tbuckley/cabot-search huggingface dataset:
Glycated haemoglobin and metabolic control of diabetes mellitus: external versus locally established clinical targets for primary care
Authors: C. Butler, J. Peters, N. Stott
Journal: BMJ (1995)

To examine current targets for glycated haemoglobin as a marker for metabolic control in diabetes mellitus in relation to datasets from several areas, and to consider whether target setting could be improved.Data collected from enhanced care records of general practices for a representative community based sample of people with diabetes.3022 people with diabetes on the lists of 37 general practices (total list size 222,550) in South Glamorgan in 1992; samples of glycated haemoglobin had been processed at two laboratories with different methodologies and reference ranges.Last glycated haemoglobin level measured in subjects for 1992 and published data from other studies considered in relation to existing goals and standards for the metabolic control of diabetes.An ascertainment rate for people with diabetes of 1.36% was obtained. The rate of data capture for haemoglobin A1 was 75.7%, and the mean level for study samples was 10.5% at one laboratory and 10.0% at the other (similar values to those of comparable studies). These mean levels of haemoglobin A1 in representative populations of people with diabetes are poor or very poor according to published standards, including those of the British Diabetic Association. These findings are set in the context of the psychology of goal setting and performance in complex clinical situations.Targets for clinical care that are set in the absence of normative data and local feasibility assessments should be treated with caution. Targets are more likely to enhance health care if target setters recognise the importance of psychological aspects of goal setting and motivation.
Enalapril and metoprolol in diabetic nephropathy
Authors: K J Hardy
Journal: BMJ (1990)

in animals has shown that allogeneic bone marrow transplantation can alter the course of immune mediated disorders such as lupus nephritis and diabetes mellitus.'It is interesting to speculate that allogeneic bone marrow transplantation may have a therapeutic role in the management of serious intractable autoimmune disorders.
EFFECT OF RANDOMIZED LIPID LOWERING WITH SIMVASTATIN AND EZETIMIBE ON CATARACT DEVELOPMENT: THE SEAS STUDY
Authors: Casper N. Bang, Anders Greve, Morten La Cour, Kurt Boman, Christa Gohlke-Baerwolf, Simon Ray, Terje Pedersen, Anne Rossebø, Peter Okin, Richard Devereux, Kristian Wachtell
Journal: Journal of the American College of Cardiology (2014)
Different Approaches to Influenza Vaccination
Authors: Keiji Fukuda, Marie Paule Kieny
Journal: New England Journal of Medicine (2006)

In this issue of the Journal, two important and timely studies address basic questions related to the use and performance of influenza vaccines.1,2 The findings are also informative because both studies were conducted in the 2004–2005 influenza season when the influenza A (H3N2) components in both the inactivated and the live attenuated influenza vaccines were not optimally matched to the circulating strains. In one of the studies, King et al. investigated whether the vaccination of children 5 years of age or older with a live attenuated influenza vaccine reduced the spread of influenza to households and the community through . . .
MRFIT After 10.5 Years-Reply
Authors: Marcus Kjelsberg
Journal: JAMA (1990)

<h3>In Reply.—</h3> The conclusions referred to by Dr Rosborough et al are that, after 10.5 years of follow-up, mortality rates were lower for MRFIT men who received special intervention than for men who received their usual care by 10.6% for coronary heart disease and 7.7% for all causes, and that these reductions were primarily due to a 24% lower death rate from acute myocardial infarction for men in the special intervention group than for those receiving usual care. Also, for the large subgroup, those free of abnormalities at baseline in electrocardiograms taken with the patient resting, men in the special intervention group had mortality rates 21% lower for coronary heart disease and 16% lower for all causes. The issues raised about<i>P</i>values are important, but such numbers should not be the sole basis for interpretation of the results and support for the study hypotheses. Dr Rosborough et al
Genome-Wide Evolutionary Conservation of N-Glycosylation Sites
Authors: C. Park, J. Zhang
Journal: Molecular Biology and Evolution (2011)

Although posttranslational protein modifications are generally thought to perform important cellular functions, recent studies showed that a large fraction of phosphorylation sites are not evolutionarily conserved. Whether the same is true for other protein modifications, such as N-glycosylation is an open question. N-glycosylation is a form of cotranslational and posttranslational modification that occurs by enzymatic addition of a polysaccharide, or glycan, to an asparagine (N) residue of a protein. Examining a large set of experimentally determined mouse N-glycosylation sites, we find that the evolutionary rate of glycosylated asparagines is significantly lower than that of nonglycosylated asparagines of the same proteins. We further confirm that the conservation of glycosylated asparagines is accompanied by the conservation of the canonical motif sequence for glycosylation, suggesting that the above substitution rate difference is related to glycosylation. Interestingly, when solvent accessibility is considered, the substitution rate disparity between glycosylated and nonglycosylated asparagines is highly significant at solvent accessible sites but not at solvent inaccessible sites. Thus, although the solvent inaccessible glycosylation sites were experimentally identified, they are unlikely to be genuine or physiologically important. For solvent accessible asparagines, our analysis reveals a widespread and strong functional constraint on glycosylation, unlike what has been observed for phosphorylation sites in most studies, including our own analysis. Because the majority of N-glycosylation occurs at solvent accessible sites, our results show an overall functional importance for N-glycosylation.
625 RISK FACTORS FOR HEPATOTOXICITY OF ARV IN HIV/HCV CO-INFECTED PATIENTS WITH A 6 YEARS FOLLOW-UP AFTER A COMPLETION OF A FULL COURSE ANTI-HCV TREATMENT
Authors: E. Krastinova, F. Bani-Sadr, S. Pol, P. Cacoub, E. Rosenthal, C. Perronne, F. Carrat
Journal: Journal of Hepatology (2009)
Cooperative effect of adenosine deaminase and ABO-secretor genetic complex on susceptibility to childhood asthma
Authors: N. Bottini, F. Ronchetti, F. Gloria-Bottini
Journal: European Respiratory Journal (2002)

To the Editor: 

In a cohort of asthmatic children, we have recently shown that the ABO-secretor genetic complex influences susceptibility to asthma in children 1.

Since previous studies have shown an association of asthma with adenosine deaminase (ADA) genotype 2, we have searched for possible interactions between the two systems concerning their effects on susceptibility to asthma in children.

The sample study has been described in a previous paper 1 and was composed of 165 children, 109 males and 56 females, aged from 1 month–15 yrs. The criterion for inclusion in the study was the occurrence of two or more episodes of wheezing in the last 6 months, irrespective of aetiology/pathogenesis of the attack.

A consecutive series of 362 newborn infants from the same Caucasian population in Rome, Italy, was used as the control sample.

ADA phenotype was determined by starch gel electrophoresis according to the method of Spencer et al. 3. ABO and secretor phenotypes were determined according to a standard laboratory procedure 1.

Table 1⇓ shows the distribution of secretor-ABO-ADA …
Cyclooxygenase blockade elevates leukotriene E4 production during acute anaphylaxis in sheep.
Authors: D R Robinson, M Skoskiewicz, K J Bloch, G Castorena, E Hayes, E Lowenstein, C Melvin, F Michelassi, W M Zapol
Journal: The Journal of Experimental Medicine (1986)

We examined changes in the levels of eicosanoids in blood and pulmonary lymph of anesthetized sheep undergoing acute anaphylaxis. Within 1-3 min of intravenous antigenic challenge of previously sensitized sheep, there were approximately 7-30-fold elevations in mean arterial plasma levels of thromboxane B2 and 6-ketoprostaglandin F1 alpha, respectively, as measured by RIA. Negligible changes in levels of these cyclooxygenase products were found in both nonsensitized sheep and in sensitized sheep treated with indomethacin before antigenic challenge. In contrast, no changes in levels of sulfidopeptide leukotrienes (SPLT) in pulmonary lymph were detectable by RIA during anaphylaxis in sensitized or nonsensitized sheep, but levels of SPLT in indomethacin-treated sensitized sheep increased more than fivefold above levels in lymph from both other groups of animals. The immunoreactive SPLT in lymph from indomethacin-treated sheep was accounted for as LTE4, as demonstrated by mobility on HPLC and absorbance at 280 nm. These results support the possibility that certain undesirable effects of nonsteroidal antiinflammatory drugs, such as cardiopulmonary reactions in aspirin-sensitive individuals, and impaired renal and cardiac function during therapy with these drugs, may be related in part to augmented synthesis of the 5-lipoxygenase pathway products, especially those of the sulfidopeptide class. Increased LT production could also limit the antiinflammatory effectiveness of these drugs in many disease states.
ANALGESIA FROM SPINAL SUBARACHNOIDEAN COCAINIZATION.
Authors: JOHN B. MURPHY
Journal: JAMA (1901)

Since the anouncement of the first death from chloroform anesthesia the medical profession has been constantly looking for an anesthetic that might be administered without danger. Ether then was reinstated and heralded as a drug without danger, when given as an anesthetic. Shortly after its adoption several deaths occurred which were attributed to its use, and the mortality has been constantly increasing, especially within the last five years. The combination of ether, alcohol and chloroform was submitted to the profession as a substitute for the individual drugs and the claim made that the danger would be less. The various mixtures, however, have met the same fate as the separate ingredients. Nitrous oxid, the oldest of the general anesthetics, was again advanced, as was also ethyl bromid, but both were found impracticable, except for very short operations. Each of the anesthetics mentioned above has its special field wherein it may be
Pseudo–Myocardial Infarction
Authors: Szu-Chun Hung, Chern-En Chiang, Jen-Dar Chen, Philip Yu-An Ding
Journal: Circulation (2000)

A 41-year-old man was admitted to the hospital because of severe lower sternal pain with diaphoresis for 1 hour.He had no history of peptic ulcer disease and denied smoking, alcohol abuse, and use of illicit drugs.An ECG (Figure 1) revealed ST-segment elevation of 2 mm and peaked upright T waves in leads V 1 through V 3 , with reciprocal changes in lead II and inverted T waves in V 4 through V 6 .Particular noteworthy were the bizarre T waves observed in the limb leads.Cardiac enzymes, liver function tests, and serum electrolytes, amylase, and lipase were within normal limits.A diagnosis of acute myocardial infarction was suspected.Thrombolytic therapy was considered but was rejected by the patient.Intravenous nitroglycerin, heparin, and ␤-blocker were administered but did not ameliorate his symptoms.An echocardiogram showed no wall motion abnormalities.Serial cardiac enzymes were normal.A contrast-enhanced CT scan (Figure 2) and MRI (Figure 3) of the abdomen 1 day after
845-6 Anatomical observations of the left atrium and pulmonary veins by multislice computed tomography in patients with atrial fibrillation
Authors: Monique R.m Jongbloed, Jeroen J Bax, Martijn S Dirksen, Ernst E van der Wall, Albert de Roos, Martin J Schalij
Journal: Journal of the American College of Cardiology (2004)
Study of Genetic Prediabetic South Indian Subjects: Importance of hyperinsulinemia and β-cell dysfunction
Authors: C Snehalatha, A Ramachandran, K Satyavani, E Latha, Vijay Viswanathan
Journal: Diabetes Care (1998)

OBJECTIVE To study 1) whether abdominal adiposity was present in adult offspring of two NIDDM parents, 2) whether abdominal adiposity was associated with the development of glucose intolerance, and 3) the association of pancreatic β-cell function with impaired glucose tolerance (IGT) and NIDDM in these groups. RESEARCH DESIGN AND METHODS One hundred offspring whose parents both had NIDDM were studied (60 men, 40 women, mean age 34 ± 6.9 years, BMI 27.4 ± 4.1 kg/m2). None had a history of glucose intolerance. Nondiabetic control subjects with no family history of diabetes were also studied for comparison (21 men, 19 women, age 36 ± 10.3 years, BMI 26 ± 3.7 kg/m2). A standard oral glucose tolerance test was done for all, and plasma glucose, C-peptide, and insulin responses were measured. Abdominal fat measurements at L4-L5 were made using a computed axial tomography scan. Subcutaneous fat (SF), visceral fat (VF), and total fat (TF) areas were measured and VF/SF ratio was calculated. An index of insulin secretion (Δ I/G) was derived as the ratio of incremental insulin at 30 min divided by 30-min plasma glucose. RESULTS IGT was detected in 32 offspring and diabetes in 21 offspring. Diabetic men had a higher TF area than the other groups. SF, VF, and VF/SF ratios were similar in control men and in offspring with normal glucose tolerance (NGT), IGT, or diabetes. Among control subjects, women had significantly lower VF than men. Female offspring had higher VF than the control subjects, but intragroup variations were absent. Fasting insulin and all C-peptide responses were higher in NGT compared with control subjects (P &amp;lt; 0.02). The 2-h insulin and C-peptide responses were higher in IGT subjects (P &amp;lt; 0.005). In diabetic subjects, the insulin-to-glucose ratio, C-peptide-to-glucose ratio, and Δ I/G were significantly low compared with all other groups (P &amp;lt; 0.005). Multiple logistic regression analysis showed that the area of insulin response had a positive association and Δ I/G had a negative association with diabetes, while age, sex, BMI, waist-to-hip ratio, abdominal fat areas, fasting and 2-h insulin, area of insulin, and the C-peptide measurements did not show independent associations. Two-hour insulin showed a positive association with IGT, while increasing area of insulin showed a negative association. CONCLUSIONS Visceral adiposity seemed to precede glucose intolerance only in women, but it had no independent association with IGT or NIDDM. Insulin resistance, indicated by higher plasma insulin response, and insulin secretory defect, indicated by low Δ I/G at 30 min, were associated with diabetes. β-cell defect was not independently associated with IGT. Increased abdominal visceral adiposity does not appear to be a prerequisite for development of IGT or diabetes in Asian Indians with a strong genetic predisposition for diabetes.
Emerging Robotic Platforms for Minimally Invasive Surgery
Authors: V. Vitiello, None Su-Lin Lee, T. P. Cundy, None Guang-Zhong Yang
Journal: IEEE Reviews in Biomedical Engineering (2012)

Recent technological advances in surgery have resulted in the development of a range of new techniques that have reduced patient trauma, shortened hospitalization, and improved diagnostic accuracy and therapeutic outcome. Despite the many appreciated benefits of minimally invasive surgery (MIS) compared to traditional approaches, there are still significant drawbacks associated with conventional MIS including poor instrument control and ergonomics caused by rigid instrumentation and its associated fulcrum effect. The use of robot assistance has helped to realize the full potential of MIS with improved consistency, safety and accuracy. The development of articulated, precision tools to enhance the surgeon's dexterity has evolved in parallel with advances in imaging and human-robot interaction. This has improved hand-eye coordination and manual precision down to micron scales, with the capability of navigating through complex anatomical pathways. In this review paper, clinical requirements and technical challenges related to the design of robotic platforms for flexible access surgery are discussed. Allied technical approaches and engineering challenges related to instrument design, intraoperative guidance, and intelligent human-robot interaction are reviewed. We also highlight emerging designs and research opportunities in the field by assessing the current limitations and open technical challenges for the wider clinical uptake of robotic platforms in MIS.
Identifying medical students at risk of subsequent misconduct
Authors: A. Reid
Journal: BMJ (2010)

Fitness to practise should be determined by both academic and non-academic ability

Most medical practitioners never cross the path of their professional regulatory body, but in every jurisdiction a small number exhibit serious deficiencies in their professional performance or conduct. As well as exposing their patients to risk or in some cases causing serious harm, they generate a substantial workload and considerable expense for regulatory bodies. These valuable resources could be better used in raising general standards of medical practice and supporting diligent members of the profession. In the linked case-control study (doi:10.1136/bmj.c2040), Yates and James look for factors in a doctor’s medical school career that are associated with subsequent professional misconduct.1 

In medical regulation, as in medical practice, prevention is better than cure. Since the 1990s, progressive regulatory bodies have introduced early intervention and remediation based systems for managing poorly performing practitioners as a supplement to their disciplinary processes. However, these regulatory systems apply only to practitioners who are already medically registered.

The years that medical students spend at university provide a valuable opportunity to …
A cutaneous B-cell lymphoma of novel immunophenotype
Authors: S. C. MAYOU, F. E. COTTER, A. J. NORTON, C. L. DAVIES, D. D. MUNRO
Journal: British Journal of Dermatology (1991)

Summary A case of low-grade B-cell malignant lymphoma with a prolonged restriction to the skin is described. A rearrangement of the immunoglobulin heavy-chain gene was detected using molecular techniques. The histology showed many similarities to primary mucosal lymphomas and this may represent a skin counterpart of these tumours.
Activation of the hypertrophic right ventricle in the dog
Authors: G. E. FREUD, M. C. STERN, H. WATSON, D. DURRER
Journal: Cardiovascular Research (1975)

Right ventricular hypertrophy (RVH) of mild, moderate, or severe degree was produced in six dogs following systolic overload of the right ventricle by surgical banding of the pulmonary trunk. Activation of the myocardium and specialized conducting tissue of the right ventricle was studied using intramural multi-electrodes or an exploring electrode, first with the heart in situ and then with the heart in a modified Langendorff perfusion circuit. Normal epicardial and intramural activation patterns were found in RVH, and the prolonged excitation time was found to be due to the increased muscle mass. No delay in activation was found in any part of the specialized conducting tissue of the right ventricle. Late activated Purkinje fibres were found in the outflow tract of the right ventricle in the dogs with hypertrophy and in a control series of normal dogs. The present electrocardiographic criteria for complete and incomplete right bundle branch block (RBBB) are based on widening of the QRS complex and the rSR pattern. This type of change can occur also in RVH. Because it has been shown here that no delay occurs in the specialized conducting system of the right ventricle in RVH secondary to systolic loading; the application of criteria to electrocardiograms that also fulfil the criteria for RVH may be misleading. It is suggested that in such cases the diagnosis of a conduction disturbance must also depend upon other methods, and that the terms "incomplete' and "complete' RBBB should be handled with care in this context.
History of books and journals and periodicals in rheumatology.
Authors: E G Bywaters
Journal: Annals of the Rheumatic Diseases (1991)

Rheum' comes from the Greek-a 'watery dis- charge' (OED)-and rheumatological literature as we scan it today has had two main historical sources for its now ever faster running river of words: (a) the spa waters and hydrology from the Middle Ages onward, beautifully illustrated in mediaeval woodcuts, and (b) the more modern mainstream of general medicine itself, even more widely and more strongly flowing and with a lot of very fertile silt, which today has almost blocked its older tributary, except perhaps in middle Europe.There, those ancient waterways and spas still flourish, discharging their rheum with state support and the modern gloss of physical medicine, benefiting both doctors and also, perhaps, patients.
The Electrocardiogram in Some Indian Population Groups
Authors: S. G. SRIKANTIA, S. PADMAVATI, C. GOPALAN
Journal: Circulation (1964)

Of 941 subjects studied, there were 16 cases of myocardial infarction of which one was a silent infarct. Of these, nine were in the low-income group and seven in the high-income group. All the cases were among the civilian population. About 11 of the subjects had high voltage in the chest leads without any evidence of hypertension or other heart disease. These were equally distributed at all ages in the different income groups, civil and military. There was no significant difference in the incidence of ST-segment depression in the various groups. On the other hand, T-wave changes in standard leads, I, II and left chest leads was higher in the high-income groups at all ages than in the low-income groups and the increase was significant after the age of 50 years. ST and T-wave changes following exercise were slightly higher in the high-income groups than in the low-income groups among the civilian subjects. The incidence of Grusin's abnormality was higher in the low-income group, both civil and military, than in the high-income groups. The incidence of ischemic heart disease (and of electrocardiographic abnormalities generally) was very low in this study as compared to studies elsewhere.