tbuckley/cabot-search huggingface dataset:
Intensified conventional insulin treatment and neuropsychological impairment.
Authors: P Reichard, A Britz, U Rosenqvist
Journal: BMJ (1991)

OBJECTIVE--To assess whether intensified insulin treatment, with an increased frequency of hypoglycaemic episodes, leads to cognitive deterioration. DESIGN--Prospective randomised trial of intensified conventional treatment and standard treatment. SETTING--Outpatient clinic for patients with insulin dependent diabetes. SUBJECTS--96 patients with insulin dependent diabetes, high blood glucose concentrations, and non-proliferative retinopathy were randomised to intensified conventional treatment (n = 44) or standard treatment (n = 52). MAIN OUTCOME MEASURES--Glycated haemoglobin concentration (metabolic control); the number of hypoglycaemic episodes reported by patients at each visit; results of computerised neuropsychological tests performed at entry and after five years. RESULTS--Mean glycated haemoglobin concentration during the study was 7.2% (SE 0.1%) with intensified conventional treatment and 8.7 (0.1%) with standard treatment (p less than 0.001). During five years 34 (77%, 95% confidence interval 53% to 100%) of the patients given intensified treatment and 29 (56%, 36% to 75%) of the others had at least one episode of serious hypoglycaemia (p less than 0.05). The intensified conventional treatment group had a mean of 1.1 episodes of serious hypoglycaemia per patient per year compared with 0.4 episodes in the standard treatment group. Results of the neuropsychological tests were similar in the two groups after five years. CONCLUSIONS--Intensified conventional insulin treatment led to lower blood glucose concentrations and a higher frequency of hypoglycaemic episodes, but patients showed no signs of cognitive deterioration.
Toxoplasmosis Transmitted at Autopsy
Authors: Harold C. Neu
Journal: JAMA (1967)

<h3>To the Editor:—</h3> The occurrence of lymphadenitis in human toxoplasmosis is well recorded by Siim.<sup>1</sup>However, the mode of transmission and time course of the disease remains far from clear. Most of our knowledge of acquired toxoplasmosis is based on infections in laboratory workers and on occasional cases of accidental inoculation.<sup>2</sup>It has been suggested that insect vectors may play a role, but this is inadequately proven.<sup>3,4</sup> In the case recorded here a pathologist became acutely ill with toxoplasmosis two months after the autopsy of a patient who died with Hodgkin's disease and toxoplasmic ventriculitis. Histological studies of a lymph node from the pathologist were not specific, but the organism was isolated in two laboratories. The value of serological studies, culture of biopsy material, and the rationale for therapy are discussed. <h3>Report of a Case:—</h3> A 35-year-old pathologist was seen in June 1965 because of an unexplained
Glomerular filtration rate &amp;lt; 45 mL/min/1.73 m^2 with microalbuminuria was associated with increased risk for CV death
Authors: Dena E. Rifkin, Mark J. Sarnak
Journal: Annals of Internal Medicine (2008)

Source Citation Hallan S, Astor B, Romundstad S, et al. Association of kidney function and albuminuria with cardiovascular mortality in older vs younger individuals: the HUNT II study. Arch Intern Med. 2007;167:2490-6. [PMID: 18071172]
Surgeon from Sierra Leone treated for Ebola in Nebraska dies
Authors: M. McCarthy
Journal: BMJ (2014)

A surgeon who caught Ebola virus disease while working in Sierra Leone died early in the morning of 17 November while undergoing treatment in the biocontainment unit at Nebraska Medical Center in Omaha, Nebraska.

Martin Salia, a Sierra Leone national and a permanent US resident, practiced as a surgeon at Kissy United Methodist Hospital in Freetown, Sierra Leone. He was flown to Omaha from Sierra Leone on 15 November.

“Dr Salia was extremely critically ill …
War Lessons as Applied to Civil Practice
Authors: R. Sanderson
Journal: BMJ (1919)

Jujuy~~~~_'9 _99 _7_ Democritus and Empedocles saw her that the physicist deals, while the physiologist and physician deal, or ought to deal, with that truer and deeper vision of her as she appeared to Hippocrates.On the practical side the phlysicist aims at guiding and controlling Nature, whereas the physician aims at helping her.The object of this lecture will have been attained if I have succeeded in indicating how we may help in one of her tight places that ever more marvellous " Nature " which the keen intellectual yision of Hippocrates first began to reveal definitely to tlhe world.
Physiology of the Digestive Tract: An Introductory Text
Authors: W. H. J. Summerskill
Journal: JAMA (1966)

This new edition of Davenport's<i>Physiology of the Digestive Tract</i>should prove even more popular than its predecessor. Comprehensive and crammed with factual information, it is written with the smooth, concise, and witty style that befits a former Rhodes Scholar. Among the extensive changes are improved illustrations and greater amounts of information derived from studies in man. The number of pages has not increased, and superficially the premature middleage spread that characterizes later editions of successful books seems to be controlled. However, the print is smaller, and the text has in fact been expanded by approximately 20% The book, intended for students of medicine and physiology, occasionally uses plausible explanations to sustain a didactic rather than dogmatic approach. References are relatively few. The author moves adroitly between species, usually man and dog, although his occasional forays into organic or psychosomatic disease sometimes seem haphazard. In certain chapters, detail might be
Elusive cause of hypomagnesaemia
Authors: K. Swaminathan, J. Wilson
Journal: BMJ (2011)

A 46 year old man presented with carpopedal spasm, muscle cramps, and a prolonged QTc interval on a background of a week's history of diarrhoea and vomiting. He had a history of Barrett's oesophagus and had been taking 40 mg omeprazole daily for many years. He had severe hypocalcaemia and hypomagnesaemia, with a corrected calcium and magnesium of 1.77 mmol/L (reference range 2.15-2.65) and 0.13 mmol/L (0.75-1), respectively. Serum parathyroid hormone was low at 3.1 ng/L (8-55). Intravenous replacement of fluids and electrolytes restored the biochemical abnormalities. He was discharged on oral alfacalcidol and magnesium glycerophosphate. At six week follow-up, calcium had normalised (2.25 mmol/L) but symptomatic hypomagnesaemia persisted, with a serum magnesium of 0.27 mmol/L. Extensive evaluation, including upper and lower gastrointestinal endoscopy and distal duodenal biopsies, failed to identify a cause for his persistent hypomagnesaemia. He was admitted for recurrent intravenous magnesium infusions because his magnesium values were between 0.27 mmol/L and 0.29 mmol/L in spite of oral magnesium supplements. An intervention (figure⇓arrows labelled A and B) resulted in dramatic normalisation of serum magnesium values with no need for further oral or intravenous magnesium replacement. The patient's serum magnesium concentrations
MotViz: A Tool for Sequence Motif Prediction in Parallel to Structural Visualization and Analyses
Authors: Muhammad Sulaman Nawaz, Sajid Rashid
Journal: Genomics Proteomics & Bioinformatics (2012)

Abstract Linking similar proteins structurally is a challenging task that may help in finding the novel members of a protein family. In this respect, identification of conserved sequence can facilitate understanding and classifying the exact role of proteins. However, the exact role of these conserved elements cannot be elucidated without structural and physiochemical information. In this work, we present a novel desktop application MotViz designed for searching and analyzing the conserved sequence segments within protein structure. With MotViz, the user can extract a complete list of sequence motifs from loaded 3D structures, annotate the motifs structurally and analyze their physiochemical properties. The conservation value calculated for an individual motif can be visualized graphically. To check the efficiency, predicted motifs from the data sets of 9 protein families were analyzed and MotViz algorithm was more efficient in comparison to other online motif prediction tools. Furthermore, a database was also integrated for storing, retrieving and performing the detailed functional annotation studies. In summary, MotViz effectively predicts motifs with high sensitivity and simultaneously visualizes them into 3D strucures. Moreover, MotViz is user-friendly with optimized graphical parameters and better processing speed due to the inclusion of a database at the back end. MotViz is available at http://www.fi-pk.com/motviz.html.
Pathological Healing Response of Explanted MitraClip Devices
Authors: Elena Ladich, Mary Beth Michaels, Russell M. Jones, Elizabeth McDermott, Leslie Coleman, Jan Komtebedde, Donald Glower, Michael Argenziano, Ted Feldman, Masataka Nakano, Renu Virmani
Journal: Circulation (2011)

The safety and effectiveness of the MitraClip device (Abbott Vascular, Menlo Park, CA) is being evaluated in the Endovascular Valve Edge-to-Edge Repair Study (EVEREST) clinical studies. The healing response after device implantation has not previously been characterized in humans.A total of 67 explanted devices (implantation duration, 1 to 1878 days) from 50 patients were submitted for histological evaluation. Explants were analyzed in 4 implantation intervals: acute (≤30 days; n=7), subacute (31 to 90 days; n=23), chronic (91 to 300 days; n=18), and long term (>300 days; n=19). The acute healing response consisted of platelet/fibrin deposition. The subacute response exhibited granulation tissue with early fibrous encapsulation (pannus). The chronic response was characterized by various degrees of tissue bridging between the device arms. The long-term healing response demonstrated collagen-rich matrix (by type I collagen), incorporating the device components with complete encapsulation by organized, fibrous growth. In long-term devices with minimal surgical disruption, a fibrous tissue bridge (mean area, 7.39±4.3 mm(2)) was observed over and between the device arms, resulting in atrial tissue continuity between the 2 valve leaflets. Devices demonstrated no evidence of endocarditis, mechanical wear, component fracture, or corrosion up to the time of explantation (median, 119 days; first and third quartiles, 42 and 365 days).In all patients, device mechanical integrity was maintained up to the time of explantation. Four phases of physiological healing were observed: platelet and fibrin deposition, inflammation, granulation tissue, and finally, fibrous encapsulation. Long-term device fibrous encapsulation with extension over adjacent mitral leaflets and tissue bridge formation adds structural stability. Clinical Trial Registration- URL: http://clinicaltrials.gov/show/NCT00209274. Unique identifiers: NCT00209339 and NCT00209274.
Multicentre randomised controlled study comparing carvedilol with variceal band ligation in the prevention of variceal rebleeding
Authors: Adrian J. Stanley, Sheila Dickson, Peter C. Hayes, Ewan H. Forrest, Peter R. Mills, Dhiraj Tripathi, Joanna A. Leithead, Kim MacBeth, Lyn Smith, Daniel R. Gaya, Harry Suzuki, David Young
Journal: Journal of Hepatology (2014)
New programme of antenatal care in general practice.
Authors: G N Marsh
Journal: BMJ (1985)

The conclusions from recent analyses of the clinical worth of routine antenatal attendances have been used in the setting of a modern primary health care team. As a result the number of times a low risk nulliparous woman is seen by her general practitioner has been reduced from 15 to eight and a low risk multiparous woman from 15 to six. The number of consultations with a midwife has also been considerably reduced. The time saved is used in longer, more structured consultations and for more intensive care of high risk, usually socially deprived, women. Despite these reductions in consultations organised, well recorded care of this type renders antenatal attendances at a hospital virtually unnecessary for low risk women.
Patients receive an inadequate dose of antidepressants for an inadequate period
Authors: T M MacDonald, I C Reid, A D McMahon
Journal: BMJ (1997)

Editor—K Milligan considers our comments on the prescribing of low doses of antidepressants to be misleading because some patients get these drugs for indications other than depression.1 2 Our study showed that less than 1% of subjects received an adequate dose of tricyclic antidepressants for an adequate period (>90 days). Our argument would stand …
Olanzapine in the Treatment of Low Body Weight and Obsessive Thinking in Women With Anorexia Nervosa: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Hany Bissada, Giorgio A. Tasca, Ann Marie Barber, Jacques Bradwejn
Journal: American Journal of Psychiatry (2008)

Anorexia nervosa is associated with high mortality, morbidity, and treatment costs. Olanzapine, an atypical antipsychotic, is known to result in weight gain in other patient populations. The objective of this trial was to assess the efficacy of olanzapine in promoting weight gain and in reducing obsessive symptoms among adult women with anorexia nervosa.The study was a double-blind, placebo-controlled, 10-week flexible dose trial in which patients with anorexia nervosa (N=34) were randomly assigned to either olanzapine plus day hospital treatment or placebo plus day hospital treatment.Compared with placebo, olanzapine resulted in a greater rate of increase in weight, earlier achievement of target body mass index, and a greater rate of decrease in obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions.These preliminary results suggest that olanzapine may be safely used in achieving more rapid weight gain and improvement in obsessive symptoms among women with anorexia nervosa. Replication, in the form of a large multicenter trial, is recommended.
Serum Heat Shock Protein 27 Levels Represent a Potential Therapeutic Target for Atherosclerosis
Authors: Tara A. Seibert, Benjamin Hibbert, Yong-Xiang Chen, Katey Rayner, Trevor Simard, Tieqiang Hu, Charles M. Cuerrier, Xiaoling Zhao, Jacqueline de Belleroche, Benjamin J.W. Chow, Steven Hawken, Kumanan R. Wilson, Edward R. O'Brien
Journal: Journal of the American College of Cardiology (2013)
Modulation of ERK1/2 Levels by Enantiomers of Formoterol in Human Airway Smooth Muscle Cells
Authors: R.J. Hasan, A.L. Reno, E.A. Duru, J.L. Parks, R.A. Panettieri, W.J. Calhoun, B.T. Ameredes
Journal: Journal of Allergy and Clinical Immunology (2010)
Hyperinsulinemia Enhances Transcriptional Activity of Nuclear Factor-κB Induced by Angiotensin II, Hyperglycemia, and Advanced Glycosylation End Products in Vascular Smooth Muscle Cells
Authors: Inga Golovchenko, Marc L. Goalstone, Peter Watson, Michael Brownlee, Boris Draznin
Journal: Circulation Research (2000)

Abstract—Pathogenesis of macrovascular complications of diabetes may involve an activation of the transcription factor nuclear factor-κB (NF-κB) by hyperglycemia and advanced glycosylation end products (AGEs). Activation of NF-κB is believed to be dependent on activation of the Rho family of GTPases. Although the precise mechanism of the Rho-mediated action is not completely understood, posttranslational modification of the Rho proteins by geranylgeranylation is required for their subsequent activation. We observed that in cultured vascular smooth muscle cells (VSMCs), insulin stimulated the activity of geranylgeranyltransferase (GGTase) I and increased the amounts of geranylgeranylated Rho-A from 47% to 60% ( P &lt;0.05). GGTI-286, an inhibitor of GGTase I, blocked both effects of insulin. Increased availability of prenylated Rho-A significantly augmented the abilities of angiotensin II (Ang II), hyperglycemia, and AGEs to activate NF-κB, as measured by NF-κB response-element luciferase reporter activity. Preincubations of VSMCs with insulin for 24 hours doubled NF-κB transactivation by Ang II, hyperglycemia, and AGEs. This priming effect of insulin was completely inhibited by GGTI-286. We demonstrate for the first time, to our knowledge, that insulin potentiates NF-κB–dependent transcriptional activity induced by hyperglycemia, AGEs, and Ang II in VSMCs by increasing the activity of GGTase I and the availability of geranylgeranylated Rho-A.
Systolic blood pressure peak during maximal exercise testing: A possible determinant of endothelial turnover in healthy subjects
Authors: Michele M. Ciulla, Carola Gianni, Pietro Broglia, Silvia Lonati, Ilaria Silvestris, Roberta Paliotti, Fabrizio Giofrè, Erica Rampoldi, Agostino Cortelezzi, Fabio Magrini
Journal: American Journal of Hematology (2009)
ATM and the Mre11-Rad50-Nbs1 Complex Respond to Nucleoside Analogue–Induced Stalled Replication Forks and Contribute to Drug Resistance
Authors: Brett Ewald, Deepa Sampath, William Plunkett
Journal: Cancer Research (2008)

Abstract The Mre11-Rad50-Nbs1 complex and autophosphorylated Ser1981-ATM are involved in recognizing and repairing DNA damage, such as double-strand breaks (DSB). However, the role of these factors in response to stalled replication forks is not clear. Nucleoside analogues are agents that are incorporated into DNA during replication, which cause stalling of replication forks. The molecular mechanisms that sense these events may signal for DNA repair and contribute to survival but are poorly understood. Cellular responses to both DSBs and stalled replication forks are marked by H2AX phosphorylation on Ser139 (γ-H2AX), which forms nuclear foci at sites of DNA damage. Here, concentrations of the nucleoside analogues 1-β-d-arabinofuranosylcytosine (cytarabine; ara-C), gemcitabine, and troxacitabine, which inhibited DNA synthesis by 90% within 2 hours, were determined for each agent. Using γ-H2AX as a marker for changes in chromatin structure, we show that Mre11, Rad50, Nbs1, and phosphorylated ATM respond to nucleoside analogue–induced stalled replication forks by forming nuclear foci that colocalize with γ-H2AX within 2 hours. Because neither DSBs nor single-strand breaks were detectable after nucleoside analogue exposure, we conclude that this molecular response is not due to the presence of DNA breaks. Deficiencies in ATM, Mre11, or Rad50 led to a 2- to 5-fold increase in clonogenic sensitization to gemcitabine, whereas Nbs1 and H2AX deficiency did not affect reproductive growth. Taken together, these results suggest that ATM, Mre11, and Rad50 are required for survival after replication fork stalling, whereas Nbs1 and H2AX are inconsequential. [Cancer Res 2008;68(19):7947–55]
Predictors of Pneumocystis carinii pneumonia in HIV-infected persons. Pulmonary Complications of HIV Infection Study Group.
Authors: J D Stansell, D H Osmond, E Charlebois, L LaVange, J M Wallace, B V Alexander, J Glassroth, P A Kvale, M J Rosen, L B Reichman, J R Turner, P C Hopewell
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

The Pulmonary Complications of HIV Infection Study is a prospective, multicenter, observational study evaluating pulmonary disease among HIV-infected persons. For approximately 52 mo, 1,182 HIV-infected subjects were followed. All participants were evaluated for pulmonary disease on a predetermined schedule. There were 145 episodes of Pneumocystis carinii pneumonia (PCP). Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/microl and 95% had CD4 counts less than 200/microl. Subtle changes in diffusing capacity for carbon monoxide (DLCO) were associated with PCP. Univariate analysis identified recurrent undiagnosed fevers, night sweats, oropharyngeal thrush, and unintentional weight loss to be associated with risk among persons with CD4 counts above 200/microl. Subjects in whom CD4 counts declined to below 200/microl and who were not receiving preventive therapy were nine times more likely to develop PCP within 6 mo compared with subjects who received such therapy. A strong trend toward differences between the sexes was detected. Black subjects had less than one third the risk of developing PCP as did white subjects (p < 0.0001). There was no significant difference in risk by HIV transmission category, study site, frequency of follow-up, age, education, smoking history, or use of antiretroviral therapy. Multivariable analysis revealed low CD4 lymphocyte count (p < 0.0001), use of prophylaxis (p < 0.0001), racial differences (p < 0.0001), and declining DLCO (p = 0.015) to influence risk. Constitutional signs and symptoms indicate increased risk for PCP among HIV-infected persons with CD4 counts above 200/microl.
Effects of Changes in Body Position on the Severity of Obstruction to Left Ventricular Outflow in Idiopathic Hypertrophic Subaortic Stenosis
Authors: DEAN T. MASON, EUGENE BRAUNWALD, JOHN ROSS
Journal: Circulation (1966)

The circulatory responses to alterations in posture were determined in 10 patients with idiopathic hypertrophic subaortic stenosis. Tilting to a 45° head-up position augmented the subaortic gradient by an average of 35 mm Hg and intensified the obstruction to left ventricular outflow. In addition, the post-extrasystolic decrease of the arterial pulse pressure became more prominent. Tilting to a 20° head-down position reduced the gradient by an average of 11 mm Hg and tended to reduce the severity of the obstruction. Elevation of the lower extremities also resulted in a reduction of the intraventricular systolic pressure gradient, the reduction averaging 28 mm Hg, and apparently increased the dimensions of the obstructing orifice. It is postulated that these effects on the obstruction to outflow induced by changes in posture result primarily from alterations in left ventricular volume secondary to changes in venous return. As a consequence, in the upright position, the size of the left ventricular outflow tract is reduced and the intraventricular pressure gradient is augmented while the cardiac output is reduced, resulting in an intensification of the obstruction. The opposite changes occur during the head-down tilt or during elevation of the legs. These hemodynamic findings provide an explanation for the intensification of symptoms commonly experienced by patients with idiopathic hypertrophic subaortic stenosis in the erect position, and for the discrepancies between the symptoms and the severity of obstruction determined by cardiac catheterization carried out in the supine position. Assumption of the head-down, legs-up position is suggested as an emergency therapeutic maneuver for patients with hypertrophic subaortic stenosis.
Fracture of the Acetabulum
Authors: Otto E. Aufranc, Wiliam N. Jones, William H. Harris
Journal: JAMA (1964)

Dr. W. H. Harris: A 64-year-old man was brought to the emergency ward 15 minutes after he was struck by a car. The patient was not unconscious but he was confused and had partial amnesia for the events immediately before the accident. His past medical history was not remarkable. His blood pressure was 130/80 mm Hg. There was acute tenderness around the left hip, and both ankles were swollen, tender, and slightly deformed. No pulses were palpable in his feet. There was no evidence of injury to the chest or abdomen. There was no evidence of malfunction of the nervous system except his confusion. His blood pressure began to fall and dropped to 80/60 mm Hg, but rapid administration of one unit of blood and slow administration of a second unit of blood restored his vital signs to normal. A catheter was introduced into his bladder, and the urine obtained