tbuckley/cabot-search huggingface dataset:
Analysis of Sodium o-Iodohippurate Renogram-Reply
Authors: Sandor H. Wax
Journal: JAMA (1962)

To the Editor:—  Dr. Winter's comments are technical quibbling. The real point to be made is that the majority of people in the field have been referring to the total height of point  of the renogram as the  spike. Dr. Winter now knows that at point  only 16% to 28% of the radioactivity is due to  capacity. The misnomer  spike leads to attempts to interpret impaired renal blood flow from the first 1 to 2 minutes of the renogram curve. As Dr. Winter states, it is only during the first 17 seconds that a significant portion of the curve relates to radioactivity in the blood flowing into the kidney. In 50 patients studied with 1-131 albumin and 1-131 o-iodohippurate at 5-second time constant at a recording paper speed of 30 cm. per minute, we could not differentiate unilateral vascular abnormality in this 20-second segment. The
Medical colleges and faculties unite to tackle obesity after "failure" of current strategies
Authors: N. Hawkes
Journal: BMJ (2012)

The Academy of the Royal Medical Colleges has launched an inquiry into effective ways to reduce the prevalence of obesity. Supported by all 21 royal medical colleges and faculties, the academy says that the three month inquiry will be the springboard for campaigning activity that will continue into next year.

In an article in the Observer newspaper Terence Stephenson, president of the Royal College of Paediatrics and Child Health and chairman of the academy’s steering group, criticised the government’s “responsibility deals” with the food industry, saying that instead it must take on the major brands, which he likened to the tobacco companies of the last century in blocking moves to …
Insulin plus a Sulfonylurea Agent for Treating Type 2 Diabetes
Authors: Anne L. Peters
Journal: Annals of Internal Medicine (1991)

Purpose: To review the recent literature on the efficacy of combined insulin and sulfonylurea therapy in patients with type 2 diabetes. Data Sources: Pertinent articles were obtained through an English-language MEDLINE search from 1979 to 1990 and from the references of these articles. Study Selection: We reviewed the studies in which patients with poorly controlled diabetes received insulin and a sulfonylurea agent and in which insulin treatment alone (usually given in conjunction with a placebo) was compared with insulin plus sulfonylurea therapy. Data Extraction: Pre- and post-treatment insulin doses, blood glucose levels, glycated hemoglobin values, C-peptide levels, and insulin levels were analyzed. Other data were analyzed separately. Results of Data Synthesis: Data from similar trials were compared. Data from concurrent trials were analyzed separately from data derived from cross-over trials. Weighted mean fasting blood glucose levels, glycated hemoglobin levels, insulin dosage, and fasting C-peptide concentrations were determined for insulin plus placebo and insulin plus sulfonylurea agent groups for both types of studies. In concurrent trials, the weighted mean post-treatment glycated hemoglobin level was 11.1% after insulin plus placebo compared with 10.0% after insulin plus a sulfonylurea agent. In cross-over trials, the corresponding values were 10.6% and 9.8%. Conclusions: Combination therapy with insulin and a sulfonylurea agent only slightly improved glycemic control in patients with type 2 diabetes. When a sulfonylurea agent was used, less exogenous insulin was needed, but fasting serum insulin levels were not different between the treatment groups. Such therapy did not produce nearly normal blood glucose concentrations and therefore should not be used in patients with poorly controlled type 2 diabetes receiving insulin.
Enhanced Survival of the LINCL Mouse Following CLN2 Gene Transfer Using the rh.10 Rhesus Macaque-derived Adeno-associated Virus Vector
Authors: Dolan Sondhi, Neil R Hackett, Daniel A Peterson, Jamie Stratton, Michael Baad, Kelly M Travis, James M Wilson, Ronald G Crystal
Journal: Molecular Therapy (2006)

Late infantile neuronal ceroid lipofuscinosis (LINCL) is a lysosomal storage disorder caused by mutations in the CLN2 gene and a deficiency of tripeptidyl peptidase I (TPP-I). Prior studies with adeno-associated virus (AAV) serotype 2 or 5 mediated transfer of the CLN2 complementary DNA to the central nervous system (CNS) of CLN2−/− mice cleared CNS storage granules, but provided no improvement in the phenotype or survival of this model of LINCL. In this study, AAV serotypes (AAV2, AAV5, AAV8, and AAVrh.10) were compared for the delivery of the same CLN2 expression cassette. AAVrh.10, derived from rhesus macaque, provided the highest TPP-I level and maximum spread beyond the site of injection. The AAVrh.10-based vector functioned equally well in naive rats and in rats previously immunized against human serotypes of AAV. When administered to the CNS of CLN2−/− mice, the AAVrh.10CLN2 vector provided widespread TPP-I activity comparable to that in the wild-type mice. Importantly, the AAVrh.10CLN2-treated CLN2−/− mice had significant reduction in CNS storage granules and demonstrated improvement in gait, nest-making abilities, seizures, balance beam function, and grip strength, as well as having a survival advantage. Late infantile neuronal ceroid lipofuscinosis (LINCL) is a lysosomal storage disorder caused by mutations in the CLN2 gene and a deficiency of tripeptidyl peptidase I (TPP-I). Prior studies with adeno-associated virus (AAV) serotype 2 or 5 mediated transfer of the CLN2 complementary DNA to the central nervous system (CNS) of CLN2−/− mice cleared CNS storage granules, but provided no improvement in the phenotype or survival of this model of LINCL. In this study, AAV serotypes (AAV2, AAV5, AAV8, and AAVrh.10) were compared for the delivery of the same CLN2 expression cassette. AAVrh.10, derived from rhesus macaque, provided the highest TPP-I level and maximum spread beyond the site of injection. The AAVrh.10-based vector functioned equally well in naive rats and in rats previously immunized against human serotypes of AAV. When administered to the CNS of CLN2−/− mice, the AAVrh.10CLN2 vector provided widespread TPP-I activity comparable to that in the wild-type mice. Importantly, the AAVrh.10CLN2-treated CLN2−/− mice had significant reduction in CNS storage granules and demonstrated improvement in gait, nest-making abilities, seizures, balance beam function, and grip strength, as well as having a survival advantage.
13th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC): alternative testing methodologies and conceptual issues.
Authors: B J Blaauboer, M Balls, M Barratt, S Casati, S Coecke, M K Mohamed, J Moore, D Rall, K R Smith, R Tennant, B A Schwetz, W S Stokes, M Younes
Journal: Environmental Health Perspectives (1998)

Substantial world-wide resources are being committed to develop improved toxicological testing methods that will contribute to better protection of human health and the environment. The development of new methods is intrinsically driven by new knowledge emanating from fundamental research in toxicology, carcinogenesis, molecular biology, biochemistry, computer sciences, and a host of other disciplines. Critical evaluations and strong scientific consensus are essential to facilitate adoption of alternative methods for use in the safety assessment of drugs, chemicals, and other environmental factors. Recommendations to hasten the development of new alternative methods included increasing emphasis on the development of mechanism-based methods, increasing fundamental toxicological research, increasing training on the use of alternative methods, integrating accepted alternative methods into toxicity assessment, internationally harmonizating chemical toxicity classification schemes, and increasing international cooperation to develop, validate, and gain acceptance of alternative methods.
Textbook of General Medicine and Primary Care
Authors: Andrew Zaager
Journal: JAMA (1988)

Dr Noble aims to dispel two myths: that it is the specialist, not the internist or general practitioner, who is responsible for the care of the very sick, and that the obligation of such care ought to rest solely on major teaching hospitals. The book is organized into four main sections: "The Primary Care Patient," which contains chapters on the periodic health examination, prospective care of the healthy adult, and environmental and occupational health; "Emergencies"; "General Medicine and Primary Care," oriented according to organ system and making up the bulk of the text; and "Management of Special Patients," which deals with, among others, the medical management of the surgical patient, the geriatric patient, and the homosexual patient. The first section makes a concerted effort to clarify the psychology that underlies the physician-patient relationship and to understand the factors that cause a patient to seek (or not to seek) medical care.
The Diagnostic Utility of the Febrile Agglutinin Tests
Authors: Terrance J. Zuerlein, Philip W. Smith
Journal: JAMA (1985)

The purpose of our study was to analyze the use of febrile agglutinin (FA) serologic tests in the diagnosis of Salmonella (typhi and paratyphi), Rickettsia, Brucella, and Francisella infections. Data were collected in a retrospective chart study of 202 titer requests covering a 42-month period at our teaching hospital. We found that no diagnoses were made by utilizing complete six-antigen FA panels. Three cases of infection were diagnosed serologically, all three with more discriminately selected single-antigen titers. These three cases each had a positive epidemiological history suggestive of disease prior to ordering FA tests. Our data suggest that the FA tests (especially the Salmonella group antigen) are an overutilized set of laboratory tests and are often difficult to interpret. It is much more important to make a diagnosis based on clinical findings and epidemiological criteria.
US panel rejects routine use of BRCA cancer screening in women
Authors: M. McCarthy
Journal: BMJ (2013)

Women whose family history does not suggest that they have an increased risk of carrying harmful BRCA1 and BRCA2 mutations should not undergo routine BRCA testing, according to draft recommendations released on 2 April by the US Preventive Services Task Force (USPSTF).1

Women whose family history suggests that they carry the cancer susceptibility genes should be tested but only after expert genetic counseling, the USPSTF panel said.

About 12.3% of women will develop breast cancer in their lifetime, and 2.8% will die from the disease. Clinically …
The functional border zone in conscious dogs.
Authors: K P Gallagher, R A Gerren, X H Ning, S P McManimon, M C Stirling, M Shlafer, A J Buda
Journal: Circulation (1987)

Studies focusing on the functional border zone have been performed largely with anesthetized, open-chest preparations. Therefore, we instrumented 14 dogs at sterile surgery with sonomicrometers arrayed to measure systolic wall thickening across the perfusion boundary produced by circumflex coronary occlusion. We fitted sigmoid curves to the data to model the distribution of wall thickening impairment as a function of distance from the perfusion boundary, which was delineated with myocardial blood flow (15 micron diameter microspheres) maps. Using this approach, we defined the functional border zone as the distance from the perfusion boundary to 97.5% of the sigmoid curve's nonischemic asymptote. The lateral extent of the functional border zone, measured 10 min and 3 hr after occlusion, was 32 and 28 degrees of circumference, respectively. To evaluate the severity of nonischemic dysfunction, we measured average systolic wall thickening within the functional border zone. It was reduced from 3.69 +/- 1.10 (mean +/- SD) mm to 2.98 +/- 1.07 mm (p less than .01) and 2.74 +/- 1.12 mm (p less than .01) early and late after coronary occlusion. Thus, a narrow functional border zone was evident during circumflex coronary occlusion in conscious dogs. Its lateral extent was limited to approximately 30 degrees (similar to findings in open-chest, anesthetized dogs), severe dysfunction was restricted to the immediate vicinity of the perfusion boundary, and the average severity of nonischemic dysfunction within the functional border zone was mild.
Chronic administration of membrane sealant prevents severe cardiac injury and ventricular dilatation in dystrophic dogs
Authors: DeWayne Townsend, Immanuel Turner, Soichiro Yasuda, Joshua Martindale, Jennifer Davis, Michael Shillingford, Joe N. Kornegay, Joseph M. Metzger
Journal: Journal of Clinical Investigation (2010)

Duchenne muscular dystrophy (DMD) is a fatal disease of striated muscle deterioration caused by lack of the cytoskeletal protein dystrophin. Dystrophin deficiency causes muscle membrane instability, skeletal muscle wasting, cardiomyopathy, and heart failure. Advances in palliative respiratory care have increased the incidence of heart disease in DMD patients, for which there is no cure or effective therapy. Here we have shown that chronic infusion of membrane-sealing poloxamer to severely affected dystrophic dogs reduced myocardial fibrosis, blocked increased serum cardiac troponin I (cTnI) and brain type natriuretic peptide (BNP), and fully prevented left-ventricular remodeling. Mechanistically, we observed a markedly greater primary defect of reduced cell compliance in dystrophic canine myocytes than in the mildly affected mdx mouse myocytes, and this was associated with a lack of utrophin upregulation in the dystrophic canine cardiac myocytes. Interestingly, after chronic poloxamer treatment, the poor compliance of isolated canine myocytes remained evident, but this could be restored to normal upon direct application of poloxamer. Collectively, these findings indicate that dystrophin and utrophin are critical to membrane stability–dependent cardiac myocyte mechanical compliance and that poloxamer confers a highly effective membrane-stabilizing chemical surrogate in dystrophin/utrophin deficiency. We propose that membrane sealant therapy is a potential treatment modality for DMD heart disease and possibly other disorders with membrane defect etiologies.
Inferior Frontal White Matter Anisotropy and Negative Symptoms of Schizophrenia: A Diffusion Tensor Imaging Study
Authors: Adam Wolkin, Steven J. Choi, Sandor Szilagyi, Michael Sanfilipo, John P. Rotrosen, Kelvin O. Lim
Journal: American Journal of Psychiatry (2003)

The purpose of this study was test the hypothesis that abnormalities of inferior frontal white matter are related to the negative symptoms of schizophrenia.Fractional anisotropy of white matter tracts in the prefrontal area of 10 schizophrenic patients was determined by diffusion tensor imaging. Patients were also assessed for severity of negative symptoms by using the Schedule for the Assessment of Negative Symptoms (SANS).Inferior frontal white matter fractional anisotropy was significantly inversely correlated with the SANS global ratings of negative symptoms.These data, while preliminary, suggest that impaired white matter integrity in the inferior frontal region may be associated with the severity of negative symptoms in schizophrenia.
Cardiovascular Disease Risk Reduction for Tenth Graders
Authors: J D Killen, M J Telch, T N Robinson, N Maccoby, C B Taylor, J W Farquhar
Journal: JAMA (1988)

All tenth graders in four senior high schools (N = 1447) from two school districts participated in a cardiovascular disease risk-reduction trial. Within each district, one school was assigned at random to receive a special 20-session risk-reduction intervention and one school served as a control. At a two-month follow-up, risk factor knowledge scores were significantly greater for students in the treatment group. Compared with controls, a higher proportion of those in the treatment group who were not exercising regularly at baseline reported regular exercise at follow-up. Almost twice as many baseline experimental smokers in the treatment group reported quitting at follow-up, while only 5.6% of baseline experimental smokers in the treatment group graduated to regular smoking compared with 10.3% in the control group. Students in the treatment group were more likely to report that they would choose "heart-healthy" snack items. Beneficial treatment effects were observed for resting heart rate, body mass index, triceps skin fold thickness, and subscapular skin fold thickness. The results suggest that it is feasible to provide cardiovascular disease risk-reduction training to a large segment of the population through school-based primary prevention approaches.
Primary Human T-Lymphotropic Virus Type III Infection
Authors: DAVID D. HO
Journal: Annals of Internal Medicine (1985)

Primary infection with the human T-lymphotropic virus type III (HTLV-III) was documented in three patients by virus isolation during acute illness and concurrent or subsequent HTLV-III seroconversion. All patients had fevers, rigors, arthralgias, and myalgias. Additional symptoms included truncal maculopapular rash, urticaria, abdominal cramps, and diarrhea. Lymphocytic meningitis accompanied the febrile illness in two patients. The estimated incubation period was 3 to 6 weeks, and the symptoms lasted 2 to 3 weeks. Seroconversion occurred 8 to 12 weeks after presumed exposure and was manifested by a characteristic antibody response pattern. Physicians should consider the possibility of primary HTLV-III infection when evaluating patients who belong to one of the risk groups for the acquired immunodeficiency syndrome and who have prolonged febrile illnesses.
STUDIES IN SRBACEOUS GLAND ACTIVITY BY MEANS OF OSMIC ACID FILTER PAPERS.
Authors: ALLENE SCOTT, FREDERICK KALZ
Journal: British Journal of Dermatology (1956)

Journal Article STUDIES IN SRBACEOUS GLAND ACTIVITY BY MEANS OF OSMIC ACID FILTER PAPERS. Get access ALLENE SCOTT, M.D., ALLENE SCOTT, M.D. Dept of Medicine, Subdepartment of Dermatology, MeGill University and the Royal Victoria Hospital in Montreal Search for other works by this author on: Oxford Academic Google Scholar FREDERICK KALZ, M.D. FREDERICK KALZ, M.D. Dept of Medicine, Subdepartment of Dermatology, MeGill University and the Royal Victoria Hospital in Montreal Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 68, Issue 2, 1 February 1956, Pages 52–54, https://doi.org/10.1111/j.1365-2133.1956.tb12781.x Published: 01 February 1956
Clinical Remarks ON THE FUNCTIONAL ELEMENT IN CERTAIN FORMS OF ANOSMIA
Authors: P. McBride
Journal: BMJ (1907)

Loss or diminutioni of the sense of smen may arise from many causes, and perhaps it may be well to begin these remarks with a brief strvey of the chief etiological factors which may be responsible for the defect.Anoemia may be caused by: l.Obstructions In the nostrils which prevent odorous jparticles from reaching the olfactory reglon (atresia, devia- tions of or projectionS from the septum, tumoure, hypertrophy, inflammatoty swelling etc.).2. Changes In the o\factory region, whiah may be Inflam- matory, caused by disease (syphilis, tubercle, or atrophy, as in ozhena and-old-age), or due to injury.In this category we may also place cases in which loss of smell has been caused byr he local appli6ation of toxi 3 substances (cocaine, tobacco, or 'faial douohts aontainihig carbolic acid, sulphate of zinc, or alum).-3. Injury, oongenital defeots, or disease affecting the olfac- tory centres, bulbs, or nerves (falls or blows on the head, defective development, general toxic agents-for example.-morphine, tobacco,, alcohol, and Jead-diseases of the central nervous, system, such as.cerebral and cerebellar tumours, fooomotor ataxia, etc.).. Probably the anosmia which some- times follows exposure to very powerful odours and that which has been observed in pyrexia may be classed under this heading.4. Causes which we cannot localize, but which probably have a definite pathological, basis, of which the most important is influenza.
Reconfiguration of surgical, emergency, and trauma services in the United Kingdom
Authors: A. Black
Journal: BMJ (2004)

Centralisation of services is politically impossible 

To find the royal colleges proposing that acute inpatient care in the United Kingdom should be provided in fewer, larger, better equipped, and better staffed hospitals is not unusual. What would be unusual would be to find a government two years out from a general election rushing to implement such advice. The Senate of Surgery of Great Britain (comprising the four surgical royal colleges, the dental faculties, and 10 surgical specialty associations) has published a policy paper that seeks to speak with a single voice for the surgical community (www.rcpsg.ac.uk/recreport.htm).1 This policy paper signals a wish for a debate on this controversial topic and a wish to participate.

These surgeons want a lot—and not for the first time, and not just the surgeons. The senate suggested something similar in 1997, but it did not happen.2 The Royal College of Physicians wants to phase out acute emergency admissions from isolated smaller units and transfer the work to properly equipped and staffed larger units.3 The arguments …
Tuberculosis Among Elderly Persons: An Outbreak in a Nursing Home
Authors: WILLIAM W. STEAD
Journal: Annals of Internal Medicine (1981)

An epidemic of tuberculosis among elderly residents of a nursing home was caused by the presence of a highly infectious patient (sputum smear positive) for at least 12 months. Forty-nine (30%) of 161 previously tuberculin-negative residents (mean age, 73.5 years) became infected, and eight (17%) developed progressive primary tuberculosis, including one who died. Also, 21 (15%) of 138 tuberculin-negative employees were infected, of whom one (5%) developed clinical tuberculosis. The epidemic was finally stopped by giving preventive treatment with isoniazid to all converters, despite their advanced ages. Only three of 39 patients so treated manifested toxicity that subsided on withdrawal of isoniazid. The fraction of elderly persons harboring a dormant tuberculous infection today is smaller than generally thought. If one of this group develops active tuberculosis, however, it may endanger 80% to 90% of fellow residents and employees. Tuberculin reactors showed a significant protection against developing tuberculosis from exogenous reinfection.
Hospital doctor is sacked nine years after he was first suspended
Authors: C. Dyer
Journal: BMJ (2011)

A consultant cardiologist has been sacked nearly nine years after his employer first suspended him.

Raj Mattu was suspended by University Hospitals Coventry and Warwickshire NHS Trust in February 2002 over allegations of bullying. His suspension occurred shortly after he had gone to the BBC with revelations about two patients dying in overcrowded bays at Walsgrave Hospital, Coventry, in September 2001.

He was dismissed on 30 November 2010 and is appealing against his sacking. A spokesman for the BMA, which is representing him, said, “Dr Mattu was dismissed following a disciplinary hearing, which he was unable to attend due …
A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears
Authors: Richard B. Frobell, Ewa M. Roos, Harald P. Roos, Jonas Ranstam, L. Stefan Lohmander
Journal: New England Journal of Medicine (2010)

We conducted a randomized, controlled trial involving 121 young, active adults with acute ACL injury in which we compared two strategies: structured rehabilitation plus early ACL reconstruction and structured rehabilitation with the option of later ACL reconstruction if needed. The primary outcome was the change from baseline to 2 years in the average score on four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS) — pain, symptoms, function in sports and recreation, and knee-related quality of life (KOOS4; range of scores, 0 [worst] to 100 [best]). Secondary outcomes included results on all five KOOS subscales, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the score on the Tegner Activity Scale.