tbuckley/cabot-search huggingface dataset:
Gestational Diabetes: Should It Be Added to the Syndrome of Insulin Resistance?
Authors: Charles M Clark, Chunfu Qiu, Barbara Amerman, Beverly Porter, Naomi Fineberg, Saleh Aldasouqi, Alan Golichowski
Journal: Diabetes Care (1997)

OBJECTIVE The significance of gestational diabetes mellitus (GDM) results from its short-term detrimental effects on the fetus and its long-term prediction of NIDDM in the mother. We compared several variables associated with insulin resistance between GDM and non-GDM pregnant women to show the similarities between GDM and NIDDM (and thus insulin resistance). RESEARCH DESIGN AND METHODS On the basis of a 3-h oral glucose tolerance test (OGTT), 52 GDM patients and 127 non-GDM patients were recruited from pregnant, non-diabetic women who had a nonfasting 1-h-50-g glucose screening test ≥ 7.2 mmol/l (130 mg/dl) performed between 16 and 33 weeks of gestation (a total of 518 of 3,041 women drawn from six community health care prenatal clinics were screened positive). During the OGTT, several potential markers of insulin resistance were measured at fasting and 2-h time points, in addition to the standard glucose measurements. The relationship of these variables with the diagnosis of GDM was studied. RESULTS GDM patients, compared with non-GDM patients, had 1) higher prepregnancy weight (P = 0.011), prepregnancy BMI (P = 0.006), C-peptide at fasting (P = 0.002) and at 2 h (P &amp;lt; 0.001), insulin at fasting (P = 0.001) and at 2 h (P &amp;lt; 0.001), triglycerides at fasting (P = 0.005) and at 2 h (P = 0.003), free fatty acids at fasting (P = 0.017), β-hydroxybutyrate at fasting (P = 0.007); and 2) lower HDL cholesterol at fasting (P = 0.029). These variables were all predictive of GDM (P &amp;lt; 0.036) individually. Using stepwise logistic regression with all of these variables available, fasting (P = 0.019) and 2-h (P &amp;lt; 0.001) insulin levels, fasting free fatty acids (P = 0.031), and fasting β-hydroxybutyrate (P = 0.036) were statistically significant as jointly predictive of GDM. Comparisons between GDM patients and non-GDM patients matched by BMI confirmed that the metabolic abnormalities persisted when difference in BMI was taken into account. Concomitant blood pressure measurements in women with GDM did not differ significantly from those without GDM. CONCLUSIONS Our results show that many of the known metabolic components of the syndrome of insulin resistance (syndrome X) are predictive of GDM. These results are in keeping with the argument that GDM is one phase of the syndrome of insulin resistance. We suggest that GDM be looked upon as a component of the syndrome of insulin resistance that provides an excellent model for the study and prevention of NIDDM in a relatively young age-group.
Intratracheal instillation of keratinocyte growth factor decreases hyperoxia-induced mortality in rats.
Authors: R J Panos, P M Bak, W S Simonet, J S Rubin, L J Smith
Journal: Journal of Clinical Investigation (1995)

Alveolar type II cell proliferation occurs after many forms of lung injury and is thought to play a critical role in alveolar epithelial repair. Keratinocyte growth factor/fibroblast growth factor 7 (KGF) has been shown to promote alveolar type II cell growth in primary culture and alveolar epithelial hyperplasia in vivo. In this study, we used immunohistochemical analysis to determine the intrapulmonary distribution and cellular localization of recombinant human KGF (rhKGF) instilled into the trachea of rats. 6 h after administration, immunoreactive KGF was observed within the lung parenchyma and along alveolar epithelial cell membranes. By 18-24 h, KGF was detected intracellularly in alveolar epithelial cells and intraalveolar macrophages. Immunoreactive KGF was not demonstrable 48 h after delivery or in lung sections from PBS-treated animals. Intratracheal instillation of 5 mg/kg rhKGF stimulated a marked, time-dependent increase in the alveolar type II cell specific labeling index to a maximum level of 33 +/- 3% 48 h after rhKGF administration compared with 1.3 +/- 0.3% after PBS instillation. In addition, this increase in type II cell proliferation in vivo was documented by flow cytometric analysis of isolated type II cells which revealed a nearly fivefold increase in the proportion of cells traversing through the S and G2/M phases of the cell cycle. To test the hypothesis that KGFs effects on type II cells in vivo might affect the response to lung injury, rats were treated with rhKGF and exposed to hyperoxia. Animals that received 1 or 5 mg/kg rhKGF exhibited dramatically reduced mortality (P < 0.001, for both doses). Survival for animals treated with 0.1 mg/kg rhKGF was not significantly different from either untreated rats or animals treated with heat-denatured rhKGF. The lungs of rhKGF-treated animals that survived hyperoxia exposure had minimal hemorrhage and no exudate within the intraalveolar space. These experiments established that intratracheal administration of rhKGF stimulated alveolar type II cell proliferation in vivo and reduced hyperoxia-induced lung injury in rats. Directed delivery of KGF to the lungs may provide a therapeutic strategy to preserve or restore the alveolar epithelium during exposure to hyperoxia or other injurious agents.
Interaction of chelating agents with cadmium in mice and rats.
Authors: V Eybl, J Sýkora, J Koutenský, D Caisová, A Schwartz, F Mertl
Journal: Environmental Health Perspectives (1984)

The influence of several chelating agents (CaDTPA, ZnDTPA, CaEDTA, ZnEDTA, DMSA, D-penicillamine and DMPS, DMP and DDC) on the acute toxicity of CdCl2 and on the whole body retention and tissue distribution of cadmium after the IV application of 115mCdCl2 was compared in mice. The chelating agents were applied immediately after the application of cadmium. CaDTPA, ZnDTPA and DMSA appeared to be the most effective antidotes. However, DMSA increased the amount of cadmium retained in kidneys. The treatment of cadmium-poisoned mice with the combination of DMSA (IP) and ZnDTPA (SC) (all the compounds were injected in equimolar dose) decreased the toxicity of cadmium more than treatment with one chelating agents (given in a 2:1 dose). However, by studying the effect of these chelating agents and their combination of the retention and distribution of Cd in mice, it was demonstrated that the combined application of the antidotes showed little or no improvement over the results obtained with the most effective of the individual components. In the urine of rats injected with CdCl2 and treated with the chelating agents (CaDTPA, ZnDTPA, DMSA), the presence of cadmium complexes was demonstrated. The formation of mixed ligand chelates in vivo was not proved. Experiments in mice given a single injection of 115mCd-labeled Cd complexes of DMPS, DMSA and DTPA showed a high retention of cadmium in the organisms after the IV application of CdDMPS and CdDMSA complexes.
Children in adult intensive therapy units.
Authors: J Appleyard, M Joseph
Journal: BMJ (1970)

tered by artificially ventilating the patient on this circuit.For this reason I chose for my example the much more widely used situation in which the vaporizer is outside the circuit.A fresh gas flow rate of 2 1. /min.was selected for comparison with higher flows, as this is the lowest flow which can be used without having to make a large adjustment to the halothane concentration for dilution by gases already in the circuit.In addition, the commonly used Fluotec Mark 2 becomes inaccurate below flows of 2 1./min., but this particular problem has now been overcome by the-development of the Fluotec Mark 3 which is stated to be accurate down to flows of 250ml./min.Leak-proof apparatus is important for all anaesthetic circuits, and its importance increases as the fresh gas flow entering the circuit decreases.I therefore am quite unrepentant in asking for leak-proof cir- cuits.One point in Dr. J. R. J. Beddard's letter (18 April, p. 176) needs correcting.It has been shown that 5-6 (not 10-15) 1. per minute is adequate to eliminate carbon dioxide from the alveoli on the Magill circuit in both the spontaneously breathing' and the ventilated patient.2Finally, I hope that this article has done something to encourage the more economic practice of anaesthesia, but fear that too much apathy exists in the profession for there to be any great impact.
Some Factors Influencing the Development of a Voluntary PKU Screening Program
Authors: Vanja A. Holm
Journal: JAMA (1970)

Mandatory legislation for phenylketonuria (PKU) screening has recently created considerable controversy. This report analyzes three years' experience with a voluntary program in the state of Washington. Sixty-nine percent of newborns were screened in 1967, the last year of the survey reported. The major factor influencing development of screening practice seemed to be physician interrelationships, strongest in the most populous communities, which either favored or hindered the adoption of a screening program. Other medicosociological factors considered had less or no influence. Further observations made that might be considered when planning future mass screening programs were (1) sparsely populated areas and small hospitals need support; (2) the type of testing policy adopted by a hospital staff determines the effectiveness of its program; and (3) screening programs need periodic surveillance to continue to be effective.
Frequency and prognostic impact of mutations in SRSF2, U2AF1, and ZRSR2 in patients with myelodysplastic syndromes
Authors: Felicitas Thol, Sofia Kade, Carola Schlarmann, Patrick Löffeld, Michael Morgan, Jürgen Krauter, Marcin W. Wlodarski, Britta Kölking, Martin Wichmann, Kerstin Görlich, Gudrun Göhring, Gesine Bug, Oliver Ottmann, Charlotte M. Niemeyer, Wolf-Karsten Hofmann, Brigitte Schlegelberger, Arnold Ganser, Michael Heuser
Journal: Blood (2012)
Aging and the musculoskeletal system
Authors: D. Hamerman
Journal: Annals of the Rheumatic Diseases (1997)

I heard the old, old men say, "Everything alters And one by one we drop away".They had hands like claws, and their knees Were twisted like the old thorn trees By the waters W B Yeats 1 Geriatric and rheumatological linkages: public health implicationsEditors in medical journals worldwide have selected aging as the 1997 Global Theme Issue.In proposing this article, the editors of the Annals have considered the importance and implications of the growth of the very elderly population in developed countries and the widespread prevalence of musculoskeletal conditions in this age group.Broadening the scope of this discussion from osteoarthritis, about which I have written in this journal earlier, 2 to include musculoskeletal disorders, permits consideration of a range of interactive conditions that also aVect soft tissues, tendons, and ligaments (fibromyalgia, tendinitis), bones (osteoporosis), the intervertebral discs (degeneration), and muscles (polymyalgia, myopathies).This article will focus primarily on aging associated conditions involving bones, muscles, and peripheral joints.Table 1 presents the unifying features of the musculoskeletal disorders.Their public health implications in elderly persons are enormous, and encompass (a) physical and social impacts from pain, limited mobility, reduced quality of life; (b) direct expenditures for diagnosis and treatment; (c) indirect economic costs from loss of participation in the labour force. 3Among impairments identified in the National Health Interview Survey in 1988, musculoskeletal disorders were the most frequently reported-almost 30 million in the US population.In 1992 the total cost of musculoskeletal and associated conditions for all ages was $149 billion.The elderly incurred the largest share of the direct costs of medical care ($51 billion) with still substantial indirect costs caused by lost wages. 4Table 1 Unifying features of aging and musculoskeletal disorders Age associated increasing prevalence Intrinsic part of the aging process-especially for bones and muscles Part of the spectrum of chronic, non-fatal conditions Range of symptomatic presentations-limited and localised to more chronic and widespread conditions Potential for impaired functional activities, disability, falls, and fractures
Age-related changes in diaphragm muscle contractile properties and myosin heavy chain isoforms.
Authors: L E Gosselin, B D Johnson, G C Sieck
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

The present study sought to examine the effects of aging on the isometric contractile and fatigue properties as well as the myosin heavy chain (MCH) isoform composition of the rat diaphragm muscle. Male Fischer 344 (F344) specific pathogen-free rats 6 and 24 mo old were used in the study. Peak twitch force was approximately 23% lower (p < 0.05) in the senescent diaphragm compared with the young. Time to peak twitch force and one-half relaxation time of twitch force did not differ between groups. There was a significant decrease (15 to 18%, p < 0.05) in the specific force (N/cm2) of the senescent diaphragm at all stimulation frequencies (10 to 100 Hz) examined. In addition, the fatigability of the diaphragm did not significantly differ between the two groups. No significant changes in the distribution of MHC 1 and 2A isoforms were observed with aging. However, the contribution of MHC 2X significantly decreased with senescence (young, 37.5%; senescent, 30.5%), whereas the contribution of MHC 2B in the senescent diaphragm was significantly higher (young, 6.5%; senescent, 15.0%; p < 0.05). We conclude that the age-related decline in diaphragm muscle specific force is caused by intrinsic factors other than changes in MHC composition.
Thrombocytopenic Purpura Due to Quinidine
Authors: G. Moodie
Journal: BMJ (1950)

BEDIRJO 53NALThird Outbreak A third outbreak of food-poisoning occurred among a group of 80 probationer nurses who on September 14 con- sumed a lunch between 12 noon and 1.15 p.m. consisting of braised mutton, gravy, creamed potatoes, boiled dried peas, and sponge pudding with custard.Between 1 and 5 a.m. the next day 20 of them were seized with diarrhoea, colic, vomiting, and dizziness, and a further 40 had mild abdominal pain with no other symptom.The whole ot the food had been prepared by five people on the morning of consumption and it was found that the only items which all the victims had eaten were the meat and gravy and the peas.When the investigation was made the man who prepared the meat and gravy was not at work; it was later found that he had septic fingers.Apparently he had sustained a small burn on a finger a month previously.This had
Unusual Natural Immunity to Cancer
Authors: E. Sherburne Lovell
Journal: JAMA (1960)

Since cancer is considered by its very nature to be a progressive, relentless, irreversible disease, successful treatment is obviously dependent on complete obliteration or extirpation of all malignant cells, either at their primary site of origin or in metastatic sites accessible to various forms of therapy. The appearance of distant metastases after initial definitive treatment suggests disseminated malignancy, generally tantamount to a hopeless situation. When, therefore, definitive therapy for cancer is followed by disseminated metatases over a period of several years, yet is not accompanied by the anticipated over-all deterioration and exodus of the patient, it represents an unusual state of affairs. Such a case is herein reported.  Whether such a situation represents spontaneous regression of cancer or an unusual degree of host resistance or natural immunity to cancer is open to debate. There apparently exists a large hiatus in medical knowledge concerning this phenomenon, and this may prove to
Recombination-activating gene 1 (Rag1)–deficient mice with severe combined immunodeficiency treated with lentiviral gene therapy demonstrate autoimmune Omenn-like syndrome
Authors: Niek P. van Til, Roya Sarwari, Trudi P. Visser, Julia Hauer, Chantal Lagresle-Peyrou, Guus van der Velden, Vidyasagar Malshetty, Patricia Cortes, Arnaud Jollet, Olivier Danos, Barbara Cassani, Fang Zhang, Adrian J. Thrasher, Elena Fontana, Pietro L. Poliani, Marina Cavazzana, Monique M.A. Verstegen, Anna Villa, Gerard Wagemaker
Journal: Journal of Allergy and Clinical Immunology (2013)
The Tzanck Smear in the Diagnosis of Cutaneous Herpes Simplex
Authors: Alvin R. Solomon, James E. Rasmussen, James Varani, Carl L. Pierson
Journal: JAMA (1984)

We examined the effectiveness of the Tzanck preparation compared with viral isolation in 32 lesions of cutaneous herpes simplex infection in 30 consecutive patients. Seventy-eight percent had positive cultures, even though the clinical history and lesion morphological findings were typical in all situations. Other authors have also noted that viral isolation does not reach 100% even in the face of typical clinical history. Fifty-three percent of the Tzanck smears were positive. These preparations had a high correlation with positive viral cultures (94.1%). Vesicles were more likely to yield a positive culture than Tzanck smear (100% and 66.7%, respectively). Pustules yielded positive cultures in 72.8% and positive Tzanck smears in 54.5%, while crusted-ulcer lesions were usually not positive by either technique (34%, 16%). A positive Tzanck preparation is an accurate, rapid tool for the diagnosis of cutaneous herpes simplex. (<i>JAMA</i>1984;251:633-635)
Adrenergically mediated intrapancreatic control of the glucagon response to glucopenia in the isolated rat pancreas.
Authors: A Hisatomi, H Maruyama, L Orci, M Vasko, R H Unger
Journal: Journal of Clinical Investigation (1985)

Alpha adrenergic blockade with phentolamine (10 microM) reduces the glucagon response to severe glucopenia (from 150 to 25 mg/dl) to 22% of the control values in the isolated perfused rat pancreas. Propranolol (10 microM) had no significant effect. Neither alpha nor beta adrenergic blockade reduced the magnitude of glucopenic suppression of insulin secretion, but phentolamine increased insulin levels before and during glucopenia. The pattern of somatostatin secretion in these experiments resembled that of insulin. Depletion of norepinephrine from sympathetic nerve endings by pretreatment with 6-hydroxydopamine lowered the pancreatic norepinephrine content to less than 20% of control values and reduced the glucagon response to glucopenia to 69% of the controls. Combined alpha and beta adrenergic blockade during less severe glucopenia (from 120 to 60 mg/dl) reduced the glucagon response to 21% of controls. However, slight glucopenia (from 100 to 80 mg/dl), which elicited only 11% increase in glucagon in the control experiments, was not altered significantly by combined alpha and beta adrenergic blockade. Morphologic studies of adrenergic nerve terminals labeled with [3H]norepinephrine revealed associations with alpha cells. It is concluded that in the isolated rat pancreas adrenergic mediation accounts for most of the glucagon but not insulin response to glucopenia. It is controlled within the pancreas itself, possibly through a direct enhancement by glucopenia of norepinephrine release from nerve endings.
Porphyria cutanea tarda and beta-thalassaemia minor with iron overload.
Authors: R Chapman
Journal: BMJ (1980)

cases, although in two female patients this was not obtained until necropsy.There were 19 female and two male patients, the mean age of presentation was 57 9 years, and seven patients (33%) were over the age of 65.These data reveal that in Tayside the annual incidence of primary biliary cirrhosis is 10-6 per million.On 31 December 1979 16 patients with the diagnosis were still alive, revealing the point prevalence as 40 2 per million.The incidence figure is almost twice that found by Dr Triger in Sheffield (5-8 per million), and by other workers in NE England (6-0 per million-as reported at the September
Summarising economic evaluations in systematic reviews: a new approach
Authors: J. Nixon
Journal: BMJ (2001)

Systematic reviews of healthcare interventions, which are aimed at informing health policy, increasingly include economic evaluations in addition to evaluations of clinical effectiveness.1–3 The challenge reviewers face is collating, appraising, and synthesising economic evidence in such a way that it is clearly helpful in making decisions about the effects and costs of competing alternatives. However, the methodology for summarising the findings of economic evaluations is not as well established as that applied to structured summaries of clinical evidence. The aim of this paper is to illustrate and discuss the relative merits of commonly used methods and to offer a new approach that makes interpreting the evidence easier for decision makers who require a clear overview of the findings.

#### Summary points

Systematic reviews of healthcare interventions are increasingly integrating clinical and economic evidence

Methods are needed to summarise and convey clearly the findings of these reviews

The methodology for summarising the results of economic evaluations is not well established

Methods for summarising the results of economic evaluations include narratives, tables, the cost effectiveness plane, and permutation matrices

A new hierarchical method offers an effective means of summarising the results of economic evaluations within a systematic review

We describe well established methods that can be used to summarise the findings of a review of economic evaluations, namely narrative summaries, permutation matrices, and the cost effectiveness plane, and we give examples of how a permutation matrix has or could have been used in two published systematic reviews. Finally, a new method is described that presents the same information in a clear, concise, and hierarchical manner and which provides an effective tool for summarising the same results.

The most elementary method of summarising the results of a review of economic evaluations is the narrative summary, which, in conjunction with a tabular approach to …