abilities by sensuous indulgences. It behooves us to see that this coming generation is endowed with the bodily vigor to fight sucessfully the never-ceasing battle of life; for upon our shoulders is thrown this responsibility. The subject to which I wish to draw your attention is one that of late has been most thoroughly sifted in England, where a remedy for the evil has been happily ested. Every actively engaged practitioner in a large city, must have been struck by
INTRAVASCULAR ULTRASOUND LUMEN AREA PARAMETERS FOR ASSESSMENT OF PHYSIOLOGICAL ISCHEMIA BY FRACTIONAL FLOW RESERVE IN INTERMEDIATE CORONARY ARTERY STENOSIS
Authors: Rebecca Torguson, Anh Bui, Zhenyi Xue, Lowell Satler, Augusto Pichard, Itsik Ben&ndash;Dor, Ron Waksman
Journal: Journal of the American College of Cardiology (2012)
Blood ethanol. A report of unusually high levels in a living patient
Authors: K. B. Hammond
Journal: JAMA (1973)

A young woman with an unusually high blood ethanol level (780 mg/100 ml) was admitted to the emergency room at the University of Colorado Medical Center following an automobile accident. This case is presented because of the exceptional degree of central nervous system tolerance exhibited by the patient and because her ethanol elimination rate appeared to follow first-order kinetics instead of the zero-order kinetics usually seen in the metabolism of ethanol in normal individuals.
Pharmacological Modification of Gastric Emptying: Effects of Propantheline and Metoclopromide on Paracetamol Absorption
Authors: J. Nimmo, R. C. Heading, P. Tothill, L. F. Prescott
Journal: BMJ (1973)

The rate of paracetamol absorption depends on the rate of gastric emptying. Propantheline delayed gastric emptying and markedly slowed the absorption of paracetamol in six convalescent hospital patients. Conversely, the absorption of paracetamol in five healthy volunteers was accelerated by metoclopramide, a drug which stimulates gastric emptying. The total 24-hour urinary excretion of paracetamol was not influenced by propantheline or metoclopramide. Other similar absorption interactions probably occur since drugs are poorly absorbed from the stomach and many therapeutic agents influence gastrointestinal motility.
CIRCULATION OF PHENOLSULPHONEPHTHALEIN IN THE CEREBROSPINAL SYSTEM
Authors: H. C. SOLOMON
Journal: JAMA (1922)

The formation, circulation and absorption of the cerebrospinal fluid in the various fluid spaces of the central nervous system is a subject concerning which much information has been obtained. The work of Mott,<sup>1</sup>Cushing,<sup>2</sup>Frazier,<sup>3</sup>Weed<sup>4</sup>and others has shown that the greater part of the fluid is formed in the choroid plexuses situated in the ventricles of the brain. Opinion tends to the conception that the fluid is formed as a secretion rather than as a transudate. It is possible that some of the fluid is formed on the surface of the cortex of the brain or spinal cord as a secretion of the serous surfaces of the meninges. However, if this is so, it is only an insignificant portion of the fluid that is so formed. The greater portion of the fluid is formed by the choroid plexuses of the lateral ventricles. The fluid
THE PSYCHIC TREATMENT OF INEBRIETY AND ITS RELATION TO SO-CALLED CURES.
Authors: L. D. MASON
Journal: JAMA (1907)

We apply the term inebriate to a class of persons who, involuntarily and not as a matter of choice, have become habituated to the use of alcoholic liquors in excess, either periodically or more or less habitually, and who, under these conditions, have lost their self-control and whose will power is entirely in abeyance to their appetite. I maintain, however, that in a large proportion of cases the will power is not destroyed, or so handicapped as to be beyond the power of resurrection, but is overcome and held in subjection by a master passion, which dominates the will. The indications, then, are simple; we must rouse the latent will power and make it aggressive; in other words, oppose the psychic to the physical nature. "The flesh lusteth (or striveth) against the spirit. We must reverse this order of things. All forms of inebriety are not subject to this method
Sickle-Cell Anemia: Molecular and Cellular Bases of Therapeutic Approaches
Authors: Jurrien Dean, Alan N. Schechter
Journal: New England Journal of Medicine (1978)

THE term "molecular disease" was coined almost 30 years ago by Linus Pauling and his associates to describe their analysis of the abnormality in sickle-cell anemia.1 Since that time tremendous progress has been made in the understanding of the structure and function of this mutant hemoglobin molecule and the conditions under which it aggregates when deoxygenated to form a gel. Indeed, in the last decade, particularly in the last few years, there has been an explosive growth in knowledge of the structure of the gel of sickle hemoglobin and the mechanism of its formation. The exact relations among gelation, sickling . . .
Levocetirizine is effective for symptom relief including nasal congestion in adolescent and adult (PAR) sensitized to house dust mites
Authors: P. C. Potter
Journal: Allergy (2003)

Background: Antihistamines are the most commonly prescribed class of medication for perennial allergic rhinitis (PAR). The primary objective of this study was to determine whether levocetirizine (Xyzal ® ), the active enantiomer of cetirizine, could achieve at least a 50% improvement in PAR symptoms compared to the placebo over the first week of treatment. Methods: A total of 294 patients with PAR due to house dust mites were randomized in this 8‐week double‐blind, placebo‐controlled, multicentre trial to receive either levocetirizine 5 mg/day or placebo. Mean Total Four‐Symptom Scores (T4SS) (nasal pruritus, ocular pruritus, rhinorrhoea and sneezing) were compared between treatment groups over weeks 1, 4 and 6. All individual symptom scores, including nasal congestion, were also studied. Results: Levocetirizine showed an 86% improvement in T4SS over the first week of treatment and a 47% improvement over the entire treatment period compared with placebo. Absolute changes from baseline were 3.64 and 2.47 for levocetirizine and placebo, respectively. Individual symptom scores showed statistically significant ( P ≤ 0.01) differences in favour of levocetirizine for all study time‐points. Nasal congestion was unexpectedly significantly improved ( P &lt; 0.001). The incidence of reported adverse events was comparable between treatment and placebo group. Conclusions: Levocetirizine 5 mg/day is an effective and well‐tolerated treatment of PAR. In addition, levocetirizine is effective for the relief of nasal congestio.
Simple screening test for Cushing's syndrome
Authors: D. Mattingly, C. Tyler
Journal: BMJ (1967)

Tetracosactrin-Besser et al. concentrations attained 1 mg. of depot-tetracosactrin was approximately equivalent to 80 units of corticotrophin-gel.Mean plasma cortisol levels had returned to normal by 24 hours after the corticotrophin-gel, and by 48 hours after both doses of the depot tetracosactrin.To maintain a continuously elevated plasma cortisol corticotrophin-gel in this dose must be given twice daily and 1 mg. of the depot-tetracosactrin once daily; after 2 mg.alternate daily administration might be sufficient.All three preparations gave maximal adrenal cortical stimulation over the first four hours.The depot-tetracosactrin was simpler to give than the corticotrophin-gel.Local discomfort was more common after the synthetic preparation.We are grateful to Professor E. F. Scowen and Dr. P. V. Cole for their interest and to the physicians of St. Bartholomew's Hospital and St. Leonard's Hospital for permission to study patients under their care.CIBA Laboratories kindly provided the depot-tetra- cosactrin, which is
Health status after hip or knee arthroplasty
Authors: C Jinks
Journal: Annals of the Rheumatic Diseases (2003)

Hip and knee problems are a major cause of pain and disability.Although only a minority of sufferers-those with severe symptoms and disability in association with radiographic osteoarthritis-will be candidates for surgery, this still means that in America, for example, 400 000 primary hip and knee arthroplasties are performed each year, 1 and the demand is increasing. 2 Randomised controlled trials of arthroplasty versus other treatments have not generally been performed, but total hip arthroplasty and total knee arthroplasty procedures are perceived by the public and by health professionals to be largely successful.][10][11] A large interview based study, carried out in France by Boutron and colleagues and reported in this issue of the Annals, has now confirmed this finding. 12
A 75-Year-Old Woman With an Abdominal Aortic Aneurysm and Emphysema
Authors: Lee Goldman
Journal: JAMA (1998)

DR PARKER: Mrs H is a 75-year-old woman weighing the risks and benefits of proceeding with an elective surgical repair of an abdominal aortic aneurysm. She lives in the greater Boston area with her husband and has her health care insurance through Medicare.
Flucloxacillin, a New Isoxazolyl Penicillin, Compared with Oxacillin, Cloxacillin, and Dicloxacillin
Authors: R. Sutherland, E. A. P. Croydon, G. N. Rolinson
Journal: BMJ (1970)

Flucloxacillin, a new isoxazole penicillin, is active against penicillinase-producing strains of <i>Staphylococcus aureus</i> and is well absorbed in man after oral and intramuscular administration. Compared with isoxazole penicillins in current clinical use—namely, oxacillin, cloxacillin, and dicloxacillin—flucloxacillin has proved as active against Gram-positive cocci, including penicillin-resistant staphylococci. The extent of binding of flucloxacillin to the protein of human serum was similar to that of oxacillin and cloxacillin and less than that of dicloxacillin. In man flucloxacillin given orally produced total and free serum levels higher than those obtained with oxacillin and cloxacillin; total serum levels similar to those of dicloxacillin, and free levels greater than those of dicloxacillin. Similarly, after intramuscular injection the free serum levels of flucloxacillin were higher than those of oxacillin, cloxacillin, and dicloxacillin.
Socioeconomic Status, Service Patterns, and Perceptions of Care Among Survivors of Acute Myocardial Infarction in Canada
Authors: David A. Alter
Journal: JAMA (2004)

Some have argued that Canada's uniquely restrictive approach to private health insurance keeps the socioeconomic elite inside the public system so that their demands and influence elevate the standard of service for all Canadian citizens. The extent to which this theory is a valid representation of Canadian health care is unknown.To explore how patients with acute myocardial infarction from different socioeconomic backgrounds perceive their care in Canada's universal health care system and to correlate patients' backgrounds and perceptions with actual care received.Prospective observational cohort study with follow-up telephone interviews of 2256 patients 30 days following acute myocardial infarction discharged from 53 hospitals across Ontario, Canada, between December 1999 and June 2002.Postdischarge use of cardiac specialty services; satisfaction with care; willingness to pay directly for faster service or more choice; and mortality according to income and education, adjusted for age, sex, ethnicity, clinical factors, onsite angiography capacity at the admitting hospital, and rural-urban residence.Compared with patients in lower socioeconomic strata, more affluent or better educated patients were more likely to undergo coronary angiography (67.8% vs 52.8%; P<.001), receive cardiac rehabilitation (43.9% vs 25.6%; P<.001), or be followed up by a cardiologist (56.7% vs 47.8%; P<.001). Socioeconomic differences in cardiac care persisted after adjustment for confounders. Despite receiving more specialized services, patients with higher socioeconomic status were more likely to be dissatisfied with their access to specialty care (adjusted RR, 2.02; 95% confidence interval, 1.20-3.32) and to favor out-of-pocket payments for quicker access to a wider selection of treatment options (30% vs 15% for patients with household incomes of Can 60 000 dollars or higher vs less than Can 30 000 dollars, respectively; P<.001). After adjusting for baseline characteristics, socioeconomic status was not significantly associated with mortality at 1 year following hospitalization for myocardial infarction.Compared with those with lower incomes or less education, upper middle-class Canadians gain preferential access to services within the publicly funded health care system yet remain more likely to favor supplemental coverage or direct purchase of services.