tbuckley/cabot-search huggingface dataset:
Effect of Training Status on Regional Disposal of Circulating Free Fatty Acids in the Liver and Skeletal Muscle During Physiological Hyperinsulinemia
Authors: Patricia Iozzo, Teemu Takala, Vesa Oikonen, Jörgen Bergman, Tove Grönroos, Ele Ferrannini, Pirjo Nuutila, Juhani Knuuti
Journal: Diabetes Care (2004)

OBJECTIVE—Fat metabolism is increasingly implicated in the pathogenesis of type 2 diabetes. Endurance training has been shown to prevent hepatic steatosis and to alter skeletal muscle fat metabolism, and regional free fatty acid (FFA) uptake adaptations were suggested as a mechanism. Thus, we tested whether endurance training modifies the uptake of plasma FFAs occurring in the liver and in skeletal muscle during anabolic, i.e., hyperinsulinemic, conditions. RESEARCH DESIGN AND METHODS—Trained and untrained healthy male subjects underwent positron emission tomography scanning of the liver and thigh regions, with the FFA analog 14(R,S)-[18F]fluoro-6-thia-heptadecanoic acid, during euglycemic hyperinsulinemia. Tracer influx rate constants in skeletal muscle (MKi) and liver (LKi) were multiplied by plasma FFA levels to obtain FFA uptake for skeletal muscle (MFU) and liver (LFU), respectively. RESULTS—Athletes showed increased Vo2max (P &amp;lt; 0.0001), insulin-mediated glucose disposal (M value, 61 ± 4 vs. 46 ± 3 μmol · min−1 · kg−1, P = 0.01), and plasma lactate levels during the clamp and lower percentage of body fat mass (P = 0.002). MKi was 25% higher in athletes than in sedentary men (P = 0.03). In all subjects, MKi and MFU were positively correlated with the M value (r = 0.56, P = 0.02, and r = 0.51, P = 0.03, respectively) and with plasma lactate levels (r = 0.63, P = 0.006, and r = 0.63, P = 0.005, respectively). LKi was significantly reduced by 20% in the athletes (P = 0.04). By multiple regression, LFU was inversely correlated with the two fitness categories (P = 0.008), and it was lower in athletes. Linear fitting of liver data showed time consistency, indicating no release of FFAs as a mechanism for the reduced liver retention in athletes. CONCLUSIONS—We conclude that endurance training promotes insulin-mediated glucose and FFA disposal in skeletal muscle, while lowering hepatic FFA uptake. Such changes may result in a divergent pattern of fat accumulation in the two organs.
GMC hears that doctor who faked results is "indispensable" to the NHS
Authors: C. Dyer
Journal: BMJ (2009)

Stroke is a frequently reported, though uncommon, complication of drug abuse, primarily cocaine. The pathogenesis is uncertain, although such cerebrovascular events may result from sympathetically mediated vasoconstriction of cerebral vessels. Amphetamine, another sympathomimetic amine that is commonly abused, may also cause strokes by producing cerebral vasospasm and/or vasculitis. Amphetamine and its derivatives are frequent adulterants of illegally obtained cocaine and may also be used concurrently; the effect(s) of this combination of drugs upon the cerebral vasculature is not known. Our aim was to develop an animal model that would enable us to study the ability of these drugs to produce acute cerebral vasospasm and to observe the response to IV administration of amphetamine and cocaine, either alone or together. Magnified basilar artery arteriograms were obtained in 12 New Zealand white rabbits before and after IV administration of cocaine, methamphetamine, or both, at various dosages. Low doses produced mild vasodilatation. At higher doses, the animals who received cocaine and methamphetamine alone showed little or no basilar artery spasm, but coadministration produced definite basilar artery vasospasm, reflecting a synergistic vasoconstrictive effect. If a similar response exists in the human cerebral vasculature, then this could help explain the cause of strokes associated with drug abuse.
Effectiveness of the Ultraflex Diamond Stent for the Palliation of Malignant Biliary Obstruction
Authors: J. Ahmad, E. Siqueira, J. Martin, A. Slivka
Journal: Endoscopy (2002)

Endoscopically placed metallic biliary stents provide durable drainage for malignant biliary obstruction. The best-studied metal stent is the Wallstent, which has a greater duration of patency than polyethylene stents. Recently, the Ultraflex Diamond stent has been introduced, with reports from Europe which suggest efficacy similar to that of the Wallstent. We report our experience with this new metal stent and compare it with a historical cohort of Wallstent-treated patients.Between July 1997 and July 1998 all metal stents placed for malignant biliary obstruction were Diamond stents (10 mm diameter, 6 or 8 cm length). Prospective follow-up details with regard to patient death or stent occlusion were obtained. In total, 32 patients underwent stenting, but 11 patients were excluded because of the following: death from pre-existing cholangitis (2); placement of bilateral hilar stents (2); placement of stent through occluded metal stents (3); failure to palliate jaundice due to complex hilar stricture (2) or concomitant liver failure (1); or inability to obtain follow-up (1), leaving 21 patients for analysis. Occlusion rates and stent patency were also determined retrospectively for 19 patients with malignant biliary obstruction who had Wallstents (10 mm diameter, 6.8 cm length) placed during the preceding year and for whom accurate and complete follow-up details were available.In the Diamond stent group there were 14 men and seven women, mean age 73. In the Wallstent group there were 11 men and eight women, mean age 66. The types of cancer, level of stricture and percentage with prior polyethylene stenting were similar in both groups. Stent occlusion occurred in 9/21 (43%), Diamond stents at a mean of 74 +/- 43 days compared with 8/19 (42%) Wallstents at a mean of 178 +/- 138 days (P < 0.04). Mean time of stent patency was 110 +/- 89 days for Diamond stents and 253 +/- 218 days for Wallstents (P < 0.01). Analysis of occlusion-free survival using a Kaplan-Meier plot showed a trend favoring the Wallstent (P = 0.12; Wilcoxon test).The occlusion rate and patency of Diamond stents for malignant biliary obstruction appear to be inferior to those of Wallstents and similar to reported values for polyethylene stents. Prospective randomized comparisons of Wallstents and newer self-expanding metal stents are warranted.
The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: Results from a multi-institutional retrospective study
Authors: Alan B. Fleischer, Steven R. Feldman, James O. Barlow, Beiyao Zheng, Holly B. Hahn, Tsu-Yi Chuang, Karla S. Draft, Loren E. Golitz, Ernest Wu, Aaron S. Katz, John C. Maize, Todd Knapp, Barry Leshin
Journal: Journal of the American Academy of Dermatology (2001)
The simplified version of Boyle's Law leads to errors in the measurement of thoracic gas volume.
Authors: A L Coates, K J Desmond, D L Demizio
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

When using Boyle's Law for thoracic gas volume (Vtg) measurement, it is generally assumed that the alveolar pressure (Palv) does not differ from barometric pressure (Pbar) at the start of rarefaction and compression and that the product of the change in volume and pressure (delta P x delta V) is negligibly small. In a gentle panting maneuver in which the difference between Palv and Pbar is small, errors introduced by these assumptions are likely to be small; however, this is not the case when Vtg is measured using a single vigorous inspiratory effort. Discrepancies in the Vtg between the "complex" version of Boyle's Law, which does not ignore delta P x delta V and accounts for large swings in Palv, and the "simplified" version, during both a panting maneuver and a single inspiratory effort were calculated for normal control subjects and patients with cystic fibrosis or asthma. Defining the Vtg from the complete version as "correct," the errors introduced by the simplified version ranged from -3 to +3% for the panting maneuver whereas they ranged from 2 to 9% for the inspiratory maneuver. Using the simplified equation, the Vtg for the inspiratory maneuver was 0.135 +/- 0.237 L greater (p < 0.02) than for the panting maneuver. This discrepancy disappeared when the complete equation was used. While the errors introduced by the use of the simplified version of Boyle's Law are small, they are systematic and unnecessary.
Congenital dislocation of the hip.
Authors: R. Owen
Journal: BMJ (1968)

BmJoum "depression" is as precise as the diagnosis and therapy of " anaemia " without further analysis.'I recently listened to a lecture for general practitioners on depression by a consultant psychiatrist, in which nearly every psychiatric complaint or condition other than schizo- phrenia, mania, and sociopathy was accused of being "depression."Does anyone else share my misgivings about the near-total victory of " depression " over psychiatry ?I am, etc.,
Thank You, United States of America
Authors: Oluwole G. Ajao
Journal: JAMA (1975)

<h3>To the Editor.—</h3> Permit me to thank the United States of America for what she has done for me. On Jan 7, 1967-the middle of winter in the United States—a lonely figure in summer jacket arrived at O'Hare Airport, Chicago, after about a 16-hour flight from hot and humid Nigeria. The lonely figure was in the United States for a rotating internship, to be followed by a residency program in surgery. That lonely figure was I. After about eight years in the United States and passing through about three hospitals, I finally completed my surgical residency at St Mary's Hospital, Rochester, NY. After this, I had a 1 1/2-year fellowship for renal transplantation and hemodialysis at Bellevue and New York University Hospitals. During the course of my residency program, I obtained my Canadian Board certification (FRCS). I have just recently passed part 1 of the American Board examination. My wife,
Demonstrating Alcoholic Cirrhosis of the Liver by Tc-99m BIDA Scintigram
Authors: WEI-JEN SHIH, FRANK H. DeLAND, PEGGY A. DOMSTAD
Journal: Clinical Nuclear Medicine (1984)

Six patients with decompensated cirrhosis of the liver underwent Tc-99m BIDA studies. All demonstrated 1) persistently high blood pool activity in the heart, lung, and soft tissue, 2) slow hepatic tracer uptake, 3) prolonged liver-to-bowel transit time, and 4) visualization of an enlarged spleen. Four of the six patients demonstrated evidence of ascites and in one patient there were visible collateral veins of the abdomen. These findings are due primarily to hepatic dysfunction and retaining Tc-99m BIDA in blood pool because of Tc-99m BIDA exclusively hepatic excretion and little or no alternative renal excretion. All six Tc-99m sulfur colloid studies were performed concomitantly. Except for bone marrow uptake and reversal of the normal liver-spleen ratio of radioactivity, the imaging abnormalities observed with Tc-99m BIDA were similar to those seen by Tc-99m SC. It is concluded that with Tc-99m BIDA studies, three of six abnormal findings, as described, suggest a decompensated stage of cirrhosis of the liver.
Certification and Recertification: One Approach to Professional Accountability
Authors: John A. Benson
Journal: Annals of Internal Medicine (1991)

Professional accountability requires a self-regulating profession to set and maintain credible, useful standards for its members. Voluntary certification and recertification--evaluation by peers--serves the responsibility of the profession to establish and enforce its own standards. The goal of certification by the American Board of Internal Medicine is to improve the quality of medical care by ensuring that the certified internist and subspecialist possess the knowledge, skills, and attitudes essential to the provision of excellent care. Without a true constituency and with a valid certification process, the Board provides a credential sought by nearly every graduate resident and acceptable both to the profession and patients. Recertification now presents the opportunity to foster continuing scholarship and self-improvement throughout the career of an internist.
New Disease Prevention Effort Goes by the Book
Authors: Charles Marwick
Journal: JAMA (1994)

"PPIP," says the Department of Health and Human Services (HHS), announcing a new nationwide campaign to "increase the healthy life spans of Americans by making disease prevention a standard part of medical practice." The initials stand for Put Prevention Into Practice, and the department's chief medical officer, Philip R. Lee, MD, assistant secretary for health, describes the effort as "nothing less than reforming medical care and extending healthy life by shifting primary care practices toward prevention." The HHS is issuing a 400-page textbook entitled<i>Clinician's Handbook of Preventive Services</i>, intended for primary care providers including nurse practitioners, physicians' assistants, pediatricians, internists, and family physicians. The book is in two parts, one dealing with children and adolescents and the other with adults. Each part has three sections: screening, immunizations and prophylaxis, and counseling. An introductory overview contains a handy preventive care timeline chart that indicates how frequently tests or examinations should
Dengue Fever in Penang
Authors: F. M. T. Skae
Journal: BMJ (1902)

two colonies of B. coli on one of the slope agar tubes, no other organism was found.Pericardiunm.-There were evidences of a slight plastic pericarditis, a few flakes of fibrin being adherent to the heart muscle.This condition was not diagnosed during life, and it was entirely owing to the restric- tions placed on the necropsy by the parents that none of the fi aid could be properly collected and examined.It is, however, quite permissible to reason that in all probability the condition was pneumonic in origin.Heart.-The right cavity was in a state of slight dilatation, and other- wise the whole organ was perfectly healthy.The valves were absolutely sound, and there was no evidence whatever of any existent endocarditis; and it is, further, a significant fact that no infarcts of any kind were met with in any of the internal organs examined.Elbow-joint.-Nosign of inflammation, swelling, or other abnormality was visible.However, I aspirated the joint with a sterile needle, and withdrew a few drops of practically clear fluid containing a small number of floating flocculi.Coverslips made direct from the fluid presented a few capsulated Gram-staining hastate cocci, but cultures both in blood broth and on blood agar remained sterile.I have, however, no doubt in my mind that the organisms were no other than genuine pneumococci.Middle Ear.-During the child's stay in the hospital no discharge or ear trouble ever manifeited itself.At the necropsy.however I introduced in the middle ear on each side a sterile pipette, but entirely failed to withdrawn even one drop of fluid.
Changes in the localization of the rat canalicular conjugate export pump mrp2 in phalloidin-induced cholestasis
Authors: Daniel Rost, Jürgen Kartenbeck, Dietrich Keppler
Journal: Hepatology (1999)

Administration of phalloidin, one of the toxic peptides of the mushroom Amanita phalloides , leads to rapid and sustained cholestasis in rats. Although attributed to the interaction of phalloidin with microfilaments, the events leading to cholestasis are incompletely understood. The adenosine triphosphate (ATP)–dependent, apical conjugate export pump, termed multidrug resistance protein 2 (Mrp2) or canalicular multispecific organic anion transporter, is the major driving force for bile salt–independent bile flow. We investigated the role of Mrp2 in phalloidin–induced cholestasis. Bile flow decreased to 53% and 31% of control at 15 and 30 minutes after phalloidin (0.5 mg/kg), respectively. Mrp2–mediated [ 3 H]leukotriene excretion into bile during the initial 45 minutes was reduced to 44% of control when [ 3 H]LTC 4 was injected 15 minutes after phalloidin treatment. Mrp2 was progressively lost from the hepatocyte canalicular membrane and detected predominantly on intracellular membrane structures together with other canalicular proteins including P–glycoproteins, ecto–ATPase, and dipeptidyl–peptidase IV. By contrast, structures involved in intercellular adhesion (zonula occludens, zonula adhaerens, and desmosomes) as well as intermediate filaments of the cytokeratin type appeared largely unaffected within 30 minutes after phalloidin. In line with the immunofluorescence analysis, immunoblots indicated a loss of Mrp2 and P–glycoproteins from the canalicular membrane and a 3– and 4.6–fold increase of these transport proteins in the microsomal fraction, respectively. Our results indicate that phalloidin induces marked alterations of the hepatocyte canalicular architecture and a loss of Mrp2 together with other proteins from the canalicular membrane. The resulting cholestasis can therefore be explained in part by the loss of export pumps, including Mrp2, from the canalicular membrane.
Slit/Robo Signaling Modulates the Proliferation of Central Nervous System Progenitors
Authors: Víctor Borrell, Adrián Cárdenas, Gabriele Ciceri, Joan Galcerán, Nuria Flames, Ramón Pla, Sandrina Nóbrega-Pereira, Cristina García-Frigola, Sandra Peregrín, Zhen Zhao, Le Ma, Marc Tessier-Lavigne, Oscar Marín
Journal: Neuron (2012)
UK government spells out new plan for NHS in England
Authors: N. Hawkes
Journal: BMJ (2011)

GP commissioning consortiums in England will be obliged to include two lay members, a hospital specialist, and a nurse on their boards, the government has announced. Their name will be changed from GP or GP led consortiums to “clinical commissioning groups,” and they will be required to meet in public and publish their minutes.

To avoid conflicts of interest the nurse and specialist cannot be employed by local NHS providers, the government says in its response to the report of the Future Forum, the body it set up to elicit responses to its Health and Social Care Bill in the wake of charges that the bill would destroy the NHS.

While in most respects the government has accepted the forum’s recommendations, in this instance it has gone further by insisting on board level representation of the other medical specialties.

The forum, chaired by Steve Field, former chairman of the Royal College of General Practitioners, produced a series of recommendations that the government has accepted. These include changes to the role of Monitor, which was charged under the bill with promoting competition. This duty will be removed, and Monitor’s role will be restricted to …
The Joint Commission's View of Externship Programs
Authors: John D. Porterfield
Journal: JAMA (1970)

At its Dec 13, 1969, meeting, the Board of Commissioners of the Joint Commission on Accreditation of Hospitals went on record as approving of the standards developed by the Student American Medical Association in its education externship program for junior and senior medical students from foreign medical schools who work in US hospitals. In a policy statement that came out of the December meeting, the Board of Commissioners stated that accredited hospitals participating in this SAMA program, and adhering to these published standards, would not thereby jeopardize their accreditation status. Although the Joint Commission is comfortable with the SAMA program for foreign student externships, it is concerned by the fact that there is no comparable program for students in US medical schools. Since no program does exist, the Joint Commission must depend, for accreditation purposes, on the endorsement of externship programs by deans of medical schools, and in doing so
SERUM PROTEINS IN SKIN DISEASE.
Authors: A. TICKNER, M. G. P. McCABE, P. D. MIER
Journal: British Journal of Dermatology (1959)

Journal Article SERUM PROTEINS IN SKIN DISEASE. Get access A. TICKNER, A. TICKNER The Institute of Dermatology, Homerton Grove, London, E.9 Search for other works by this author on: Oxford Academic Google Scholar M. G. P. McCABE, M. G. P. McCABE The Institute of Dermatology, Homerton Grove, London, E.9 Search for other works by this author on: Oxford Academic Google Scholar P. D. MIER P. D. MIER The Institute of Dermatology, Homerton Grove, London, E.9 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 71, Issue 10, 1 October 1959, Pages 351–359, https://doi.org/10.1111/j.1365-2133.1959.tb13362.x Published: 01 October 1959
Diurnal variation of lymphocyte subsets identified by monoclonal antibodies.
Authors: J V Bertouch, P J Roberts-Thomson, J Bradley
Journal: BMJ (1983)

Monoclonal antibodies specific for lymphocyte subsets were used to examine circulating lymphocytes obtained at frequent intervals from healthy subjects. A diurnal rhythm was found in the total numbers of lymphocytes, T cells, inducer/helper cells, suppressor/cytotoxic cells, Ia positive cells, and B cells. The lowest levels of all subsets were seen at 0900 hours and the highest levels at 2100. In some subjects the ratio of helper to suppressor cells varied considerably during the sample period, though the ratio was relatively constant for the group as a whole.
Comparison of the Prognosis of Spontaneous and Percutaneous Coronary Intervention–Related Myocardial Infarction
Authors: Sergio Leonardi, Laine Thomas, Megan L. Neely, Pierluigi Tricoci, Renato D. Lopes, Harvey D. White, Paul W. Armstrong, Robert P. Giugliano, Elliott M. Antman, Robert M. Califf, L. Kristin Newby, Kenneth W. Mahaffey
Journal: Journal of the American College of Cardiology (2012)
Differential Regulation of Endothelial Cell Permeability by cGMP via Phosphodiesterases 2 and 3
Authors: James Surapisitchat, Kye-Im Jeon, Chen Yan, Joseph A. Beavo
Journal: Circulation Research (2007)

Endothelial barrier dysfunction leading to increased permeability and vascular leakage is an underlying cause of several pathological conditions, including edema and sepsis. Whereas cAMP has been shown to decrease endothelial permeability, the role of cGMP is controversial. Endothelial cells express cGMP-inhibited phosphodiesterase (PDE)3A and cGMP-stimulated PDE2A. Thus we hypothesized that the effect of cGMP on endothelial permeability is dependent on the concentration of cGMP present and on the relative expression levels of PDE2A and PDE3A. When cAMP synthesis was slightly elevated with a submaximal concentration of 7-deacetyl-7-( O -[ N -methylpiperazino]-γ-butyryl)-dihydrochloride–forskolin (MPB–forskolin), we found that low doses of either atrial natriuretic peptide (ANP) or NO donors potentiated the inhibitory effects of MPB–forskolin on thrombin-induced permeability. However, this inhibitory effect of forskolin was reversed at higher doses of ANP or NO. These data suggest that cGMP at lower concentrations inhibits PDE3A and thereby increases a local pool of cAMP, whereas higher concentrations cGMP activates PDE2A, reversing the effect. Inhibitors of PDE3A mimicked the effect of low-dose ANP on thrombin-induced permeability, and inhibition of PDE2A reversed the stimulation of permeability seen with higher doses of ANP. Finally, increasing PDE2A expression with tumor necrosis factor-α reversed the inhibition of permeability caused by low doses of ANP. As predicted, the effect of tumor necrosis factor-α on permeability was reversed by a PDE2A inhibitor. These findings suggest that the effect of increasing concentrations of cGMP on endothelial permeability is biphasic, which, in large part, is attributable to the relative amounts of PDE2A and PDE3A in endothelial cells.