tbuckley/cabot-search huggingface dataset:
ANAPHYLACTIC SHOCK WITH HEMOCONCENTRATION TREATED INTRAVENOUSLY WITH SALINE SOLUTION
Authors: Harry Blotner
Journal: JAMA (1942)

The subject of shock, whether it is surgical or medical, is of unusual interest today. Recently I treated a patient in severe anaphylactic shock. The picture resembled so closely that of surgical shock that it appears of interest to present the details of this case. Ordinarily the treatment of anaphylactic shock is not considered in relation to the blood picture, as it is in cases of surgical shock. I believe that the treatment, based on hemoconcentration and decreased blood volume, was effective and that the method used is of practical significance. It is generally regarded now that an essential feature of shock is a relative decrease in the circulating blood volume compared with the size of the vascular system. Such an inequality may be brought about by a loss of fluid from the circulation or by an increase in the size of the vascular bed. When fluid is lost a
MPs say government scheme for GPs' premises threatens other primary care needs
Authors: Remi Guillochon
Journal: BMJ (2006)

A government scheme to provide new premises for GPs that was introduced five years ago is in danger of diverting funds away from other primary care needs, a committee of MPs said this week.

In its latest report, the public accounts committee said that no one yet knew whether the Local Improvement Finance Trust (LIFT) initiative was good value for money.

Edward Leigh, the chairman of the committee, said, “It is essential that the Department of Health and Partnerships for Health speed up their development of a mechanism for evaluating LIFT. What we really need to know is …
Susceptibility to Rubella Among Adolescents and Adults in Hawaii
Authors: Scott B. Halstead
Journal: JAMA (1969)

The presence of rubella hemagglutination-inhibition (HI) antibody was determined for 590 adolescent and adult residents of Hawaii. The percentage of persons without detectable HI antibody at a 1:10 serum dilution (rubella susceptibles) varied on four different islands from 25% to 50%. Rubella susceptibility rates were significantly higher in Japanese than in white residents. In 175 students of the University of Hawaii with known residence histories, 81 had never left Hawaii; 61 (75%) of these were rubella susceptible. Only 19 of 64 students entering Hawaii as adolescents or adults were without HI antibody. Males had significantly lower susceptibility rates than females, 30% and 45% respectively. These data indicate that induction of artificial immunity in the Hawaiian population should be a priority public health goal.
Heroin users wanted for Dutch medical experiment
Authors: T. Sheldon
Journal: BMJ (1997)

Experienced heroin users are being sought by the Dutch Ministry of Health to test the practical and technical aspects of smoking heroin as part of a medical experiment.

The health minister, Professor Els Borst-Eilers, announced in a recent letter to parliament that up to 10 heroin users are required to smoke a maximum of five tablets in tests from March …
Effects of temperature on cycle length dependent changes and restitution of action potential duration in guinea pig ventricular muscle
Authors: H. Bjornstad, P. M Tande, D. A Lathrop, H. Refsum
Journal: Cardiovascular Research (1993)

Objective: The aim was to investigate the effects of temperature on cycle length dependent changes of action potential duration and on restitution of action potential duration. Methods: Guinea pig papillary muscle action potentials were recorded using conventional microelectrode techniques. Action potential duration was measured at cycle lengths ranging from 500 to 2000 ms at both 27°C and 37°C. Restitution of action potential duration was determined by introducing an extra stimulus at progressively longer diastolic intervals from 40 to 9000 ms at pacing cycle lengths of 500, 1000, and 2000 ms. Results: At 37°C, action potential duration measured at 90% of repolarisation (APD90) during continuous pacing and the maximum value of APD90, achieved during restitution (APD90pl) decreased by 18(SEM 6) ms (n=7) and 24(7) ms (n=6), respectively, when pacing cycle length was reduced from 2000 to 500 ms. At 27°C, the magnitude of the shortening of APD90 and APD90pl observed when pacing cycle length was similarly reduced was greater than at 37°C, ie, 143(21) ms (n=6) and 115(11) ms (n=6), respectively. Thus the relation for restitution of action potential duration shifted downwards with reduction in pacing cycle length, and the magnitude of this shift was greater at 27°C than at 37°C. The difference between APD90 at the shortest diastolic interval (40 ms) and at diastolic interval of 100 ms (range of premature action potential durations) was much greater at 27°C that at 37°C at all three pacing cycle lengths. Conclusions: Reduction in temperature magnifies the cycle length dependent changes in action potential duration both during abrupt changes in cycle length, as with an extra stimulus, and during changes of steady state cycle length. This may indicate a greater dispersion of premature action potential durations during hypothermia, and hence predispose to hypothermia induced arrhythmias. Cardiovascular Research 1993;27:946-950
Lower Loop Reentry as a Mechanism of Clockwise Right Atrial Flutter
Authors: Shulong Zhang, George Younis, Ramesh Hariharan, John Ho, Yanfei Yang, John Ip, Ranjun K. Thakur, John Seger, Melvin M. Scheinman, Jie Cheng
Journal: Circulation (2004)

Right atrial reentrant tachycardia resulting from lower loop reentry (LLR) around the inferior vena cava (IVC) has been described recently. However, all reported cases of LLR in the literature have negative flutter waves on the inferior surface ECG leads similar to that of counterclockwise typical atrial flutter around the tricuspid annulus (TA). Right atrial flutter with positive flutter waves in the inferior ECG leads has been assumed to rotate as a single reentrant activation wave front around the TA, and the role of LLR in those patients is not known.Twelve consecutive patients with flutter wave morphology on surface ECG consistent with clockwise atrial flutter were studied. The endocardial activation pattern recorded from conventional multipolar electrode catheters was characteristic of clockwise atrial flutter around the TA. Entrainment pacing in all 12 patients and 3D activation sequence mapping in 7 patients, however, revealed clockwise LLR involving the lower right atrium around the IVC in 7 patients, figure-of-8 double-loop reentry around both the IVC and TA in 4, and single reentrant loop around the TA in 1. Linear radiofrequency ablation in the isthmus between the TA and IVC (TI isthmus) terminated the tachycardia in all patients.Surface ECG flutter wave morphology and limited recording intracardiac sites proved insufficient to delineate the precise mechanism of the TI isthmus-dependent clockwise right atrial flutters. Most right atrial flutters with positive flutter wave on surface ECG may be supported by a reentrant circuit around the IVC or a figure-of-8 double-loop reentry involving both the IVC and TA.
Contribution of Eotaxin-1 to Eosinophil Chemotactic Activity of Moderate and Severe Asthmatic Sputum
Authors: Gordon Dent, Chrystalleni Hadjicharalambous, Takahiro Yoshikawa, Rachel L. C. Handy, John Powell, Ian K. Anderson, Renaud Louis, Donna E. Davies, Ratko Djukanovic
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

The CC chemokine eotaxin-1 (CCL11) is chemotactic for eosinophils, basophils, and type 2 helper T cells and may play a role in allergic inflammation. We investigated its contribution as an eosinophil chemoattractant in asthmatic airway secretions (sampled as induced sputum), which possess chemotactic activity for eosinophils and T cells. Sputum samples collected from healthy subjects and subjects with mild, stable-moderate, unstable-moderate, and severe asthma were processed with phosphate-buffered saline and assayed for eotaxin by ELISA and for eosinophil chemotactic activity by fluorescence-based chemotaxis assay. The contribution of eotaxin to chemotactic activity was studied by using a high-affinity neutralizing human anti-eotaxin antibody, CAT-213. Sputum eotaxin concentration was significantly raised in moderate and severe asthma (p < 0.05 versus healthy control subjects) but not in mild asthma. Chemotactic activity was significantly increased in all asthmatic groups relative to healthy subjects (p < 0.05) and was significantly inhibited by CAT-213 (100 nM) in subjects with moderate and severe asthma, with median inhibition of 52% (p < 0.05), 78% (p < 0.0001), and 86% (p < 0.0001), respectively, in samples representing stable-moderate, unstable-moderate, and severe asthma. Eotaxin contributed to the eosinophil chemotactic activity of sputum from subjects with more severe forms of asthma but not mild asthma, suggesting that its contribution is more important in more severe disease. This activity is inhibited significantly by CAT-213.
Biomarkers of Endothelial Dysfunction and Risk of Type 2 Diabetes Mellitus
Authors: James B. Meigs
Journal: JAMA (2004)

Endothelial dysfunction occurs in diagnosed type 2 diabetes mellitus but may also precede development of diabetes.To determine whether elevated plasma levels of biomarkers reflecting endothelial dysfunction (E-selectin; intercellular adhesion molecule 1 [ICAM-1]; and vascular cell adhesion molecule 1 [VCAM-1]) predict development of type 2 diabetes in initially nondiabetic women.Prospective, nested case-control study within the Nurses' Health Study, an ongoing US study initiated in 1976.Of 121 700 women initially enrolled, 32 826 provided blood samples in 1989-1990; of those free of diabetes, cardiovascular disease, or cancer at baseline, 737 developed incident diabetes by 2000. Controls (n = 785) were selected according to matched age, fasting status, and race.Risk of confirmed clinically diagnosed type 2 diabetes by baseline levels of E-selectin, ICAM-1, and VCAM-1.Baseline median levels of the biomarkers were significantly higher among cases than among controls (E-selectin, 61.2 vs 45.4 ng/mL; ICAM-1, 264.9 vs 247.0 ng/mL; VCAM-1, 545.4 vs 526.0 ng/mL [all P values < or =.004]). Elevated E-selectin and ICAM-1 levels predicted incident diabetes in logistic regression models conditioned on matching criteria and adjusted for body mass index (BMI), family history of diabetes, smoking, diet score, alcohol intake, activity index, and postmenopausal hormone use. The adjusted relative risks for incident diabetes in the top quintile vs the bottom quintiles were 5.43 for E-selectin (95% confidence interval [CI], 3.47-8.50), 3.56 for ICAM-1 (95% CI, 2.28-5.58), and 1.12 for VCAM-1 (95% CI, 0.76-1.66). Adjustment for waist circumference instead of BMI or further adjustment for baseline levels of C-reactive protein, fasting insulin, and hemoglobin A(1c) or exclusion of cases diagnosed during the first 4 years of follow-up did not alter these associations.Endothelial dysfunction predicts type 2 diabetes in women independent of other known risk factors, including obesity and subclinical inflammation.
Abstract 2432: Fully human anti-interleukin-6 (IL-6) monoclonal antibody suppresses the growth of human tumor xenograft in vivo
Authors: Haihong Zhong
Journal: Cancer Research (2010)

Abstract Interleukin-6 (IL-6) is a pleiotropic cytokine that plays a major role in the response to injury or infection and is involved in the immune response, inflammation, and hematopoiesis. Aberrant expression of IL-6 has been implicated in many human diseases. In cancer, high levels of circulating IL-6 are observed in many tumor types and associated with poor outcome. We hypothesized that a monoclonal antibody that neutralizes IL-6 activity may be effective in inhibiting the progression of cancer. A fully humanized monoclonal antibody against human IL-6 (CAT-6001) was isolated by screening phage-display libraries. CAT-6001 completely neutralizes IL-6 activities via binding to the IL-6 receptor and signal transducer gp130 binding sites of human IL-6. We demonstrate that several cancer cell lines secrete high levels of IL-6 and soluble IL-6 receptor, and express gp130. High constitutive pStat3 activation is seen in several of these cell lines suggesting an IL-6 autocrine loop. Treatment of these cell lines with CAT-6001 effectively blocked phosphorylation of Stat3 and in some cell lines, functionally inhibited IL-6 induced cell proliferation. In vivo, CAT-6001 inhibited the growth of DU145, a human prostate cancer xenograft model, and significantly blocked the release of human IL-6 and inhibited Stat3 phosphorylation. Taken together, our data suggest that IL-6 signaling contributes to tumor growth, and provide support for the further development of CAT-6001 for the treatment of solid tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2432.
Oxygen concentrations in tents.
Authors: G W Burton, G Wray
Journal: BMJ (1967)

October, p. 129) restates the interesting association between the teratogenic and carcinogenic action of trypan blue.In fact observations which could account for the teratogenic action of the trypan blue group of compounds (acid bisazo dyes) have recently been made,' and it is interesting to speculate whether the same cellular disturbances might not also be related to some aspects of the oncogenic process.In rats trypan blue and related compounds are actively phagocytesed by macrophages and by certain extra-embryonic membranes, sub- sequently entering the vacuolar apparatus of the cells.They accumulate in hetero- lysosomes, and in this situation actively in- hibit the hydrolytic enzymes found in these organelles.In the context of placental function the short-term effect would appear to be an inhibition of embryotrophic nutrition leading to congenital malformation.Investigations to see whether lysosomal enzyme inhibition is in itself associated with carcino- genesis and whether such a cellular event could account for the development of reticu- loses are currently under way.-Weare, etc.,
Liability for Transfusion-Acquired Disease-Reply
Authors: Michael S. Rabkin
Journal: JAMA (1987)

<h3>In Reply.—</h3> We are grateful to Drs Gettinger and Polesky and Ms Lentz for their additions and clarifications. Rhode Island, rather than New Hampshire, is the fifth state whose legislature has not yet made blood transfusion a service. Apologies to practitioners in Rhode Island and New Hampshire for the error. The Minnesota case seems to lend additional support to our fundamental point that blood is no longer treated as though it were a consumer product, where defects automatically give rise to legal liability. Note, however, that the<i>Balkowitsch</i>case was decided prior to the case of<i>Cunningham v MacNeal Memorial Hospital</i><sup>1</sup>—the leading case that imposed liability in spite of the unavailability of screening tests for hepatitis—and that the analysis of<i>Balkowitsch</i>and cases cited in<i>Balkowitsch</i>was expressly rejected in<i>Cunningham</i>as "simply unrealistic."<sup>1</sup>Furthermore, the decision in<i>Balkowitsch</i>has been interpreted by at least one court
Respiratory muscle involvement in multiple sclerosis
Authors: R Gosselink, L Kovacs, M Decramer
Journal: European Respiratory Journal (1999)

Respiratory complications are common in the terminal stages of multiple sclerosis and contribute to mortality in these patients. When respiratory motor pathways are involved, respiratory muscle weakness frequently occurs. Although it is well established that weakness of the respiratory muscles produces a restrictive ventilatory defect, the degree of muscle weakness and pulmonary function are poorly related. Respiratory muscle weakness was observed in patients with normal or near normal pulmonary function. Expiratory muscle weakness is more prominent than inspiratory muscle weakness and may impair performance of coughing. Subsequently, in addition to bulbar dysfunction, respiratory muscle weakness may contribute to ineffective coughing, pneumonia, and sometimes even acute ventilatory failure may ensue. Respiratory muscle weakness may also occur early in the course of the disease. Recent studies suggest that the respiratory muscles can be trained for both strength and endurance in multiple sclerosis patients. Whether respiratory muscle training delays the development of respiratory dysfunction and subsequently improves exercise capacity and cough efficacy, prevents pulmonary complications or prolongs survival in the long-term remains to be determined.
Rate of inactivation of cytomegalovirus in raw banked milk during storage at -20 degrees C and pasteurisation.
Authors: H Friis, H K Andersen
Journal: BMJ (1982)

Samples of milk from 23 mothers attending the department of obstetrics and gynaecology and 36 who donated milk to the department9s milk bank were cultured for cytomegalovirus. Virus was isolated from samples from 12 of the milk donors but none of the mothers attending the department; follow-up studies during lactation in seven of these 12 women showed that five continued to excrete the virus. Samples were taken on three occasions from one woman who regularly excreted high titres of the virus. Storage at -20 degrees C for over three days reduced the titre by over 99%; after pasteurisation at 63 degrees C for eight minutes the milk did not contain any viable virus. It is recommended that raw banked milk used for feeding preterm babies should be kept frozen for at least 72 hours before feeding.
Gastrointestinal cell proliferation and crypt fission are separate but complementary means of increasing tissue mass following infusion of epidermal growth factor in rats
Authors: J Berlanga-Acosta, R J Playford, N Mandir, R A Goodlad
Journal: Gut (2001)

Epidermal growth factor (EGF) is a potent mitogen for the gastrointestinal tract and also influences the number of new crypts formed by crypt fission. The time course of these events and possible linkage between these two complementary mechanisms is however poorly understood. We therefore examined the temporal relationship of proliferation and fission in rats treated with EGF.Osmotic minipumps were implanted subcutaneously into male Wistar rats to infuse EGF continuously (60 microg/rat/day) for periods of 1-14 days. Proliferation and crypt branching were quantified following vincristine induced metaphase arrest and morphometric assessment of microdissected tissue.In the small intestine, EGF significantly increased epithelial cell proliferation and crypt and villus area after 24 hours of EGF, although maximal effects were only reached following six days of infusion. EGF also resulted in an approximate 30% reduction in crypt fission in the small bowel. In the colon, EGF caused a twofold increase in epithelial cell proliferation one day after infusion, from 15.3 (2.3) to 29.6 (3.5) metaphases per crypt (p<0.01). Maximal effects were seen in rats receiving EGF for seven days. For all time points, colonic crypt size increased in response to EGF. The amount of branching increased following one day of infusion with EGF (from 15.3 (1.9) to 32.4 (5.5)%; p<0.001) but was significantly lower (approximately 25% of control values) following longer periods of infusion. Crypt fission did not correlate with crypt area.EGF has profound effects on cell proliferation and also altered crypt fission, with its actions on crypt fission most pronounced in the colon where it first increased and then decreased fission. EGF can thus be a potent stimulus for crypt fission during short term infusion and may reduce the number of branched crypts present in a resting or quiescent stage. Growth factors can alter cell mass by two separate but linked mechanisms, namely altered cell production and crypt fission.
Follicular regulatory T cells expressing Foxp3 and Bcl-6 suppress germinal center reactions
Authors: Yeonseok Chung, Shinya Tanaka, Fuliang Chu, Roza I Nurieva, Gustavo J Martinez, Seema Rawal, Yi-Hong Wang, Hoyong Lim, Joseph M Reynolds, Xiao-hui Zhou, Hui-min Fan, Zhong-ming Liu, Sattva S Neelapu, Chen Dong
Journal: Nature Medicine (2011)
Edzard Ernst: the prince and me
Authors: David Cohen
Journal: BMJ (2011)

Peripartum/postpartum cardiomyopathy (PPCM) is a potentially life-threatening disease of uncertain aetiology in previously healthy women. Clinical and experimental data suggested inflammation, autoimmune processes, apoptosis and endothelial dysfunction as typical pathophysiological features of PPCM. Recent data discovered that unbalanced peri/postpartum oxidative stress linked to proteolytic cleavage of the nursing hormone prolactin into a potent anti-angiogenic, pro-apoptotic and pro-inflammatory 16-kDa subform as a potential pathomechanism for the development of PPCM. Consistent with these idea, blockade of prolactin by bromocriptine, a dopamine D2 receptor agonist, prevented the onset of disease in an experimental model of PPCM and appeared successful in small pilot trials with respect to prevention or treatment of PPCM in patients. Here we highlight the current state of knowledge on diagnosis of PPCM, provide novel insights into the pathophysiology behind the disease and outline potential consequences for the clinical management and treatment options for patients at risk for or with PPCM.
826-3 Early elevation of C-terminal telopeptide of type I collagen is highly correlated with 30-day mortality in patients with myocardial infarction regardless of infarct localization
Authors: Cord A Manhenke, Stein Ørn, Faiez Zannad, Torbjørn Aarsland, Kenneth Dickstein
Journal: Journal of the American College of Cardiology (2004)
Malaria in Somalia: Lessons in Prevention
Authors: Sue Shallow
Journal: JAMA (1995)

<h3>To the Editor.</h3> —In the article assessing malaria in US Marines returning from Somalia by Dr Newton and colleagues,<sup>1</sup>important issues regarding prevention may be obscured by their finding that 50% of patients were administered suboptimal chemoprophylaxis. The Navy Environmental and Preventive Medicine Unit No. 5 identified 132 cases of Somalia-related malaria in 128 marines. Ninety-seven individuals were interviewed.<i>Plasmodium vivax</i>accounted for 82 (65.1%) of 126 diagnoses, 34 (27.0%) were<i>Plasmodium falciparum</i>, eight (6.3%) were mixed, and two (1.6%) were unspeciated. Malaria exposure had been anticipated<sup>2</sup>and preparations made. Appropriate prescribing is published in the widely distributed<i>Navy Medical Department Guide to Malaria Prevention and Control</i>.<sup>3</sup>For doxycycline, 89 (89.9%) of 99 prescriptions were appropriate, as were 81 (92.0%) of 88 primaquine prescriptions. For mefloquine, 59 (71.1%) of 83 were appropriate. The other 24 (28.9%) included many that failed to overlap doxycycline and mefloquine by 1
The health benefits from collecting for Christian Aid
Authors: M. Schweiger
Journal: BMJ (2000)

The World Health Organisation has defined health as a state of physical, mental, and social wellbeing, not merely the absence of disease. House to house collection of charity envelopes is a exercise that can be done in three health promoting rounds. The first round is the mental health promotion exercise. Find and locate the right roads and work out the shortest way to go round them. Should I do one side at a time or cross the road at strategic junctions? Get the rules clear. Who does the corner house? Is it me or the unknown person who may be collecting from the other road? Should gates be left …