tbuckley/cabot-search huggingface dataset:
FACTORS INFLUENCING THE EXCHANGE OF SODIUM BETWEEN PLASMA AND CEREBROSPINAL FLUID*†
Authors: Robert A. Fishman
Journal: Journal of Clinical Investigation (1959)

This study is concerned with the mechanism of exchange of sodium between plasma and cerebro- spinal fluid (CSF).Several workers (1, 2) have reported that there is no significant difference be- tween the concentration of sodium in plasma and CSF.Merritt and Fremont-Smith (3) reported that the average concentration of sodium in CSF, in man, exceeded the plasma concentration by about four mEq.Davson (4) has determined the distribution ratio of sodium between CSF and plasma as 0.975 in the dog, correcting for the dif- ference in water content of these fluids.Despite the similarity in sodium concentration of these fluids and the superficial resemblance of CSF to a protein-free filtrate of plasma, intravenously ad- ministered radio-sodium reaches equilibrium in the CSF far more slowly than in the extracellular fluid (5, 6).The delay in exchange between plasma and CSF has been attributed to the existence of a blood-CSF barrier for sodium (5-7).The pres- ent experiments have been devised to note the ef- fect of a variety of physiological and pharmaco- logical alterations on the exchange of sodium be- tween these fluid compartments.* For each starred experimental group, a statistically significant change in half-time, on the average, was deter.mined using Wald's method of sequential analysis (8).The level of significance, at, was .05.The statistical tests were formulated so that a true mean sodium exchange half-time of 30 minutes (or more) would be detected with 95 per cent (or more) certainty.No statistical decision could be made about the remainder-of factors.t These dogs were not suitable for statistical analysis.
P44 COPD Patients derived benefits from attending PR: 'This has given me my life back'
Authors: L. Matheson, J. O'Connor, T. Cartwright, C. Blunt, A. Clow, C. Lee, S. Elkin
Journal: Thorax (2010)

<h3>Objectives</h3> The effectiveness of Pulmonary Rehabilitation (PR) diminishes over time. Little is known about the role of patients′ beliefs and experiences of PR in the maintenance of outcomes. The aim of this study was to explore COPD patients′ experiences of PR in completers and non-completers. <h3>Methods</h3> Purposive sampling was employed to recruit COPD patients referred to an outpatient PR. Participants were interviewed pre (n=15) and post (n=10) PR, approximately 1–2 weeks after the programme. Eight participants completed PR, two dropped out and five were lost to follow-up. Data were analysed using Thematic Analysis. <h3>Results</h3> A strong theme to emerge was ‘<i>empowerment through attending PR</i>’ as physical improvements derived from PR gave participants a sense of freedom and inspired the motivation to re-engage with life again. Participants regained greater control over the condition, and improvements in mood prompted a renewed sense of optimism and hope for the future. Social re-engagement was often the most highly valued aspect of PR, which provided companionship and normalised the condition. Collectively, positive outcomes inspired determination and ‘<i>efforts to maintain the benefits</i>’. Peer support was vital in motivating participants to continue exercise regimes. Potential barriers to maintaining exercise were discussed. ‘<i>Improvements to service provision</i>’ were felt necessary to facilitate long-term maintenance, in the form of formalised follow-up sessions and telephone calls. A few had ongoing issues with anxiety, suggesting the need for individual counselling. ‘<i>Reasons for drop-out</i>’ included a threatened sense of autonomy and control, negative illness perceptions, inappropriate timing of PR as well as practical and medical issues. These participants were still smokers, and lacked desire for behaviour change. Participants who didn′t attend displayed overwhelming scepticism about PR effectiveness. <h3>Conclusions</h3> These findings indicate that immediately following PR, patients feel empowered to continue exercising, due to perceiving multiple benefits. The value placed on peer support demonstrates that this is an important motivator in promoting maintenance. This study highlights COPD patients′ preferences in terms of how service provision aimed at facilitating long-term maintenance of outcomes could be improved, and has implications for the development of psychosocial interventions for patients who are reluctant to attend.
Genomic variants associated with primary biliary cirrhosis
Authors: Carlo Selmi, Natalie J Torok, Andrea Affronti, M Eric Gershwin
Journal: Genome Medicine (2010)

Primary biliary cirrhosis (PBC) is an autoimmune hepatobiliary disease characterized by immune-mediated injury of small and medium-sized bile ducts, eventually leading to liver cirrhosis. Several studies have addressed PBC immunopathology, and the data support an immune activation leading to autoantibodies and autoreactive T cells acting against the lipoylated 2-oxoacid dehydrogenase complexes. The causes of the disease remain unknown, but environmental factors and genetic susceptibility both contribute to its onset. Over the past two decades several association studies have addressed the role of genetic polymorphisms in PBC pathogenesis and have reported multiple associations. However, only a few studies had sufficient statistical power, and in most cases results were not independently validated. A genome-wide association study has recently been reported, but this too awaits independent confirmation. The aim of this present work is to critically review the numerous studies dedicated to revealing genetic associations in PBC, and to predict the potential for future studies based on these data.
Genetic and environmental factors in polymyalgia rheumatica
Authors: M. A CIMMINO
Journal: Annals of the Rheumatic Diseases (1997)

Polymyalgia rheumatica (PMR) is a disease that rheumatologists feel confident in recognising in their daily practice. In the classic form, its diagnosis is straightforward and standard corticosteroidal treatment usually yields excellent results, at least in the first months. In contrast with the feeling that PMR is a disease that can be readily treated, the aetiology and pathogenesis are still obscure. Unlike several other forms of rheumatic disease, we do not know what the target of inflammation is in PMR. The synovial membrane is the most probable candidate as synovitis has been demonstrated by sonographic1 and immunohistochemical2 methods. In addition, the frequent occurrence of peripheral arthritis in patients with PMR further supports this possibility.3Synovitis is mild and patchy in extent, which does not explain the amount of inflammation disclosed by symptoms and laboratory tests. The skeletal muscle was considered the main site of inflammation by Barber4 who coined the name ‘polymyalgia rheumatica’. Although this theory has been discarded for a long time, recent descriptions of the association between PMR and mitochondrial myopathy5 and of corticosteroid responsive electromyographic abnormalities6 in patients with PMR have reawakened interest in the role of skeletal muscles. Vasculitis is another attractive possibility because it could comprise PMR and giant cell arteritis (GCA) under a common pathogenesis. The evidence for active vasculitis in biopsy specimens from patients with PMR, however, is scanty. There are also new data that point to bursae as the principal site of inflammation.7 The large surface of synovial tissue in bursae around glenohumeral joints could explain the amount of inflammation seen in PMR.

The main areas of research in PMR aetiopathogenesis are immunology, genetics, and the environment.

The concept that PMR cannot be an autoimmune disease because of the lack of autoantibodies has been challenged by …
Interpreting the evidence
Authors: D. Spence
Journal: BMJ (2002)

Evidence based medicine is the holy grail of medical practice—well, that is what some of us think. Remember, however, the dangers of meta-analysis,1 and even “quality sources” must be treated with some suspicion. Dark forces such as publication bias, pharmaceutical vested interest, incomplete search databases, and publication fraud are at work. Remember the first rule of medicine: “Do no harm.”2

Although the quality of the data in this review is good, it is important to be conscious of …
229. Development of a Novel Drug Delivery System Based on Intrapericardial Administration of Plasmid DNA in a Thermosensitive Gel Formulation
Authors: Caroline Roques, André Salmon, Armelle Serose, Elias Fattal, Yves Y. Fromes
Journal: Molecular Therapy (2005)

Background: Concerning myopathies, the treatment of myocardial impairment raises specific issues due to the structure and function of the myocardium. Thus, original routes of administration can be considered as direct injection into the myocardium, coronary infusion or intrapericardial injection. Gene therapy is mainly based on two different vector systems: viral or non-viral formulation of the DNA. Considering that repeated administrations of plasmid DNA (pDNA) would be mandatory to achieve the therapeutic goals and that viral transfection's main issue remains immunogenicity, non-viral vectors seem to be the best suited. Several lipidic or polymeric systems have already been tested, and in vivo, one of the most efficient appears to be polyethyleneimine (PEI). Our study aims at designing a new non-viral system for myocardial gene delivery, displaying low toxicity and the best efficiency. This system is based on condensation of plasmid DNA with PEI. These polyplexes are then included in a thermosensitive gel in order to improve the residence time of the system and administered via the intrapericardial route.
N.H.S. Superannuation Scheme
Authors: W. J. Stanley
Journal: BMJ (1965)

to their private or national insurance scheme, and have 75 % of the cost returned to them.It works perfectly well in Ireland and in America.But for heaven's sake let's be honest: 50-60% of my present work is a waste of my time; 20-30% of my patients use me merely as an extension of theNational Insurance Scheme-and successive Govern- ments use us as political pawns and vote- catchers.I like general practice, I like England, and at 36 I do not wish to emigrate.But for my family's sake I cannot just " let things be."Why drive more and more of us away when all that is needed is an honest look at the situation and an honest approach to the prob- lem.
IgA deficiency during penicillamine treatment.
Authors: R D Forrest, H Bostrom, P A Dahlberg
Journal: BMJ (1977)

cardiac massage.The apparent resistance to large doses of isoprenaline noted in previous reports1 2 was observed.In two reported cases' 3glucagon has been used successfully in the treatment of myocardial depression following beta blockade.P C MATTINGLY
Primary structure of IgE monoclonal antibodies expressing an intrastrain crossreactive idiotype.
Authors: S Haba, E M Rosen, K Meek, A Nisonoff
Journal: The Journal of Experimental Medicine (1986)

We have obtained amino acid sequences (by mRNA and amino acid sequencing) for two IgE kappa mAb that have specificity for the Ars hapten group and are related to the major idiotypic family, CRIA (crossreactive idiotype A), in the A strain of mouse. One mAb, SE20.2, fully expresses CRIA; the other, SE1.3, possesses some but not all of the characteristic idiotopes. Both IgE proteins contain VH and V kappa segments that are closely related to those associated with CRIA. The D segment of SE20.2 is also typical of CRIA+ mAb, but that of SE1.3 is one amino acid residue longer. Chain recombination experiments indicated that the L chain of SE1.3 is fully capable of supporting CRIA expression. Its deficiency with respect to idiotopes of CRIA was attributed to the extra amino acid in the D region and/or substitutions in the VH segment. A major objective was to ascertain the frequency of somatic mutations in IgE. For the VH segment (amino acids 1-98) of SE20.2, there are only three nucleotide differences and one uncertainty with respect to the nucleotide sequence of the germline gene associated with CRIA. A somewhat higher frequency of substitutions is present in the VH segment of SE1.3. The VK amino acid sequences of the IgE proteins are nearly identical to those of a prototype of the CRIA family, mAb R16.7. The results are discussed with reference to the mechanism of the IgM to IgE switch.
The evaluation of LV function in patients with myocardial infarction by Tc-99m MIBI gated SPECT
Authors: Shigeo Kawano, Yoshio Ishida, Tetsuro Katabuchi, Akiko Matsumoto, Kouhei Hayashida, Yoshiaki Hirose, Shuji Fukuoka, Junko Shimozu, Makoto Takamiya, Heiji Hasegawa
Journal: Journal of the American College of Cardiology (1996)
William Philip Dowie Logan
Authors: A. L. D. L. I. Logan
Journal: BMJ (2013)

Educated at Queens Park School, Glasgow, William Philip Dowie Logan was a pianist of a very high standard; a church organist; a student of classics, modern languages, and mathematics; and Dux Ludorum.

Shortly after qualifying, during his surgical and casualty house appointment in Glasgow, he joined the Royal Air Force’s medical volunteer reserve and served in Saskatchewan, Canada, as a pilot medical officer on a flight training base (1941-3), returning as a squadron leader (medical) based at Hixon, …
Healthcare associated infections
Authors: A. Voss
Journal: BMJ (2009)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Healthcare associated infections Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Expression of alpha 2-macroglobulin receptor/low density lipoprotein receptor-related protein and scavenger receptor in human atherosclerotic lesions.
Authors: J Luoma, T Hiltunen, T Särkioja, S K Moestrup, J Gliemann, T Kodama, T Nikkari, S Ylä-Herttuala
Journal: Journal of Clinical Investigation (1994)

Macrophage- and smooth muscle cell (SMC)-derived foam cells are typical constituents of human atherosclerotic lesions. At least three receptor systems have been characterized that could be involved in the development of foam cells: alpha 2-macroglobulin receptor/LDL receptor-related protein (alpha 2 MR/LRP), scavenger receptor, and LDL receptor. We studied the expression of these receptors in human atherosclerotic lesions with in situ hybridization and immunocytochemistry. An abundant expression of alpha 2MR/LRP mRNA and protein was found in SMC and macrophages in both early and advanced lesions in human aortas. alpha 2MR/LRP was also present in SMC in normal aortas. Scavenger receptor mRNA and protein were expressed in lesion macrophages but no expression was found in lesion SMC. LDL receptor was absent from the lesion area but was expressed in some aortas in medial SMC located near the adventitial border. The results demonstrate that (a) alpha 2MR/LRP is, so far, the only lipoprotein receptor expressed in lesions SMC in vivo; (b) scavenger receptors are expressed only in lesion macrophages; and (c) both receptors may play important roles in the development of human atherosclerotic lesions.
G(−30)A Polymorphism in the Pancreatic Promoter of the Glucokinase Gene Associated With Angiographic Coronary Artery Disease and Type 2 Diabetes Mellitus
Authors: Winfried März, Markus Nauck, Michael M. Hoffmann, Dietmar Nagel, Bernhard O. Boehm, Wolfgang Koenig, Dietrich Rothenbacher, Bernhard R. Winkelmann
Journal: Circulation (2004)

Type 2 diabetes mellitus (T2DM) increases the risk of coronary artery disease (CAD). A G(-30)A polymorphism in the beta-cell-specific promoter of glucokinase (GK-30PM) has been implicated in reduced pancreatic beta-cell function. Its impact on CAD has not been examined.The glucokinase G(-30)A variant was determined in 2567 patients with angiographic CAD and in 731 individuals in whom CAD had been ruled out by angiography. In carriers of the A allele, the adjusted OR of CAD was 1.39 (95% CI, 1.15 to 1.70). Corresponding ORs were 1.27 (95% CI, 1.02 to 1.59) and 1.92 (95% CI, 1.26 to 2.93) in individuals without and with T2DM, respectively. The prevalence of the A allele increased in parallel with the Friesinger coronary score. Patients with T2DM were more frequent among carriers of > or =1 A allele (OR, 1.17; 95% CI, 1.00 to 1.28). This association was stronger if CAD patients only were considered. The A allele was associated with higher glucose (fasting, P=0.002; 2 hours after oral glucose, P=0.017) and glycohemoglobin (HbA1c; P=0.002). Furthermore, presence of 1 A allele was negatively related to beta-cell function, estimated by beta percent (P=0.012) and by the ratios of proinsulin to insulin (P=0.025) and proinsulin to C peptide (P=0.019).The A allele of the pancreatic promoter of glucokinase increases the risk of CAD in individuals with and without T2DM. Furthermore, at least in CAD, it is associated with an augmented prevalence of T2DM.
Use of Anti-Anxiety Drugs in the Medically Ill
Authors: David Wheatley
Journal: Psychotherapy and Psychosomatics (1988)

The Stress Clinic at the Maudsley Hospital investigates anxiety due to stress and its pharmacological treatment. Nine stress areas are investigated and their relative severities estimated: social habits, social relationships, life events, psychiatric morbidity, sexual stresses, sleep, stress in old age, menstrual stresses and stress and the heart. From the results a Stress Profile can be constructed for each patient to compare the importance of these different stresses and this can also be used as a measure of change in response to treatment. The benzodiazepine (BZD) anxiolytics can be divided into two groups according to duration of action, medium (8–12 h) and long (30–100 h). Short-acting BZD drugs are particularly useful for situational anxiety, when treatment can be interrupted over night and at weekends. To overcome problems of dependence, withdrawal effects, and daytime side-effects, new non-BZD anxiolytics have been developed: buspirone, alpidem and suriclone. These may be particularly useful for long-term treatment of anxiety. Another alternative is the use of adrenergic beta-blocking drugs of which propranolol and betaxolol have been used in the Clinic, because of their relatively high concentration in the brain when taken orally. Anxiety accompanying coronary heart disease and hypertension can be controlled with anxiolytic drugs and other illnesses with an anxiety component are: sexual disorders, menstrual disorders, asthma, gastro-intestinal conditions, dermatological conditions and chronic illnesses such as malignancy and AIDS. Lack of sleep is a subtle form of stress exerting an adverse effect in almost every illness known to man. BZD hypnotics can be divided into four groups: ultra-short-acting (3–4 h), short-acting (5–6 h), medium-acting (7–8 h) and long-acting (9–12 h). Depending on the nature of the insomnia, ultra-short-acting and short-acting BZD are particularly convenient with minimal disadvantages. Nevertheless, new non-BZD hypnotics are also being developed, i.e. zolpidem and zopiclone. These drugs are relatively short-acting and of equivalent potency to the BZD without problems of dependence etc. Anxiety, as either cause or effect, accompanies many medical illnesses and the use of anti-anxiety drugs as concomitant therapy can both reduce morbidity and improve prognosis.
Kinetics of hydrolysis of cardiac S1 heavy chain isoforms and identification of light chain and acting binding sites
Authors: S. S Margossian, V. B Hatcher, S. Taylor
Journal: Cardiovascular Research (1993)

Objective: A comparative study of the kinetics of proteolysis of myosin S1 heavy chain was performed using dog ventricular and atrial S1 to distinguish between protease sensitive sites in S1 isotypes and to determine the binding sites on S1 heavy chain for LC1, LC2, and actin. Methods: Digestion of S1 as a function of actin was performed at 25°C at a trypsin to S1 ratio (w/w) of 1:1500. Myofibrils were digested (trypsin/myofibrils w/w ratio=l:300) in the presence of ATP, ADP, and under rigor conditions. Light chain and actin binding sites were identified by the gel overlay method. Results: Ventricular and atrial S1 were proteolysed at 0.13 min−1 and 0.04 min−1 respectively. Actin significantly reduced the cleavage rate of both S1 heavy chains by blocking hydrolysis at the 50/20 kD site. Myofibrillar myosin heavy chains from ventricles were also hydrolysed faster than those of the atria in the presence of 4 mM MgATP. The calculated rates were 0.42-0.50 and 0.17-0.19 min−1 for ventricular and atrial myofibrils respectively. MgADP 2 mM or absence of nucleotides reduced the cleavage rates to 0.04-0.07 (ventricular myofibrils) and 0.02-0.03 min−1 (atrial myofibrils) respectively. Gel overlay experiments showed that 125I labelled LC1 and LC2 bound to the 20 kD fragment and actin mainly to the 50 and 20 kD peptides. Conclusions: The 50/20 kD site in either ventricular or atrial S1 was blocked when actin was present, while proteolysis at the 25/50 site proceeded regardless of the presence of actin. However, the 25/50 site was less accessible to trypsin in the α myosin heavy chain, since the roughly threefold reduction in the rates of hydrolysis of atrial S1 heavy chain was also maintained in the myofibrils in rigor or in the presence of ADP. Although actin made contact with the 70 kD and the 25 kD fragments, the 50 kD and 20 kD fragments appeared to be the central “anchor” for binding of both light chains and actin.
A GAMMA CAMERA METHOD OF MEASURING REGIONAL CEREBRAL BLOOD FLOW (rCBF) BY Xe-133 WASHOUT TECHNIQUE
Authors: Paul H. Brown, J. Hanada, J. Haines, J. Roth, D. Woody, H. Shaich, H. Ono, A. Davis, J. Jarboe, D. Specht, G. Krishnamurthy
Journal: Clinical Nuclear Medicine (1984)

Previous researchers have utilized the Obrist method for measurement of rCRB using end-tidal, exhaled air counts to correct for recirculation. Choice of the appropriate end-tidal air point is difficult and requires rapid air sampling (0.3 sec) with concomitant poor statistics. A comparison was made between this end-tidal air sampling method and a simpler-to-use average, expiratory air curve (6 sec sampling) in 9 normal volunteer controls, and in 9 patients with carotid artery stenosis or occlusion. The Obrist deconvolution technique was adopted for use on a Picker 4 gamma camera and MDS computer. A high sensitivity collimator insert with square holes measuring 1.7 cm across and 3.8 cm in depth was used. A one minute combination Xenon-133 inhalation and equilibrium period was followed by 10 minutes of washout. A two component exponential was fitted to the deconvoluted brain curves. For the functional images, a MDS rainbow color translation table was used. Two sequences of 9 point spatial smoothing were tested, one with a single smooth before curve generation and another with 2 smooths after. The new method, using 6 second, average expiratory air sampling and a single 9 point spatial smooth before curve generation, demonstrated areas of decreased flow which corresponded to the angiographic findings and clinical findings in each case and demonstrated them equal to or better than the standard method. By the new method, very few abnormal areas were found in the controls, and decreases in the control patients were almost always less than when using the 0.3 sec air sampling time.