tbuckley/cabot-search huggingface dataset:
Multiple Severe Complications From Recreational Ingestion of MDMA ('Ecstasy')
Authors: Christopher Brown
Journal: JAMA (1987)

<h3>To the Editor.—</h3> We would like to report the case of a young woman who suffered serious but reversible toxic reactions from a recreational dose of 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") and whose blood levels of MDMA were much higher than in any of the fatalities reported by Dowling et al.<sup>1</sup> <h3>Report of a Case.—</h3> A 32-year-old woman and her friend, both of whom had used MDMA before, ingested an alleged 100 to 150 mg of MDMA powder mixed in apple juice. The patient reported rapid onset of general body tingling, vivid color enhancement, and visual hallucinations, but had no memory of ensuing events. Two hours after ingestion, her friend brought her to the emergency department. Significant findings included agitation; hallucinations; combativeness; diaphoresis; dilated pupils (7 mm); pulse rate, 150 beats per minute; blood pressure, 90/50 mm Hg; respirations, 36/min; rectal temperature, 41.6°C; diffuse wheezing; diminished bowel sounds; vertical nystagmus; tonic
523 HEMODYNAMIC EFFECTS OF TEZOSENTAN, A DUAL ENDOTHELIN RECEPTOR ANTAGONIST, IN PATIENTS WITH CIRRHOSIS
Authors: D. Lebrec, J. Bosch, R. Jalan, F.J. Dudley, R. Jesic, J.C. Garcia-Pagan, R. Mookerjee, R. Moreau, P.L.M. van Giersbergen, A. Kusic-Pajic, J. Dingemanse
Journal: Journal of Hepatology (2010)
P-glycoprotein in primary acute myeloid leukemia and treatment outcome of idarubicin/cytosine arabinoside-based induction therapy
Authors: HJ Broxterman, P Sonneveld, WJL van Putten, J Lankelma, CA Eekman, GJ Ossenkoppele, HM Pinedo, B Löwenberg, GJ Schuurhuis
Journal: Leukemia (2000)
The New York State Examination Act.
Authors: Alfred L. Carroll
Journal: JAMA (1890)

<h3>To the Editor:</h3> —The publication, inThe Journal, of the Act establishing State, medical examinations in New York, may give pertinence to comments on its principal provisions, some of which concern only the profession in the State wherein they are to be operative, while others are of interest — either as examples or warnings—to all who desire the advancement of medical education, and who seek such advancement through legislation under our peculiarly liberal system of representative government, in which every voting citizen—and,<i>a fortiori</i>, every legislator—has an inalienable right to form a conclusive opinion on all subjects, whether within or beyond the range of his information and experience. Under such a system, and with inevitable regard to political expediency, the erection of separate examining boards from the homœopathic and eclectic sects was, perhaps, a "<i>conditio sine quâ non</i>" for the framers of the bill, who have endeavored to counteract the
Role of Cytokines in the Mechanism of Action of Amlodipine: The PRAISE Heart Failure Trial
Authors: Emile R Mohler, Leif C Sorensen, Jalal K Ghali, Douglas D Schocken, Park W Willis, John A Bowers, Anne B Cropp, Milton L Pressler
Journal: Journal of the American College of Cardiology (1997)

Objectives. We sought to determine whether the beneficial effects of amlodipine in heart failure may be mediated by a reduction in tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) levels. We postulated that TNF-alpha and IL-6 levels may also have predictive value in patients with congestive heart failure (CHF). Background. The molecular mechanism for progression of CHF may involve cytokine overexpression. The effect of amlodipine on cytokine levels in patients with CHF is unknown. Methods. In the Prospective Randomized Amlodipine Survival Evaluation (PRAISE) trial, we used enzyme-linked immunosorbent assay to measure plasma levels of TNF-alpha in 92 patients and IL-6 in 62 patients in New York Heart Association functional classes III and IV randomized to receive amlodipine (10 mg/day) or placebo. Blood samples were obtained for cytokine measurement at baseline and at 8 and 26 weeks after enrollment. Results. The baseline amlodipine and placebo groups did not differ in demographics and cytokine levels. Mean (±SD) plasma levels of TNF-alpha were 5.69 ± 0.32 pg/ml, and those of IL-6 were 9.23 ± 1.26 pg/ml at baseline. These levels were elevated 6 and 10 times, respectively, compared with those of normal subjects (p < 0.001). Levels of TNF-alpha did not change significantly over the 26-week period (p = 0.69). However, IL-6 levels were significantly lower at 26 weeks in patients treated with amlodipine versus placebo (p = 0.007 by the Wilcoxon signed-rank test). An adverse event—CHF or death—occurred more commonly in patients with higher IL-6 levels. Conclusions. Amlodipine lowers plasma IL-6 levels in patients with CHF. The beneficial effect of amlodipine in CHF may be due to a reduction of cytokines such as IL-6. (J Am Coll Cardiol 1997;30:35–41)
Changes in AIDS Survival Time in Two San Francisco Cohorts of Homosexual Men, 1983 to 1993
Authors: Dennis Osmond
Journal: JAMA (1994)

<h3>Background.</h3> —During the first decade since the recognition of the acquired immunodeficiency syndrome (AIDS), new therapies have been introduced and the frequency of clinical manifestations has changed. The impact of these changes on AIDS survival, however, has not been well characterized. <h3>Design.</h3> —A prospective cohort study of the outcomes of human immunodeficiency virus (HIV) infection. <h3>Setting.</h3> —Homosexual and bisexual men residing in San Francisco, Calif, recruited in 1983 and 1984 for two prospective studies and followed up for more than 9 years with clinical examinations. <h3>Participants.</h3> —A total of 761 HIV-positive homosexual and bisexual men. <h3>Main Outcome Measures.</h3> —Survival time from a CD4 lymphocyte count at 0.20×10<sup>9</sup>/L (200/μL and from a clinical AIDS diagnosis to death. <h3>Results.</h3> —Median survival time from a CD4 lymphocyte count at 0.20× 10<sup>9</sup>/L increased from 28.4 months in the October 1983 to November 1986 period to 40.1 months in the November 1986 to November 1988 period and is estimated at 38.1 months in the November 1988 to February 1993 period. Patients diagnosed with<i>Pneumocystis carinii</i>pneumonia (PCP) accounted for most of this increase with a gain in median survival time of 9.7 months (<i>P</i>=.0009), compared with a nonsignificant decline in the survival time of those patients without a PCP diagnosis. Multivariate analysis showed that rate of CD4 lymphocyte loss (<i>P</i>&lt;.001) and receipt of both PCP prophylaxis and antiretroviral therapy (<i>P</i>=.04) were significantly associated with longer survival time, whereas antiretroviral therapy alone was not (<i>P</i>=.81). Time to death from a clinical AIDS diagnosis was 14.7 months in the 1983 to 1986 period, 19.1 months in the 1986 to 1988 period, and an estimated 15.7 months in the 1988 to 1993 period. <h3>Conclusions.</h3> —Survival time from a CD4 lymphocyte count at 0.20×10<sup>9</sup>/L has improved significantly by about 1 year; yet survival time using the 1987 AIDS case definition has shown small improvement. The largest increase in survival time from a CD4 lymphocyte count at 0.20×10<sup>9</sup>/L was in patients diagnosed with PCP, suggesting that PCP prophylaxis and treatment were more important factors in longer survival time than antiretroviral therapy. (<i>JAMA</i>. 1994;271:1083-1087)
Direct Observation of Community-Based Ambulatory Encounters Involving Medical Students
Authors: Scott H. Frank
Journal: JAMA (1997)

The current shift of predoctoral medical education from inpatient tertiary settings to community-based, ambulatory practice has raised questions about the effect of the medical student on the process of patient care.To determine how the presence of a medical student during the ambulatory medical encounter affects the use of clinical time and patient satisfaction.Cross-sectional, multimethod study using direct observation of ambulatory care by research-trained nurses.A total of 16 community-based family practice offices accepting family practice clerkship students.A total of 452 outpatient visits with and without student involvement.Clinical time use as measured by the Davis Observation Code; patient satisfaction was assessed with the Medical Outcomes Study 9-item visit rating scale.When students were involved, physicians spent more time discussing visit expectations (P=.03) and less time in history taking (P=.007), providing assessment (P=.01), and answering questions (P=.04). Despite these differences, patients were equally satisfied with explanations received, and there was no change in the rank order of the 5 most commonly observed physician behaviors. There was no difference in time spent in treatment planning, physical examination, health education, or social chatting. The physician spent equal time with the patient with (10.3 minutes) and without (9.9 minutes, P=.6) student involvement. There was no decrease in patient satisfaction when students were involved. Physicians were more likely to discuss another family member's problems when a student was present (P=.001). Students were directed to care for minority patients at a disproportionate rate (P=.001), controlling for confounding variables.Medical student involvement alters the content but not the duration of the ambulatory medical encounter. Application of validated measures indicate that students did not impair patient satisfaction or hinder the physicians' ability to ensure that patient expectations for the visit were met.
Increased frequency of CD8+ CD45R0+ memory T lymphocytes in acute hepatitis B virus infection
Authors: Maria-Christina Jung, Winfried Schraut, Teresa Santantonio, Ulrich Spengler, Dieter Eichenlaub, Joseph Eisenburg, Reinhard Zachoval, Robert Hoffmann, Gustav Paumgartner, Giuseppe Pastore, Haul Will, Gert Riethmüller, Hans-Werner Löins Ziegler-Heitbrock, Gerd-Rudolf Pape
Journal: Journal of Hepatology (1993)
Treatment of Severe Diabetes Mellitus by Insulin Infusion
Authors: W. Kidson, J. Casey, E. Kraegen, L. Lazarus
Journal: BMJ (1974)

A new and simple form of insulin therapy for diabetic hyperglycaemia and ketoacidosis has been developed using a continuous intravenous infusion of insulin at a rate of 2.4 U/hr to maintain serum insulin concentration at physiological levels. This rate raises the mean serum insulin to 83 muU/ml and has a therapeutic effect which is not augmented by higher infusion rates. The response to such low doses of insulin indicates a need for a reappraisal of currently held theories about insulin resistance in diabetic ketoacidosis. In 11 diabetic patients with a mean plasma glucose of 514 mg/100 ml this therapy produced continuous falls in plasma glucose at a mean rate of 75 mg/100 ml/hr, and 10 out of 11 patients recovered within eight hours. This form of therapy is simple to institute, not complicated by hypoglycaemia, and avoids the confusion and empiricism of previously described forms of therapy.
Incidence of Autoimmune Diseases in Celiac Disease: Protective Effect of the Gluten-Free Diet
Authors: Jacques Cosnes, Christophe Cellier, Sheila Viola, Jean–Frederic Colombel, Laurent Michaud, Jacques Sarles, Jean–Pierre Hugot, Jean–Louis Ginies, Alain Dabadie, Olivier Mouterde, Matthieu Allez, Isabelle Nion–Larmurier
Journal: Clinical Gastroenterology and Hepatology (2008)
Withdrawing Life Support in Canada and the United States
Authors: Lori A. Whittaker
Journal: JAMA (1995)

<h3>To the Editor.</h3> —I read with interest the article by Dr Cook and colleagues<sup>1</sup>describing factors that influence Canadian health care workers in their decision to withdraw life support from critically ill patients. There are innumerable medical and ethical considerations involved in end-of-life decisions. The authors effectively illustrate that several factors unrelated to patient characteristics influence Canadian health care workers in their decisions, leading to "extreme variability" in how these situations are handled in Canada. The situation is a little different in the United States, however, and the authors do not allude to the differences in making end-of-life decisions that exist between the two countries. An important influence on who actually makes the decision is the allocation of health care resources. Canada has a nationalized system of health care in which limited resources (including intensive care unit [ICU] beds and life support equipment) are allocated on the basis of
Early Morning Attenuation of Endothelial Function in Healthy Humans
Authors: Maria E. Otto, Anna Svatikova, Rodrigo Bellio de Mattos Barretto, Simone Santos, Michal Hoffmann, Bijoy Khandheria, Virend Somers
Journal: Circulation (2004)

Cardiovascular events such as myocardial infarction, sudden death, and stroke have a peak incidence in the early hours after waking. The mechanisms involved in this circadian variation are not clear. Endothelial dysfunction is associated with increased risk for cardiovascular events. We tested the hypothesis that endothelial function is reduced in the early morning, around the time of waking, compared with measurements obtained both before sleep and later in the day in healthy humans.We studied 30 subjects (19 men, 11 women; mean age, 41.6 years). All participants underwent polysomnography to exclude obstructive sleep apnea or other sleep disorders. Brachial artery flow-mediated endothelium-dependent vasodilation (FMD) and endothelium-independent dilation (non-FMD) were measured on 3 different occasions: before subjects went to sleep (9 PM), the next morning immediately after waking (6 AM), and during the late morning 5 hours after waking (11 AM). All subjects had normal sleep with good sleep efficiency of 84+/-2%. Compared with before sleep, FMD decreased markedly in the early morning after waking and recovered by late morning (9 pm, 7.5+/-1%; 6 am, 4.4+/-0.7%; 11 am, 7.7+/-1%; P=0.02). Non-FMD was similar for the 3 periods of observation (9 pm, 17.3+/-1.6%; 6 am, 17.2+/-1.3%; 11 am, 18.5+/-1.7%).FMD is blunted in the early morning in healthy subjects. Decreased endothelial function in the early morning may have implications for our understanding of the morning peak in cardiac and vascular events.
Isolated Systolic Hypertension in the Elderly
Authors: Margaret A. Winker
Journal: JAMA (1991)

Isolated systolic hypertension (ISH) affects up to two thirds of all individuals with hypertension between the ages of 65 and 89 years,<sup>1</sup>and its prevalence, as estimated by the Systolic Hypertension in the Elderly Program (SHEP) Pilot Study, ranges from 6% of individuals aged 60 through 69 years to 18% of those aged 80 years or older.<sup>2</sup>This extremely common disease is an independent risk factor for the development of cerebrovascular and cardiovascular morbidity and mortality, and, in the Framingham Study, it was the single greatest risk factor other than age for the development of cardiovascular disease in the elderly population.<sup>3</sup> Isolated systolic hypertension is believed to result from the pathophysiology of aging, which includes decreased connective tissue elasticity and atherosclerosis, resulting in increased peripheral vascular resistance,<sup>4</sup>and diminished β<sub>2</sub>receptor sensitivity, leading to decreased smooth muscle relaxation.<sup>5</sup>Because of the presumed irreversible "stiffening"
Susceptibility to Induced and Spontaneous Carcinogenesis Is Increased in Fatless A-ZIP/F-1 but not in Obese <i>ob/ob</i> Mice
Authors: Vitaly Ablamunits, Yehuda Cohen, Irina B. Brazee, Harold P. Gaetz, Charles Vinson, Simon Klebanov
Journal: Cancer Research (2006)

Abstract Obesity is typically associated with increased tumor susceptibility, whereas caloric restriction, a regimen resulting in leanness, inhibits carcinogenesis. The link between adiposity and malignancies suggests that adipose tissue may influence carcinogenesis. An adipose tissue hormone, leptin, could be procarcinogenic because it stimulates proliferation in various tissues and tumor cell lines. Leptin may contribute to the correlation between adiposity and malignancies as its levels are usually increased in obese subjects and reduced by caloric restriction. We hypothesized that leptin deficiency, despite obesity, would inhibit carcinogenesis in leptin-null ob/ob mice and tested this hypothesis in two models: (a) two-stage skin carcinogenesis initiated by 7,12-dimethylbenz(a)anthracene and promoted by phorbol 12-myristate 13-acetate (PMA) and (b) p53 deficiency. Contrary to a typical association between obesity and enhanced carcinogenesis, obese ob/ob mice developed induced skin papillomas and spontaneous p53-deficient malignancies, mostly lymphomas, similarly to their lean littermates. Surprisingly, lipodystrophic (ZIP) mice that had very little both adipose tissue and leptin were highly susceptible to carcinogenesis. Hyperphagia, hyperinsulinemia, and hyperglycemia are unlikely to have contributed significantly to the enhancement of carcinogenesis in ZIP mice because similarly hyperphagic, hyperinsulinemic, and hyperglycemic ob/ob mice had normal susceptibility to carcinogenesis. Our data suggest that, in contrast to a well-known correlation between obesity and cancer, the direct effect of adipose tissue may rather be protective. (Cancer Res 2006; 66(17): 8897-902)
Pollen metabolome analysis reveals adenosine as a major regulator of dendritic cell–primed TH cell responses
Authors: Stefanie Gilles, Agnes Fekete, Xin Zhang, Isabelle Beck, Cornelia Blume, Johannes Ring, Carsten Schmidt-Weber, Heidrun Behrendt, Philippe Schmitt-Kopplin, Claudia Traidl-Hoffmann
Journal: Journal of Allergy and Clinical Immunology (2011)
Mortality in men admitted to hospital with acute urinary retention: database analysis
Authors: James N Armitage, Nokuthaba Sibanda, Paul J Cathcart, Mark Emberton, Jan H P van der Meulen
Journal: BMJ (2007)

<b>Objectives</b> To investigate mortality in men admitted to hospital with acute urinary retention and to report on the effects of comorbidity on mortality. <b>Design</b> Analysis of the hospital episode statistics database linked to the mortality database of the Office for National Statistics. <b>Setting</b> NHS hospital trusts in England, 1998-2005. <b>Participants</b> All men aged over 45 who were admitted to NHS hospitals in England with a first episode of acute urinary retention. <b>Main outcome measures</b> Mortality in the first year after acute urinary retention and standardised mortality ratio against the general population. <b>Results</b> During the study period, 176 046 men aged over 45 were admitted to hospital with a first episode of acute urinary retention. In 100 067 men with spontaneous acute urinary retention, the one year mortality was 4.1% in men aged 45-54 and 32.8% in those aged 85 and over. In 75 979 men with precipitated acute urinary retention, mortality was 9.5% and 45.4%, respectively. In men with spontaneous acute urinary retention aged 75-84, the most prevalent age group, the one year mortality was 12.5% in men without comorbidity and 28.8% in men with comorbidity. The corresponding figures for men with precipitated acute urinary retention were 18.1% and 40.5%. Compared with the general population, the highest relative increase in mortality was in men aged 45-54 (standardised mortality ratio 10.0 for spontaneous and 23.6 for precipitated acute urinary retention) and the lowest for men 85 and over (1.7 and 2.4, respectively). <b>Conclusions</b> Mortality in men admitted to hospital with acute urinary retention is high and increases strongly with age and comorbidity. Patients might benefit from multi-disciplinary care to identify and treat comorbid conditions.
Abstract LB-96: A novel blood preservation system to study oncogenic signaling pathway biomarkers by flow cytometry in leukemia/lymphoma clinical trials
Authors: Anil Pahuja, Abdel Saci, Shyam Sarikonda, Armin Graber, Benjamin Lee, Jelveh Lameh, Shabnam Tangri, Naveen Dakappagari
Journal: Cancer Research (2014)

Abstract Propelled by the advent of new technologies and an evolving regulatory landscape, the desire to personalize cancer treatments has never been greater. There is a critical need to reliably evaluate target inhibition and pharmacodynamic activity of investigational drugs in biologically relevant compartments. However, the ability to fulfill such a task in global clinical trials is complicated by varying technical expertise available at clinical sites and considerations about specimen stability for centralized laboratory analysis. We developed a novel formalin-based preservation method that enables specimen stabilization in a single step, requiring less than 20 minutes, without the need for specialized training or instrumentation. Stabilized specimens can be frozen for shipping and batched analysis at a later time point, in a specialized laboratory. Using this preservation method, we developed a flow assay enabling identification of multiple cell-types, and quantification of intracellular biomarkers in target cellular compartments, in both the peripheral blood (PB) and bone marrow (BM). We present pharmacodynamic (PD) data for a novel anticancer investigational agent intended for acute myeloid leukemia and multiple myeloma and its effect on multiple target biomarkers of the PI3K signaling pathway, including phosphorylation of the S6 ribosomal protein (S6). Our novel fixation method allowed detection of pS6 modulation in a dose dependent manner in both tumor cells and PB or BM in response to the novel investigational agent. Assay sensitivity and concordance were evaluated by comparing flow assay with western blot analysis, with each assay performed at a different site using the same batched frozen samples; exceptional preservation of phosphorylated proteins for more than 72 hours could be observed, when frozen immediately following fixation. In conclusion, our novel preservation method enables reliable quantification of signaling biomarkers in centralized laboratories at different time points post sample (PB or BM) acquisition requiring minimal processing at collection sites. Citation Format: Anil Pahuja, Abdel Saci, Shyam Sarikonda, Armin Graber, Benjamin Lee, Jelveh Lameh, Shabnam Tangri, Naveen Dakappagari. A novel blood preservation system to study oncogenic signaling pathway biomarkers by flow cytometry in leukemia/lymphoma clinical trials. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-96. doi:10.1158/1538-7445.AM2014-LB-96
Distal axonopathy: one common type of neurotoxic lesion.
Authors: P S Spencer, H H Schaumburg
Journal: Environmental Health Perspectives (1978)

Neurotoxic chemicals commonly produce retrograde degeneration of the axons of long and large nerve fibers in the central and peripheral nervous system. This produces a clinical picture of polyneuropathy in man and animals in which sensory and motor disturbances develop in the feet and hands then progress with time to the legs and arms. Distal axonopathy, as the underlying pathologic process is termed, is one of four principal types of neurotoxic diseases, the others including degeneration of neurons (neuronopathy), myelin sheaths (myelinopathy) and damage to the neurovasculature (neurovasculopathy). In the experimental animal, these four types of neurotoxic diseases can be distinguished by examining selected areas of brain and nerve tissues prepared by contemporary methods of tissue fixation. These procedures may form the basis of a new and sensitive assay for neurotoxicity.
Upper Endoscopy in Patients with Angina and Normal Coronary Angiograms
Authors: O. Frøbert, P. Funch-Jensen, N. O. Jacobsen, A. Kruse, J. P. Bagger
Journal: Endoscopy (1995)

Background and Study Aims: It has been recommended that patients with angina, a normal coronary angiogram, and no other signs of heart disease, should be evaluated using esophagogastroduodenoscopy before referral to dynamic esophageal investigations. The aim of the present study was to investigate the clinical value of upper endoscopy in this patient group.