tbuckley/cabot-search huggingface dataset:
The Misinterpretation of Electrocardiograms with Postprandial T-Wave Inversion
Authors: ISIDORE ROCHLIN, W. L. JACK EDWARDS
Journal: Circulation (1954)

Postprandial changes in the electrocardiogram are generally considered to be slight and not subject to misinterpretation. Four patients are presented in whom a diagnosis of coronary artery disease had been made because of flattening or inversion of the T waves in the bipolar or lateral V leads. The changes in T waves were temporary and could be produced by a high-carbohydrate meal. In addition, T-wave changes after a similar meal were studied in 85 normal young adults and 47 patients.
Activation of plasminogen into plasmin at the surface of endothelial microparticles: a mechanism that modulates angiogenic properties of endothelial progenitor cells in vitro
Authors: Romaric Lacroix, Florence Sabatier, Agnès Mialhe, Agnès Basire, Ralph Pannell, Hélène Borghi, Stephane Robert, Edouard Lamy, Laurent Plawinski, Laurence Camoin-Jau, Victor Gurewich, Eduardo Angles-Cano, Françoise Dignat-George
Journal: Blood (2007)
A CASE OF APPENDICITIS, ASSOCIATED WITH HYPEREMESIS GRAVIDARUM.
Authors: MARK A. RODGERS
Journal: JAMA (1907)

While I have no idea of advocating the removal of the appendix as a cure for pernicious vomiting of pregnancy, I take this opportunity of calling attention to the fact that an inflamed appendix may at times be a form of peripheral irritation sufficient to cause hyperemesis.  History.  —The patient, a primipara, aged 20, gave the following history when she first came under my observation: There had never been any marked irregularity in menstruation, although she. was hysterical and had somewhat marked exacerbations at the periods. For two years previous to my first visit there had been occasional attacks of cramps, with pain in the region of the appendix, attended with vomiting and fever. A diagnosis of appendicitis had already been made by other physicians and operation had been advised. When I saw the patient she was about four months pregnant and had had repeated attacks since conception had taken
Differences in Generalists' and Cardiologists' Perceptions of Cardiovascular Risk and the Outcomes of Preventive Therapy in Cardiovascular Disease
Authors: Peter D. Friedmann
Journal: Annals of Internal Medicine (1996)

To compare generalists' and cardiologists' estimates of baseline cardiovascular risk and the outcomes of preventive therapy.Cross-sectional mail survey using written case simulations of typical patients from primary prevention trials for hypercholesterolemia and isolated systolic hypertension, and tertiary prevention studies of coronary artery bypass surgery for chronic stable angina with left main coronary stenosis.Nationally representative sample of 599 practicing family physicians, general internists, and cardiologists selected from the American Medical Association masterfile. Among eligible physicians, 84 (44%) of 191 family physicians, 77 (40%) of 194 general internists, and 66 (34%) of 194 cardiologists responded.Estimates of risk at baseline and after therapy, and whether therapy generally would be recommended.For both primary prevention case simulations (scenarios), cardiologists provided lower, more accurate estimates of baseline cardiovascular risk and of absolute therapeutic benefit than either family physicians or general internists. The range of the generalists' estimates was extremely wide. Perceptions of relative risk reduction and treatment recommendations for the primary prevention scenarios did not differ among specialties. Overall, generalists who would not recommend primary preventive therapy in these scenarios appeared to give more accurate estimates than did generalists who would recommend such therapy.Many generalists have inflated perceptions of cardiovascular risk without treatment and of the benefit of risk-modifying medical treatment. Further study should assess the reasons for these misperceptions and their effect on counseling about primary preventive therapy.
Ecological risk assessment of endocrine disruptors.
Authors: T H Hutchinson, R Brown, K E Brugger, P M Campbell, M Holt, R Länge, P McCahon, L J Tattersfield, R van Egmond
Journal: Environmental Health Perspectives (2000)

The European Centre for Ecotoxicology and Toxicology of Chemicals proposes a tiered approach for the ecological risk assessment of endocrine disruptors, integrating exposure and hazard (effects) characterization. Exposure assessment for endocrine disruptors should direct specific tests for wildlife species, placing hazard data into a risk assessment context. Supplementing the suite of mammalian screens now under Organization for Economic Cooperation and Development (OECD) validation, high priority should be given to developing a fish screening assay for detecting endocrine activity in oviparous species. Taking into account both exposure characterization and alerts from endocrine screening, higher tier tests are also a priority for defining adverse effects. We propose that in vivo mammalian and fish assays provide a comprehensive screening battery for diverse hormonal functions (including androgen, estrogen, and thyroid hormone), whereas Amphibia should be considered at higher tiers if there are exposure concerns. Higher tier endocrine-disruptor testing should include fish development and fish reproduction tests, whereas a full life-cycle test could be subsequently used to refine aquatic risk assessments when necessary. For avian risk assessment, the new OECD Japanese quail reproduction test guideline provides a valuable basis for developing a test to detecting endocrine-mediated reproductive effects; this species could be used, where necessary, for an avian life-cycle test. For aquatic and terrestrial invertebrates, data from existing developmental and reproductive tests remain of high value for ecological risk assessment. High priority should be given to research into comparative endocrine physiology of invertebrates to support data extrapolation to this diverse fauna.
Validity of Markers of Dilution in Small Volume Lung Lavage
Authors: PETER A. DARGAVILLE, MICHAEL SOUTH, PETER VERVAART, PETER N. McDOUGALL
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Definitive analysis of solute concentrations in lung lavage fluid involves the use of a marker of dilution to correct for variable recovery of epithelial lining fluid (ELF), but the question of the most appropriate dilutional marker remains unresolved. In lavage fluid collected from infants with lung disease and healthy control subjects, we examined ELF concentration of protein, albumin, sphingomyelin (SM), and IgA secretory component (SC), and critically appraised the relative validity of SC and urea as dilutional markers in the context of lung infection and lung injury. Protein, albumin, and SM were found not to be valid dilutional markers, as their ELF concentration varied significantly between the diseased, recovering, and normal lung. Differences in concentration were noted in both tracheal aspirate samples (TA, 4 × 0.5 ml) and nonbronchoscopic bronchoalveolar lavage fluid (NB-BAL, 3 × 1 ml/kg), but were not uniform (e.g., TA—disease versus control: albumin 2.8 versus 0.68 mg/ml, SM 45 versus 16 μ g/ml, both p < 0.05; NB-BAL—disease versus recovery: protein 8.1 versus 4.8 mg/ml, albumin 2.9 versus 1.4 mg/ml, both p < 0.05). Overall, SC concentrations in ELF were not different between the diseased and normal lung, but in the NB-BAL samples, significantly higher SC concentration was noted in viral bronchiolitis and pneumonia than in noninfective lung diseases. No clear evidence of additional influx of urea into lavage fluid in association with epithelial disruption was found in the diseased lung. Comparative analysis of SC and urea revealed no difference in TA samples, but in NB-BAL specimens, urea best standardized the lavage concentration of surfactant indices to correspond to the degree of lung dysfunction as indicated by oxygenation index. We conclude that SC and urea, but not protein, albumin, or SM, are valid dilutional markers with which to estimate ELF recovery during small volume lung lavage. Urea appears a more appropriate choice in return fluid derived from the distal tracheobronchial tree, and SC should not be used in the context of lung infection.
Canine bile contains anticrystallization factors that inhibit precipitation of calcium carbonate
Authors: Lillian G. Dawes, Robert V. Rege, Edward W. Moore, Shuji Shimizu, Donald J. Ostrow
Journal: Hepatology (1991)

Previous studies have strongly suggested that human bile contains a substance(s) that interferes with the precipitation of calcium phosphate and carbonate from solution. These studies, however, did not distinguish between calcium binding by biliary constituents resulting in decreased calcium carbonate saturation (alterations in solution thermodynamics) and true inhibition of calcium salt precipitation by kinetic factors. Because our recent studies have shown that canine common duct bile is always supersaturated with calcium carbonate (thermodynamically at risk for precipitation), we hypothesized that it must contain kinetic factors that inhibit formation and/or growth of calcium carbonate crystals. Effects of canine bile, bovine albumin and the bile salt taurocholate on calcium carbonate precipitation were studied in highly supersaturated solutions of calcium carbonate that spontaneously undergo rapid precipitation. Measured free ionized calcium concentrations, [Ca ++ ], and calculated calcium carbonate saturation indices were compared in test solutions and controls to evaluate the thermodynamic effects of test solutions on the degree of saturation in the assay system. It is shown that addition of only 0.2 ml of normal canine gallbladder bile to the assay system (a 1:101 dilution of biliary components) abolished precipitation. A lesser inhibitory effect (a decrease in the rate of precipitation) was observed when gallbladder bile was diluted but was lost after 10-fold dilution. Canine common duct bile caused a decrease in the rate of precipitation similar to diluted gallbladder bile. In contrast, sodium taurocholate (250 mmol/L), the major bile salt in the dog, and albumin (1.5 gm/L), the most abundant protein in bile, had only a minimal inhibitory effect. We conclude that normal bile contains kinetic factors that inhibit calcium carbonate precipitation and protect against calcium-containing gallstones. These effects are not due to changes in calcium carbonate saturation but rather to alterations in precipitation kinetics. (Hepatology 1991;14:701-706.)
910. AAV8-Mediated Expression of Glucocerebrosidase Ameliorates the Storage Pathology in the D409V/null Gaucher Mouse
Authors: Kerry McEachern, John Marshall, Jennifer B. Nietupski, Karen M. Brennan, Christine M. Barbon, Wei-Lien Chuang, William Kennedy, Gregory A. Grabowski, Seng H. Cheng
Journal: Molecular Therapy (2005)

Gaucher disease is the most common of the >40 described lysosomal storage disorders. The primary manifestation of Gaucher disease is the accumulation of glucosylceramide (GL-1), predominantly in the macrophages of liver and spleen, due to a genetic defect in the lysosomal hydrolase glucocerebrosidase (GC). A mouse model of Type I Gaucher disease (D409V/null) was used to assess the efficacy of AAV8-mediated gene therapy. This mouse model exhibits only 5% of normal GC activity in visceral tissues resulting in elevated GL-1 levels and the appearance of enlarged macrophages (Gaucher cells) in liver, lung, and spleen at 3 months of age. The AAV vector (AAV8/DC172-hGC) used for these studies contained a hepatocyte-restricted promoter, DC172 (human 1-microglobulin enhancer, human 1-anti-trypsin promoter), to drive the expression of human GC. Intravenous administration of 31011 drp of AAV8/DC172-hGC into 4-week old D409V/null mice (prior to development of disease pathology) generated high levels of GC in the liver and serum, and subsequent uptake by the spleen and lung. Expression was sustained for the duration of the study (6 months) and was effective at preventing both the accumulation of GL-1 in the tissues and the consequent onset of Gaucher disease symptoms. A subsequent study in older mice (4-month old) with established disease pathology showed that administration of a similar dose of AAV8/DC172-hGC was also effective at reversing GL-1 storage in the affected tissues. Furthermore, AAV-treated mice were largely devoid of the lipid-engorged macrophages that were frequently observed in vehicle-treated D409V/null mice. A dose-response study, in which 5-month old mice received 31011, 11011 or 31010 drp of AAV8/DC172-hGC, yielded high and sustained expression of GC in all treatment groups. Three months post-injection, both the 31011 and 11011 drp dosed mice demonstrated a dramatic reduction in GL-1 levels and the number of Gaucher storage cells in liver, lung and spleen. Treatment also corrected the abnormal pathology, cell differentials and MIP-1 levels in the lungs of the D409V/null mice in a dose-dependent manner. Additionally, no antibodies to GC were detected, in accordance with previous AAV gene therapy studies using hepatocyte-restricted promoters. These data demonstrate the effectiveness of AAV-mediated gene therapy at preventing and correcting the biochemical and pathological abnormalities in the mouse model and thus support its continued development in the treatment of Gaucher Disease.
The Diary of a Breast
Authors: I. M Peat
Journal: BMJ (1995)

Elisa Seagrave Faber, pounds sterling9.99, pp 287, ISBN 0 571 17446 9

Talk of an epidemic of breast cancer may seem alarmist, but in the United Kingdom alone the current death rate equals the loss of a fully occupied jumbo jet every week. Cathy Read's book, with its Stateside perspective and highly combative style, maintains that breast cancer is avoidable, but that the focus has shifted from prevention to early detection and treatment. Read is very suspicious of the medical profession and its vested interests and poses some uncomfortable questions about this multibillion dollar industry.

Why, she wonders, has there been no notable increase in survival rates despite the widespread screening of premenopausal women …
ON THE TEACHING OF CLINICAL MEDICINE
Authors: J. Mackenzie
Journal: BMJ (1914)

THz problems of medical education and of medical research at present engage the attention of the profession not only in this country but in many others as well.Two in- teresting reports by Abraham Flexner-one on medical education in America and Canada, and the other on medical education in Europe-have been published by the Carnegie Foundation for the advancement' of teaching.* I may here remark that I was recently for three years a physician of the out-patient department of a consumption hospital, and during the whole of that timeI never saw one patient in the earlyand curable stage.In fact, the last place for discerning the early and curable stage of consumption is in the wards or out-patient department of a consumption hospital, tor the, simlple reason that patients never go to those places until there are signs of some chst affection long after the invasion has taken plicw JAN. 3, 19141 -
GASTROINTESTINAL PERFORATIONS AND THEIR DIAGNOSIS.
Authors: F. GREGORY CONNELL
Journal: JAMA (1903)

<h3>PRESENT ACCEPTED METHODS. B. EXPLORATORY LAPAROTOMY.</h3> So we see there are but two recognized methods of arriving at a diagnosis of perforation, i. e., awaiting peritonitis or performing laparotomy. The former is unreliable and of little value; the other, while it may be of great value, is of considerable real danger. As to a choice between them the consensus of opinion is in favor of the latter. Fewer cases will die after performing an exploratory laparotomy on all suspected cases than will be lost after awaiting the development of a peritonitis to corroborate the diagnosis. By awaiting the symptoms of a peritonitis in all such cases some few will not develop them and will recover without being exposed to all the dangers of an unnecessary major operation. To perform laparotomy in all such cases will of necessity result in some few being needlessly exposed to the many dangers of
Case of Malignant Tertian Malaria
Authors: W. L. Anderson, D. B. Bradshaw
Journal: BMJ (1943)

MEDICAL MEMORANDAMEDICAL JOURAL is less than 3 it is usually considered not to be significant.When the drug was administered immediately after a meal the percentage excretion in urine was 5.5 greater than when taken between meals.The standard deviations were 15.4 and 13.5 iespectively.The above-mentioned ratio in this case is 6.5, an(d hence the difference can be considered to be statistically significant, although from the clinical point of view it is scarcely of importance.Conclusions The data presented here would appear to show that there is no advantage with respect to the blood concentration or urinary excretion, and hence absorption, in giving acid or alkali with sulphapyridine.Nor was any significant effect observed on the blood concentration by timing the administration ot the drug in relation to meals.The excretion of the drug was greater when taken immediately after as opposed to two hours before a meal.This difference was statistically significant, but clinically can scarcely be of much importance.I desire to thank Dr. Stanley G.
Patients' views on their discharge from follow up in outpatient clinics: qualitative study
Authors: Y. Burkey, M. Black, H. Reeve
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To discover the views of patients about their discharge from outpatient clinics, to detect any change in these perceptions over time, and explore how the discharge process might be improved for the patient. <b>Design:</b> A qualitative study comprising in-depth or semistructured interviews with patients 2 weeks and 3 months after discharge from an outpatient clinic. <b>Subjects:</b> 45 patients who had attended outpatient clinics on three or more occasions. <b>Setting:</b> Five general medical outpatient clinics from a Manchester provider trust. <b>Main outcome measures:</b> Aspects of the discharge consultation valued by patients included confidence that the doctor knew and understood their case; clarity of the discharge process; an explanation of the reasons for discharge; information about treatment, future care, and the mechanism for re-referral; and being seen by doctors who sought their views and allowed time for questions and reflection. <b>Conclusions</b>: Patients9 views about their discharge changed over time and varied in relation to several factors, which included patients9 perceptions of the discharge process, patients9 expectations, the way in which the outpatient clinics were organised, and patients9 relationships with, and confidence in, their general practitioners. <h3>Key messages</h3> Patients being discharged from outpatient clinics value a clear message that they are being discharged, information about their condition and care, recognition of their views, and time to ask questions Patients are usually realistic about the care that their general practitioner can provide. Specialists could make use of this knowledge in deciding when to discharge a patient The grade of the doctor at the discharge consultation has no bearing on differences in patients9 views of discharge Written information about their condition and how to look after themselves would help patients and reduce communication difficulties between hospitals and general practitioners
Repression of the DNA-binding inhibitor Id3 by Blimp-1 limits the formation of memory CD8+ T cells
Authors: Yun Ji, Zoltan Pos, Mahadev Rao, Christopher A Klebanoff, Zhiya Yu, Madhusudhanan Sukumar, Robert N Reger, Douglas C Palmer, Zachary A Borman, Pawel Muranski, Ena Wang, David S Schrump, Francesco M Marincola, Nicholas P Restifo, Luca Gattinoni
Journal: Nature Immunology (2011)
Diverse Contribution of Bone Marrow–Derived Cells to Vascular Remodeling Associated With Pulmonary Arterial Hypertension and Arterial Neointimal Formation
Authors: Makoto Sahara, Masataka Sata, Toshihiro Morita, Kazuto Nakamura, Yasunobu Hirata, Ryozo Nagai
Journal: Circulation (2007)

Recent evidence suggests that bone marrow (BM)-derived cells may differentiate into vascular cells that participate in arterial repair and/or lesion formation. However, it remains uncertain whether BM-derived cells also can participate in vascular remodeling associated with pulmonary arterial hypertension.The BM of Sprague-Dawley rats was reconstituted with that of green fluorescent protein-transgenic rats. The BM-chimeric rats were injected intraperitoneally with 60 mg/kg monocrotaline after unilateral subpneumonectomy, and they concurrently underwent wire-mediated endovascular injury in femoral artery. After 28 days, they had elevated right ventricular systolic pressure (58.8+/-5.4 versus 20.4+/-2.4 mm Hg in sham-control; P<0.01). The pulmonary arterioles were markedly thickened, with an infiltration of green fluorescent protein-positive macrophages into the perivascular areas. The endothelium of pulmonary arterioles contained only a few green fluorescent protein-positive cells, and green fluorescent protein-positive cells were seldom detected as smooth muscle cells in the lesions of thickened pulmonary arterioles. In contrast, BM-derived smooth muscle-like cells could be readily detected in the thickened neointima and media of the wire-injured femoral artery. Moreover, intravenous injection of 1x10(8) BM cells from young rats had no beneficial effects on pulmonary hypertension, pulmonary arterial remodeling, or survival in the aged rats treated with monocrotaline plus unilateral subpneumonectomy. No injected BM cell was identified as an endothelial cell or a smooth muscle cell.These results suggest that BM-derived cells can participate in arterial neointimal formation after mechanical injury, whereas they do not contribute substantially to pulmonary arterial remodeling associated with monocrotaline-induced pulmonary arterial hypertension in the pneumonectomized rats.
Rehabilitation Medicine: A Textbook on Physical Medicine and Rehabilitation
Authors: Allan J. Ryan
Journal: JAMA (1965)

In the six years since the first edition of this comprehensive book was published, scientific advances and clinical studies have necessitated the virtual rewriting of five complete chapters. "Principles of Home-Making and Housing" has been considerably revised and improved, with new diagrams and illustrations. "Principles in the Management of Communication Impairment" is a complete revision of the chapter on speech problems. Considerations of simple voice disorders and cleft palate have been omitted. "Management of Vocational Problems" has been brought up to date and amplified. Chapters on the "Evaluation and Treatment of the Child with Cerebral Palsy" and the "Patient with Vascular Disease" have been completely rewritten to take advantage of new concepts. In other chapters much new material has been added to the discussions of prescription and evaluation of occupational therapy, progressive muscular dystrophy and related disorders, and the evaluation and treatment of the patient with emphysema. The new nomenclature
Loss of Lkb1 in Adult β Cells Increases β Cell Mass and Enhances Glucose Tolerance in Mice
Authors: Accalia Fu, Andy Cheuk-Him Ng, Chantal Depatie, Nadeeja Wijesekara, Ying He, Gen-Sheng Wang, Nabeel Bardeesy, Fraser W. Scott, Rhian M. Touyz, Michael B. Wheeler, Robert A. Screaton
Journal: Cell Metabolism (2009)