tbuckley/cabot-search huggingface dataset:
Matching the needs with skills in epilepsy care
Authors: L. Ridsdale
Journal: BMJ (1995)

Like most common chronic conditions epilepsy is managed at the interface between primary and secondary care. In 1990 the cost to the health service for each person with epilepsy was pounds sterling600 in the year in which the diagnosis was made, this figure falling to less than pounds sterling200 in subsequent years, when seizures are well controlled.1 The cost of social services was five to 10 times higher, depending on the frequency of seizures. Better care and fewer seizures might therefore lead to a net gain for both patients and society. Most of that improvement needs to be made in the social aspects of care.

People who experience one or more seizures take different pathways through the medical care system. Most initially see their general practitioner, who will, if epilepsy seems probable, refer them to a specialist. For their first appointment patients will probably be allocated three quarters of an hour. The specialist may confirm the diagnosis at the end of this or at a …
The role of liver biopsy in chronic hepatitis C
Authors: Jules L. Dienstag
Journal: Hepatology (2002)

The report of the 1997 National Institutes of Health Consensus Development Conference on hepatitis C endorsed pretreatment liver biopsy. We revisit the following questions: Does liver histology help determine the urgency of, and predict the likelihood of response to, antiviral therapy, and can surrogate markers supplant histological assessment? Because the rate of progression of chronic hepatitis C is influenced by baseline histological grade/stage, patients can be stratified into those with moderate to severe hepatitis, who merit imminent therapy, and those with mild hepatitis, in whom therapy can be postponed until more effective/tolerable treatments become available. Less advanced baseline histology has been shown to be an independent predictor of responsiveness to antiviral therapy. Although the predictive value of biopsy is insufficient to withhold therapy from patients with advanced fibrosis, baseline biopsy helps gauge expectations for the outcome of therapy. Reports have been published recently suggesting that laboratory markers can predict distinctions between low-grade fibrosis and therapy-indicating septal fibrosis/cirrhosis. These indices, however, are insufficiently reliable to predict histological distinctions in populations with varying prevalences of fibrosis/cirrhosis or to provide anything more than broad qualitative distinctions, far short of the potential information in a liver biopsy. For most patients, the value of pretreatment liver biopsy outweighs its risks, provides information about the urgency of treatment, and should be retained. Studies to identify noninvasive laboratory markers of histological activity and stage, especially genetic predictors of accelerated disease progression, command a high priority. (Hepatology 2002;36:S152-S160).
Two cytosolic components of the human neutrophil respiratory burst oxidase translocate to the plasma membrane during cell activation.
Authors: R A Clark, B D Volpp, K G Leidal, W M Nauseef
Journal: Journal of Clinical Investigation (1990)

The superoxide-forming respiratory burst oxidase of human neutrophils is composed of membrane-associated catalytic components and cytosolic constituents required for oxidase activation. This study concerns the hypothesis that cytosolic oxidase components translocate to a membrane fraction when neutrophils are stimulated and the oxidase is activated. A polyclonal antiserum that recognizes two discrete cytosolic oxidase components of 47 and 67 kD was used to probe transfer blots of electrophoresed membrane and cytosol fractions of resting and stimulated neutrophils. In contrast to their strictly cytosolic localization in unstimulated cells, both proteins were detected in membrane fractions of neutrophils activated by phorbol esters and other stimuli. This translocation event was a function of stimulus concentration as well as time and temperature of exposure to the stimulus. It was inhibited by concentrations of N-ethylmaleimide that blocked superoxide formation but was unaffected by 2-deoxyglucose. There was a correlation between translocation of the cytosolic proteins and activation of the oxidase as determined by superoxide formation. Quantitative analyses suggested that approximately 10% of total cellular p47 and p67 became membrane-associated during phorbol ester activation of the oxidase. Analysis of Percoll density gradient fractions indicated that the target membrane for translocation of both proteins was the plasma membrane rather than membranes of either specific or azurophilic granules. In the cell-free oxidase system arachidonate-dependent but membrane-independent precipitation of the cytosolic oxidase proteins was demonstrated. The data show that activation of the respiratory burst oxidase in stimulated human neutrophils is closely associated with translocation of the 47- and 67-kD cytosolic oxidase components to the plasma membrane. We suggest that this translocation event is important in oxidase activation.
The Initial Stage of Canine Endotoxin Shock as an Expression of Anaphylactic Shock: Studies on Complement Titers and Plasma Histamine Concentrations*
Authors: Wesley W. Spink, Richard B. Davis, Ruth Potter, Sandra Chartrand
Journal: Journal of Clinical Investigation (1964)

Within 30 to 60 seconds after endotoxin is in- jected into adult mongrel dogs there is a decline in systemic blood pressure, a rise in portal vein pressure, a reduction in the venous return of blood to the heart, and a decrease in renal blood flow (1, 2).Endotoxin shock is comparable in many ways to acute anaphylactic shock in the dog (3).Several observations have suggested that an immune mechanism causes the initial vas- cular changes.It was demonstrated that the action of endotoxin on blood vessels was medi- ated through a heat labile factor in plasma or serum (4, 5).Gilbert and Braude (6) in studies on Escherichia coli endotoxin shock in rabbits re- ported that doses of endotoxin greater than the LD50 caused a decline in the titer of complement and a decrease in the serum concentration of E. coli antibody.Spink and Potter (7) also ob- served a prompt decrease in plasma complement values in canine endotoxin shock.The immediate effect of endotoxin on smaller vessels suggested that a vasoactive substance or substances were also implicated.If an immune mechanism were involved, histamine could be one of the substances that was liberated by an antigenantibody mechanism, and studies do point to hista- mine as a factor causing the altered vascular ac- tivity (3, 8-10).This report concerns the study of complement titers, plasma histamine concentrations, and blood pressure changes in a series of dogs given a lethal *
Diurnal Variation in Response to Intravenous Glucose
Authors: M. J. Whichelow, R. A. Sturge, H. Keen, R. J. Jarrett, L. Stimmler, S. Grainger
Journal: BMJ (1974)

Intravenous glucose tolerance tests (25 g) were performed in the morning and afternoon on 13 apparently normal persons. The individual K values (rate of decline of blood sugar) were all higher in the morning tests, and the mean values were significantly higher in the morning. Fasting blood sugar levels were slightly lower in the afternoon. There was no difference between the fasting morning and afternoon plasma insulin levels, but the levels after glucose were lower in the afternoon. Growth hormone levels were low at all times in non-apprehensive subjects and unaffected by glucose. The results suggest that the impaired afternoon intravenous glucose tolerance, like oral glucose tolerance, is associated with impaired insulin release and insulin resistance.
Self-perceived Health Status and Health-Related Quality of Life of Extremely Low-Birth-Weight Infants at Adolescence
Authors: Saroj Saigal
Journal: JAMA (1996)

To estimate and to compare the self-assessed health status and health-related quality of life of extremely low-birth-weight (ELBW) and control infants during adolescence.Prospective, observational study of an inception cohort with a concurrent control group.Geographically defined region in central-west Ontario.We interviewed 141 (83 percent) of 169 ELBW survivors born between 1977 and 1982 and 124 (86 percent) of 145 controls aged between 12 and 16 years. In addition, proxy responses obtained from parents were used for 9 severely impaired teenagers.Assessments of health status (6 attributes), measured with the Health Utilities Index Mark 2 classification system, and health-related quality of life (utilities), quantified with 2 preference measurement techniques, were used to quantify each participants self-reported, subjectively defined health state and 4 preselected hypothetical health states.Adolescents who were ELBW infants reported a higher number of attributes affected, as well as more complex and severe limitations in cognition, sensation, self-care, and pain, compared with controls. Statistically significant differences for the teenagers' health-related quality of life were noted between ELBW and control teenagers in the mean utility scores (0.87 +/- 0.26 vs 0.93 +/- 0.11; P=.02 on a conventional scale where O=dead and 1.00=perfect health). However, a similar percentage of ELBW and control teenagers (71 percent vs 73 percent) gave utility ratings of more than 0.95 for their health status.Direct measures of self-reported health status and utility scores indicated that, as a cohort, adolescents who were ELBW infants suffer from a greater burden of morbidity and rate their health-related quality of life as significantly lower than control teenagers. Nevertheless, the vast majority of ELBW respondents view their health-related quality of life as quite satisfactory and are difficult to distinguish from controls.
Critical role for CX3CR1+ mononuclear phagocytes in intestinal homeostasis
Authors: Giorgio Trinchieri
Journal: The Journal of Experimental Medicine (2014)

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Insight from Giorgio Trinchieri



A key challenge at the intestinal barrier is to minimize responses to commensal bacteria, which can lead to inflammatory bowel disease (IBD) in genetically predisposed individuals, but retain the ability to recognize and control the growth of
Glycemic Index, Glycemic Load, and Glycemic Response Are Not the Same
Authors: Alan W. Barclay, Jennie C. Brand-Miller, Thomas M.S. Wolever
Journal: Diabetes Care (2005)

The paper by Hodge et al. (1) published in the November 2004 issue of Diabetes Care aptly contrasts the potential benefits of moderately high-carbohydrate diets with a low glycemic index (GI) versus diets that have a lower glycemic load (GL) by virtue of a low carbohydrate content. In their prospective analysis of a cohort of ∼36,000 adults followed for 4 years, Hodge et. al found that higher-carbohydrate diets were associated with a lower risk of development of type 2 diabetes. However, the type of carbohydrate was equally important: low-GI carbohydrates reduced the risk, while high-GI carbohydrates increased the risk. Thus, low GI and low GL are not equivalent and produce …
Oral Contraceptives Abolish Luteal Phase Exacerbation of Hyperglycemia in Type I Diabetes
Authors: Alan Sacerdote, Sheldon J Bleicher
Journal: Diabetes Care (1982)

For some time it has been recognized that postovulatory exacerbation of hyperglycemia contributes to the instability of diabetes in many women of reproductive age. It has been suggested that increasing plasma levels of progesterone and estrogen may induce insulin resistance and consequently lead to increased hyperglycemia during the luteal phase of the menstrual cycle. Due to the fact that menstrual cycles in a given woman may vary in length and that it takes patients several days on intermediate or long-acting insulin to achieve a steady state with regard to any dosage adjustment, it is difficult to design an insulin regimen that maintains euglycemia throughout the menstrual cycle in these labile patients. Recognition of this problem led to trying a nonsequential low estrogen contraceptive as adjunctive therapy in a 20-year old woman with insulin dependent diabetes mellitus. The patient consistently suffered an exacerbation of hyperglycemia after ovulation in each cycle, lasting until the onset of menses. On 1 occasion the patient developed frank diabetic ketoacidosis. For the first 2 cycles on Lo Ovral, the hyperglycemia was postponed from the 1st postovulatory day until day 18-19 of the cycle. It was reasoned that the serum estrogen and/or progestin level might be building cumulatively, and the oral contraceptives (OCs) were subsequently withdrawn at day 19 of the cycle rather than day 21. A maximum blood glucose level of 400 mg/dl was attained at day 19 and was treated with additional regular insulin. Levels in excess of 240 mg/dl did not recur during that cycle. The following cycle OC therapy was interrupted at day 18; no blood glucose level in excess of 240 mg/dl occurred that month. Hemoglobin A1c fell from a pre-OC treatment value of 12.4% to the current A1c of 9.7%. A modest increase in blood pressure has occurred, but this is easily managed with a 2 g sodium diet and 25 mg of hydrochlorothiazide daily. On the basis of this experience, a controlled trial is warranted of low dose estrogen nonsequential OCs in lean, nonsmoking, 18-30 year old women with insulin dependent diabetes mellitus with postovulatory hyperglycemia.
Plain cigarette packets could reduce nicotine addiction
Authors: Colin Brewer
Journal: BMJ (2013)

The government has apparently capitulated to big tobacco’s recent advertising campaign about “hard evidence” for enforcing plain cigarette packaging. Although plain packaging may reinforce health warnings, arguably the most important warning—that because of nicotine, cigarette smoking is likely to become a physical addiction as well as a behavioural habit—is still optional in Britain. By downplaying addiction both big tobacco and the government effectively tell vulnerable adolescents that becoming addicted to a drug doesn’t really matter. Only about a fifth of regular smokers smoke 10 a day or fewer. In contrast, hardly …
Editorial Peer Review
Authors: George A. Gellert
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The recent publication in<i>JAMA</i>of papers from the Second International Congress on Peer Review in Biomedical Publication<sup>1</sup>demonstrates quite clearly that the strategy of using periodic conferences to generate research on peer review has been successful. It is interesting to note that since the First International Congress on Peer Review in Biomedical Publication in 1989 not only has there been an increase in the quantity of research on peer review generated (from 50 to 110 abstracts submitted),<sup>1,2</sup>but the complexity of research appearing inThe JOURNALis greater. More manuscripts from the second congress used quantitative methods and less were of a descriptive nature. These observations relate to the future study of biomedical peer review. Is there any loss associated with the gain of a shift to quantification in peer review research? Research on diseases where behavioral factors elevate risk has sought to complement
Second diphtheria booster in adults raises immunity to 92%
Authors: A. Vellinga, P. Van Damme, E. Joosens, M. van der Wielen, H. Goossens
Journal: BMJ (2001)

Medical Council is flawed as he assumes that Worcestershire Health Authority has power in managing its responsibility for a successful public health immunisation campaign. 1It is precisely because the authority is impotent as a public statutory public body that it asked the GMC to intervene.The continuing debate about measles, mumps, and rubella vaccine dents the confidence of many public and professional people, not least because of the assumption that there is no smoke without fire.Majeed's third reference indicates his anxiety despite his initial position statement on the safety of the vaccine.Patients and the media take heed of these different emphases.Maintaining a high level of vaccination cover against diseases that are seen rarely or not at all poses serious difficulties.Majeed's role as an educationalist-a position of power and responsibility-could provide a forum where these difficulties are debated.The role of medical journals and the media should not be ignored in that debate.Their keenness for headlines containing bad news, however misguided or ill informed, while
The Gram Stain
Authors: Arthur M. Fournier
Journal: Annals of Internal Medicine (1998)

On Being a Doctor1 May 1998The Gram StainArthur M. Fournier, MDArthur M. Fournier, MDUniversity of Miami School of Medicine; Miami Beach, FL 33139Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-9-199805010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The intern on my ward team presented her patient succinctly: “A 38-year-old man presents with a 1-week history of fever, pleuritic chest pain, and rust-tinged sputum. Chest x-ray shows a lobar infiltrate.”“Sounds like pneumonia,” I offered. “What did you treat him with?”“Timentin and gentamicin, one dose … He was in the hospital just a few weeks ago … We couldn't be sure what we were treating … . ”“Fever, pleuritic pain, rust-tinged sputum, lobar infiltrate-sounds like strep pneumoniae to me. Penicillin is still a wonder drug against strep pneumoniae, and it's so inexpensive. Why not do a ... Author, Article, and Disclosure InformationAffiliations: University of Miami School of Medicine; Miami Beach, FL 33139Corresponding Author: Arthur M. Fournier, MD, University of Miami School of Medicine, PO Box 016700 (R700), Miami, FL 33101. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByApoptosis-like cell death induced by Salmonella in Acanthamoeba rhysodesUtility of Gram Stain and Sputum Culture in the Management of Community-Acquired PneumoniaWhat is happening to bedside clinical teaching?Antibiotic policies and control of resistance 1 May 1998Volume 128, Issue 9Page: 776KeywordsAlcoholsFeversPenicillinPneumoniaSafetyShouldersSputumStainingThoraxVeins Issue Published: 1 May 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Stimulation of Arteriogenesis in Skeletal Muscle by Microbubble Destruction With Ultrasound
Authors: Ji Song, Ming Qi, Sanjiv Kaul, Richard J. Price
Journal: Circulation (2002)

Background— The application of ultrasound to microbubbles in skeletal muscle creates capillary ruptures. We tested the hypothesis that this bioeffect could be used to stimulate the growth and remodeling of new arterioles via natural repair processes, resulting in an increase in skeletal muscle nutrient blood flow. Methods and Results— Pulsed ultrasound (1 MHz) was applied to exposed rat gracilis muscle after intravenous microbubble injection. Capillary rupturing was visually verified by the presence of red blood cells in the muscle, and animals were allowed to recover. Ultrasound-microbubble–treated and contralateral sham-treated muscles were harvested 3, 7, 14, and 28 days later. Arterioles were assessed by smooth muscle α-actin staining, and skeletal muscle blood flow was measured with 15-μm fluorescent microspheres. An ≈65% increase in arterioles per muscle fiber was noted in treated muscles compared with paired sham-treated control muscles at 7 and 14 days after treatment. This increase in arterioles occurred across all studied diameter ranges at both 7 and 14 days after treatment. Arterioles per muscle fiber in sham-treated and untreated control muscles were comparable, indicating that the surgical intervention itself had no significant effect. Hyperemia nutrient blood flow in treated muscles was increased 57% over that in paired sham-treated control muscles. Conclusions— Capillary rupturing via microbubble destruction with ultrasound enhances arterioles per muscle fiber, arteriole diameters, and maximum nutrient blood flow in skeletal muscle. This method has the potential to become a clinical tool for stimulating blood flow to organs affected by occlusive vascular disease.
The effects of lestaurtinib (CEP701) and PKC412 on primary AML blasts: the induction of cytotoxicity varies with dependence on FLT3 signaling in both FLT3-mutated and wild-type cases
Authors: Steven Knapper, Kenneth I. Mills, Amanda F. Gilkes, Steve J. Austin, Val Walsh, Alan K. Burnett
Journal: Blood (2006)
P3-028: Mutual sensitization with telomerase-specific oncolytic virotherapy and ionizing radiation in cytotoxic activity against human cancer
Authors: Shinji Kuroda, Toshiya Fujiwara, Shunsuke Kagawa, Futoshi Uno, Toru Kojima, Yasuo Urata, Noriaki Tanaka, Toshiyoshi Fujiwara
Journal: Journal of Thoracic Oncology (2007)
Residential Traffic-Related Pollution Exposures and Exhaled Nitric Oxide in the Children’s Health Study
Authors: Sandrah P. Eckel, Kiros Berhane, Muhammad T. Salam, Edward B. Rappaport, William S. Linn, Theresa M. Bastain, Yue Zhang, Frederick Lurmann, Edward L. Avol, Frank D. Gilliland
Journal: Environmental Health Perspectives (2011)

The fractional concentration of nitric oxide in exhaled air (FeNO) potentially detects airway inflammation related to air pollution exposure. Existing studies have not yet provided conclusive evidence on the association of FeNO with traffic-related pollution (TRP).We evaluated the association of FeNO with residential TRP exposure in a large cohort of children.We related FeNO measured on 2,143 children (ages 7-11 years) who participated in the Southern California Children's Health Study (CHS) to five classes of metrics of residential TRP: distances to freeways and major roads; length of all and local roads within circular buffers around the home; traffic densities within buffers; annual average line source dispersion modeled nitrogen oxides (NOx) from freeways and nonfreeway roads; and predicted annual average nitrogen oxide, nitrogen dioxide, and NOx from a model based on intracommunity sampling in the CHS.In children with asthma, length of roads was positively associated with FeNO, with stronger associations in smaller buffers [46.7%; 95% confidence interval (CI), 14.3-88.4], 12.4% (95% CI, -8.8 to 38.4), and 4.1% (95% CI, -14.6 to 26.8) higher FeNO for 100-, 300-, and 1,000-m increases in the length of all roads in 50-, 100-, and 200-m buffers, respectively. Other TRP metrics were not significantly associated with FeNO, even though the study design was powered to detect exposures explaining as little as 0.4% of the variation in natural log-transformed FeNO (R2 = 0.004).Length of road was the only indicator of residential TRP exposure associated with airway inflammation in children with asthma, as measured by FeNO.