tbuckley/cabot-search huggingface dataset:
Methionine-enkephalin and leucine-enkephalin in human sympathoadrenal system and pheochromocytoma.
Authors: T Yoshimasa, K Nakao, H Ohtsuki, S Li, H Imura
Journal: Journal of Clinical Investigation (1982)

To elucidate the physiological and pathophysiological significance of methionine- and leucine-enkephalin (Met-and Leu-enkephalin, respectively) in human sympathoadrenal system, the contents of these peptides in normal human sympathetic nervous system, adrenal medulla, and pheochromocytomas were determined by specific radioimmunoassays combined with reverse-phase high-performance liquid chromatography. Met-enkephalin-LI and Leu-enkephalin-LI, respectively) were detected by radioimmunoassay in adrenal glands, adrenal medulla, stellate ganglia, sympathetic trunks, and celiac ganglia, and their contents in adrenal medulla were highest. Existence of authentic Met- and Leu-enkephalin was confirmed by reverse-phase high-performance liquid chromatography. Met-enkephalin was approximately 74% of Met-enkephalin-LI, whereas Leu-enkephalin was approximately 30% of Leu-enkephalin-LI in human adrenal medulla. The ratio of Met- to Leu-enkephalin was 2.6 in human adrenal medulla, whereas it was higher in sympathetic ganglia or trunks. In four cases of pheochromocytoma marked difference in Met- and Leu-enkephalin contents was found between medullary and extramedullary tumors. The contents were about three orders higher and the Met- to Leu-enkephalin ratio was lower in medullary than in extramedullary pheochromocytomas, reflecting the tissues where the tumors arose. These results suggest the physiological roles of Met- and Leu-enkephalin in sympathetic nervous system and adrenal glands and their pathophysiological significances in pheochromocytomas.
Myocardial Changes After Direct Current Electroshock
Authors: Ralph M. Sussman, David H. Woldenberg, Murray Cohen
Journal: JAMA (1964)

Direct current electroshock is an effective means of correcting atrial flutter or fibrillation. As recent reports stress the safety of this method, we are recording an unusual reaction as indicated by the electrocardiogram ( ECG), paralleling the monitored image on the oscilloscope. The patient who had had acute rheumatic fever suffered from chronic atrial fibrillation. A trial with DC shock was undertaken because of sensitivity to procainamide. Three shocks administered without anaesthesia did not restore normal rhythm. Six days later, DC shock was followed by regular sinus-dominated rhythm which coincided with the appearance of striking elevation of the S-T segment of the ECG, reminiscent of early myocardial infarction or a variant form of angina pectoris. There were no troublesome sequelae.
Evaluation and Treatment of Older Patients With Hypercholesterolemia
Authors: Timo E. Strandberg, Laura Kolehmainen, Alpo Vuorio
Journal: JAMA (2014)

Hypercholesterolemia is common among people older than 80 years. Substantial functional heterogeneity exists among older patients, and decision making for statin use differs in older patients relative to younger ones.To discuss the presentation, modifying factors, and treatment of hypercholesterolemia (usually with statins) among persons older than 80 years.MEDLINE and other sources were searched from January 1990 to June 2014. Personal libraries and a hand search of reference lists from guidelines and reviews from January 2000 to June 2014 were also used.No randomized clinical trials (RCTs) of statin or any other hypocholesterolemic medication included persons older than 80 years at baseline. Findings from 75- to 80-year-old patients enrolled in RCTs and information from observational studies support statin treatment for secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and probably in patients with diabetes without ASCVD. Harms from statin drugs are not increased in older patients, so the use of these agents for primary prevention is possible. Because people older than 80 years are biologically heterogeneous with varying life expectancy, may have frailty or comorbid conditions, and may take multiple medications, the decision to treat with statins must be individualized.Ideally, treatment of hypercholesterolemia for patients at risk of ASCVD should start before they turn 80 years old. No RCT evidence exists to guide statin initiation after age 80 years. Decisions to use statins in older individuals are made individually and are not supported by high-quality evidence.
A New Treatment for Hirsutism
Authors: ROGERIO F. CORREA de OLIVEIRA
Journal: Annals of Internal Medicine (1975)

Twenty-four hirsute female patients were treated with 100 mg of depo-medroxyprogesterone acetate intramuscularly every 15 days. Twenty-three showed definite improvement from their abnormal hair growth. All patients with initially elevated 17-ketosteroids in 24-hour urine collections showed a decrease of these metabolites with treatment. In eleven patients the initial plasma testosterone level was elevated and returned to normal values with treatment. The first patient who was submitted to this therapy stopped the treatment for 5 months and started having abnormal hair growth again. With other patients, after initial treatment with depo-medroxyprogesterone acetate intramuscularly, we started using contraception pills containing medroxyprogesterone; this maintained the reduced ectopic hair growth. The most important side effect was amenorrhea.
GRADO DE LIMPIEZA COLÓNICA MEDIDO MEDIANTE LA ESCALA DE BOSTON EN LA PRACTICA CLÍNICA HABITUAL
Authors: R Díez Rodríguez, T Khaliulina, G Rascarachi, A Miguel Peña, G Karpman Niuremberg, A Barrientos Castañeda, B Alvarez Cuenllas, S Vivas Alegre, J Espinel Díez
Journal: Endoscopy (2013)

Introducción: La escala de Boston es una herramienta útil para estandarizar el nivel de preparación en la colonoscopia. Objetivo: Analizar el grado de limpieza y los factores asociados a este, durante la colonoscopia en la práctica clínica habitual. Material y Método: Se analizaron de manera retrospectiva las colonoscopias realizadas desde Enero hasta Junio de 2013 en un hospital comarcal. Se excluyeron los pacientes en edad pediátrica, aquellos con antecedentes de cirugía colónica, con enfermedad inflamatoria intestinal o con hemorragia digestiva activa, y en los que no se utilizó la escala de Boston. La preparación estándar se baso en citrafleet. Los parametros estudiados en relación con el grado de limpieza colonica (mediante la escala de Boston) fueron: la edad, el sexo, la indicación, el turno de la exploración, la procedencia y los hallazgos encontrados. Se excluyeron del análisis las colonoscopias incompletas. Resultados: Se incluyeron 650 exploraciones de 947 analizadas. Un 5,8% (38/650) fueron incompletas: 10 por neoplasia estenosante (28,9%), 20 por falta de preparación (52,6%) y 7 por causa técnica (18,4%). El nivel de preparación fue: 2 – 3: 2,4%; 4 – 5: 12,7%; 6 – 7: 31,4%; 8 – 9 53,43%; siendo la media: 7,4 (DS: 1,7). En la tabla se muestra el análisis de los factores asociados al grado de preparación. La media de la escala de Boston para pacientes sin pólipos fue 7,21(DS: 1,72), para aquellos con pólipos menores de 0,5 cm fue 7,69(DS: 1,37) y aquellos con lesiones mayores de 0,5 cm 7,31(DS: 1,59) (pValor = 0,024). Conclusiones: Más de un 80% de los pacientes presentan una puntuación en la escala de Boston igual o mayor a 6. Los pacientes con más edad, aquellos que se realizan la colonoscopia de mañana o estando ingresados presentan un grado de limpieza menor.
Cross-linking of alpha 2-plasmin inhibitor to fibrin by fibrin-stabilizing factor.
Authors: Y Sakata, N Aoki
Journal: Journal of Clinical Investigation (1980)

The concentration of alpha 2-plasmin inhibitor in blood plasma is higher than that in serum obtained from the blood clotted in the presence of calcium ions, but is the same as that in serum obtained in the absence of calcium ions. Radiolabeled alpha2-plasmin inhibitor was covalently bound to fibrin only when calcium ions were present at the time of clotting of plasma or fibrinogen. Whereas, when batroxobin, a snake venom enzyme that lacks the ability to activate fibrin-stabilizing factor, was used for clotting fibrinogen, the binding was not observed. When fibrin-stablizing, factor-deficient plasma was clotted, the specific binding of alpha 2-plasmin inhibitor to fibrin did not occur even in the presence of calcium ions and the concentration of alpha 2-plasmin inhibitor in serum was the same as that in plasma. Monodansyl cadaverine, a fluorescent substrate of the fibrin-stablizing factor, was incorporated into alpha 2-plasmin inhibitor by activated fibrin-stablizing factor. All these findings indicate that alpha 2-plasmin inhibitor is cross-linked to fibrin by activated fibrin-stabilizing factor when blood is clotted. Analysis of alpha 2-plasmin inhibitor-incorporated fibrin by sodium dodecyl sulfate gel electrophoresis showed that the inhibitor was mainly cross-linked to polymerized alpha-chains of cross-linked fibrin. Cross-linking of alpha 2-plasmin inhibitor to fibrin renders fibrin clot less susceptible to fibrinolysis by plasmin.
Low early gallstone recurrence rate after successful extracorporeal lithotripsy in patients with solitary stones
Authors: G. Pelletier, R. Capdeville, H. Mosnier, J.M. Raymond, J. Delmont, J. Moreaux, M. Guivarch, M. Amouretti, F.X. Caroli, V.G. Levy, J.P. Etienne
Journal: Journal of Hepatology (1992)
Cardiotonic agent milrinone stimulates resorption in rodent bone organ culture.
Authors: N S Krieger, T S Stappenbeck, P H Stern
Journal: Journal of Clinical Investigation (1987)

The cardiotonic agent amrinone inhibits bone resorption in vitro. Milrinone, an amrinone analog, is a more potent cardiotonic agent with lower toxicity. In contrast to amrinone, milrinone stimulated resorption in cultures of neonatal mouse calvaria and fetal rat limb bones. Threshold doses were 0.1 microM in calvaria and 0.1 mM in limb bones; maximal stimulation occurred in calvaria at 0.1 mM. Maximal responses to milrinone and parathyroid hormone were comparable. Milrinone concentrations below 0.1 mM did not affect calvarial cyclic AMP. 0.5 microM indomethacin inhibited milrinone effects in calvaria but usually not in limb bones. 3 nM calcitonin inhibited milrinone-stimulated resorption and there was no escape from this inhibition. Structural homology between milrinone and thyroxine has been reported. We find similarities between milrinone and thyroxine actions on bone, because prostaglandin production was crucial for the effects of both agents in calvaria but not in limb bones, and neither agent exhibited escape from calcitonin inhibition.
UK universities offer degrees in “pseudoscience,” <i>Nature</i> article says
Authors: David Spurgeon
Journal: BMJ (2007)

A subject that many researchers see as a pseudoscience is achieving scientific status within the British education system, says a news report in the science journal Nature (2007:446;352-3, doi: 10.1038/446352a).

In an accompanying commentary (pp 373-4, doi: 10.1038/446373a), David Colquhoun, of University College London's pharmacology department, says, “The least that one can expect of a bachelor of science (BSc) honours degree is that the subject of the degree is science. Yet in December 2006 the UK Universities and Colleges …
Iatrogenic Immunization with Bovine Thrombin: A Mechanism for Prolonged Thrombin Times after Surgery
Authors: Michael J. Flaherty
Journal: Annals of Internal Medicine (1989)

Unexplained very-prolonged thrombin times (> 300 s) were found in plasma from four patients. Other coagulation variables were normal, and there was no history of coagulopathy. Mixing studies suggested the presence of thrombin inhibitors in patient plasma. Substitution of human thrombin for bovine thrombin in performing the thrombin time test resulted in normal clotting times, indicating that the inhibitory activity was directed primarily against bovine thrombin. Each patient had been treated with topical bovine thrombin during previous surgery. In the one patient with a preoperative thrombin time, the initial value was normal and prolongation began 16 days after surgery. An enzyme-linked immunoassay showed elevated levels of IgM or IgG antibodies to bovine thrombin in each patient tested. Affinity-purified antibodies to bovine thrombin from patient serum prolonged the thrombin time of normal plasma. These results suggest that iatrogenic immunization by intraoperative exposure to bovine thrombin is responsible for antibodies to bovine thrombin, which accounts for the prolonged thrombin times found in some patients after surgery.
The Mechanism of Low Cerebrospinal Fluid Sugar in Bacterial Meningitis.
Authors: R. G. Petersdorf
Journal: Annals of Internal Medicine (1962)

s1 April 1962The Mechanism of Low Cerebrospinal Fluid Sugar in Bacterial Meningitis.R. G. Petersdorf, M.D.R. G. Petersdorf, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-689_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe reason for depressed concentration of glucose in the spinal fluid of patients with bacterial meningitis is poorly understood, and leukocytes, microorganisms, alterations in the blood cerebrospinal fluid barrier and metabolism of glucose by neural cells have been implicated in the genesis of hypoglycorrhachia. This problem was investigated by measuringin vitrothe consumption of glucose by leukocytes in cerebrospinal fluid, pneumococci incubated with sterile cerebrospinal fluid, and pneumococci incubated with cerebrospinal fluid containing leukocytes. Only the combination of bacteria and leukocytes was capable of depressing cerebrospinal fluid glucose. When encapsulated pneumococci were employed, multiplication of microorganisms in the presence... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Seattle, Wash. (CI) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 689-689KeywordsAttentionBacteriaBacterial meningitisBlood cellsCellsCerebrospinal fluidGlucoseGlucose metabolism Issue Published: 1 April 1962 PDF downloadLoading ...
HEMORRHAGE INTO AN OVARIAN CYST SIMULATING ECTOPIC PREGNANCY
Authors: CHESTER H. WATERS
Journal: JAMA (1918)

The attention of a small group of observers has been attracted to the clinical resemblance of certain ovarian conditions to ectopic pregnancy. The majority of cases recorded have dealt with the formation of a pelvic hematocele of ovarian origin, usually due to rupture and subsequent hemorrhage from a corpus luteum cyst. The most important ovarian conditions that may suggest ectopic pregnancy are: (1) a corpus luteum or follicular cyst; (2) torsion of the pedicle of a cyst; (3) rupture of a cyst with or without intra-abdominal hemorrhage; (4) ovarian hemorrhage, and (5) hemorrhage into a cyst. Judging from the literature, the last is infrequent, especially as regards its giving rise to symptoms suggestive of ectopic pregnancy. The exceedingly close simulation of ectopic pregnancy is well shown in the following instance: <h3>History.</h3> —Mrs. D., aged 28, secundipara, whose labors had been normal, the last one occurring fourteen months before, consulted me,
Rising hospital admissions
Authors: Stephen Gillam
Journal: BMJ (2010)

Can the tide be stemmed?

Whoever wins the next election, years of famine are upon us. Budgetary belts are tightening in anticipation. All the more disquiet therefore attaches to a report from consultants Caspe Healthcare Knowledge Systems (CHKS; an independent provider of healthcare intelligence and quality improvement services) that, “threatens bankruptcy for the NHS.”1

The growth in hospital admissions for elective and emergency care apparently rose by an average of 6% in England between 2007-8 and 2008-9.1 This compares with an average annual growth of 4.6% for the preceding three years, and it is mirrored by similar rises in Wales and Northern Ireland. Emergency admissions, which are inherently less susceptible to manipulation and therefore the main cause for concern, formed the bulk of these increases. Three simple questions present themselves. Firstly, are these hospital episode statistics reliable? Secondly, if so, what is driving these increases? Lastly, what can be done to reduce unnecessary use of hospital services? Unfortunately, the answers are not so straightforward.

Hospital admission rates have long been of concern. Earlier supposed increases in emergency admissions were mainly attributable to internal transfers after admission.2 The figures have also been artificially boosted by coding differences and the conversion of …
UK public will choose which scientific puzzle to investigate for 2014 Longitude Prize
Authors: S. Ahsan
Journal: BMJ (2014)

The UK public is being offered the chance to vote for what it deems the world’s most pressing scientific issue by choosing which of six modern day conundrums should be investigated for the £10m (€12.3m; $16.8m) 2014 Longitude Prize.

Three hundred years ago the original 1714 Longitude Prize solved a major scientific problem of the time—determining the longitude of ships at sea. The …
Investigation of long term problems after obstetric epidural anaesthesia.
Authors: C. MacArthur, M. Lewis, E. G. Knox
Journal: BMJ (1992)

OBJECTIVE--To examine the association between obstetric epidural anaesthesia and subsequent long term problems. DESIGN--Postal questionnaire on health problems after childbirth linked to maternity case note data. SETTING--Maternity hospital in Birmingham. SUBJECTS--11701 women who delivered their most recent child during 1978-85 and who returned completed questionnaires. MAIN OUTCOME MEASURES--Frequencies of long term symptoms after childbirth. RESULTS--Compared with the 6935 women who did not have epidural anaesthesia the 4766 women who did more commonly experienced backache (903 (18.9%) with epidural v 731 (10.5%) without epidural), frequent headaches 220 (4.6%) v 199 (2.9%)), migraine (92 (1.9%) v 73 (1.1%)), neckache (116 (2.4%) v 112 (1.6%)), and tingling in hands or fingers (143 (3.0%) v 150 (2.2%)). The results could not be explained by correlated social or obstetric factors. The associations with head, neck, and hand symptoms were found only in women who reported backache. An excess of visual disturbances among women who had epidural anaesthesia (83 (1.7%) v 91 (1.3%)) was present only in association with migraine, but excess of dizziness or fainting (102 (2.1%) v 109 (1.6%)) was independent of other symptoms. 26 women had numbness or tingling in the lower back, buttocks, and leg, of whom 23 had had epidural anaesthesia. Of 34 women with spinal headache, nine (five after accidental dural puncture; four after spinal block) reported long term headaches. CONCLUSIONS--These associations may indicate a causal sequence, although this cannot be proved from this type of study. Randomised trials of epidural anaesthesia are required to determine whether causal relations exist.
Britain was healthier than Germany in 1914
Authors: T. Kealey
Journal: BMJ (1996)

sources outside the systematic review, such as relevant cohort studies.' Senn's concerns arise from what he calls the principle of "label invariance."We agree that many analyses of data from clinical trials are unaffected by which group is called the treated group and which the control group.The distinction does, however, need to be made in analyses of underlying risk, when this term usually refers to the risk in the placebo, control, standard, or reference treatment group.In a withdrawal trial the "standard treatment" group would comprise those patients receiving the active treatment, because then the question of interest is whether the effect of withdrawing this treatment is the same for patients who are at different levels of risk while they are receiving it.In a trial comparing two active treatments, A and B, the definition of underlying risk would depend on the precise question being addressed, which might be the effect of changing from A to B given the risk associated with A or, alternatively, the effect of changing from B to A given the risk associated with B.
Simvastatin prodrug micelles target fracture and improve healing
Authors: Zhenshan Jia, Yijia Zhang, Yen Hsun Chen, Anand Dusad, Hongjiang Yuan, Ke Ren, Fei Li, Edward V. Fehringer, P. Edward Purdue, Steven R. Goldring, Aaron Daluiski, Dong Wang
Journal: Journal of Controlled Release (2014)
Bilateral Lower Extremity Inflammatory Lymphedema in Air Force Basic Trainees
Authors: Kevin A. Fajardo, Patrick Keller, Todd Kobayashi, Chad M. Hivnor, Bryant J. Webber, Susan P. Federinko, Juste Tchandja
Journal: JAMA Dermatology (2015)

This observational study characterizes a new clinical condition identified in 55 military trainees.To determine the incidence and underlying cause of bilateral lower extremity inflammatory lymphedema in Air Force basic trainees.An observational study was conducted at Lackland Air Force Base in San Antonio, Texas. Participants included 14 243 Air Force basic trainees who entered training between September 2011 and January 2012 and the 55 trainees (0.4%) who developed bilateral lower extremity inflammatory lymphedema that occurred during the 8½-week basic training course. Two modifiable risk factors were evaluated: vaccine reaction and newly issued military footwear (combat boots and boot socks).During November 2011, all new trainees wore only white socks and running shoes rather than the issued military footwear. During December 2011 and January 2012, the scheduled administration of tetanus/diphtheria/acellular pertussis and meningococcal vaccines, respectively, was delayed by 1 week for all new trainees. A full medical record review was conducted for every confirmed case of bilateral lower extremity inflammatory lymphedema.Identification of incident cases, symptom onset, antimicrobial treatment, immunization reaction, laboratory studies, specialty referral, and biopsy.Fifty-four of the 55 incident cases (98%) of bilateral lower extremity inflammatory lymphedema occurred during the first 120 hours of training. Alterations in the timing of the military footwear used and selected vaccine administration had no effect on the incidence of new cases. Two participants (4%) experienced symptom onset before receipt of the vaccines. Oral antimicrobial medications were not found to speed symptom resolution compared with conservative treatment measures (P = .34). One incident case was diagnosed as leukocytoclastic vasculitis by tissue examination.Multiple training-related risk factors were ruled out as sources of bilateral lower extremity inflammatory lymphedema. Cases are likely secondary to prolonged standing with resultant gravity-dependent venous congestion and inflammatory vasculitis. The potential roles of undiagnosed venous reflux disease and the military physical training environment in these cases remain to be elucidated.