tbuckley/cabot-search huggingface dataset:
Acute gout during hypouricaemic therapy: prophylaxis with colchicine.
Authors: P Hollingworth, J A Reardon, J T Scott
Journal: Annals of the Rheumatic Diseases (1980)

Acute gout during hypouricaemic therapy: prophylaxis with colchicine Sir, The efficacy of the uricosuric diuretic agent tienilic acid in the treatment of both gout and hypertension is confirmed in 2 papers.1 2 During our inpatient study 3 of the 4 patients suffered attacks of gout, as is often the case when starting other kinds of hypouricaemic therapy.It is commonly held that the concomitant use of col- chicine prevents such attacks, and accordingly we looked into this in a long-term outpatient study.Twenty patients were given tienilic acid alone and 10 patients were given tienilic acid together with colchicine 1 mg b.d. on a non- selective basis.The patients were followed for between 2 and 12 months, with encouraging results in lowering both the blood pressure and serum uric acid, but owing to reports from elsewhere of hepatotoxicity the study had to be abandoned.Of the patients who received tienilic acid alone 15 suffered 27 attacks of gout within 2 months of starting therapy, whereas none of the 10 patients who received colchicine in addition suffered an attack of gout over the same period.This gives support to the unsubstantiated belief that colchicine prevents the attacks of gout which are seen after starting hypouricaemic therapy.
Health effects of toxic waste dumped in Cote d'Ivoire need urgent examination, UN expert says
Authors: J. Zarocostas
Journal: BMJ (2009)

Outstanding health and decontamination problems relating to the dumping in August 2006 of 500 tonnes of toxic waste in the Cote d’Ivoire city of Abidjan by a ship belonging to a Dutch company need urgent attention, an independent investigator has told the United Nations’ human rights body.

“There seems to be strong prima facie evidence that the reported deaths and adverse health consequences are related to the dumping of the waste from [the ship] Probo Koala ,” said Okechukwu Ibeanu, the UN’s special rapporteur on the adverse effects of the movement and dumping of toxic and dangerous products.

Many people are still experiencing health problems, he said, “especially those living near the dumping sites.”

Professor Ibeanu told reporters that the long term environmental consequences …
Missing medical information adversely affects care of patients
Authors: Kunal Khanna
Journal: BMJ (2005)

Missing clinical information on patients is common in the United States and may adversely affect the patients' health care, according to a study in JAMA (2005;293:565-71).

The authors, citing an article in the BMJ (1996;313:1062-8), wrote that managing clinical information effectively is an essential part of all medical care. But information on patients such as demographic data, medical history, treatments, test results, and family structure is often unavailable when a doctor greatly needs it, they say.

Peter Smith and colleagues at the University of Colorado Health Sciences Center surveyed 253 primary care clinicians during 1614 patients' visits between May and December 2003. For every visit …
Clinical and Social Survey of Linen Weavers
Authors: J. Deeny, H. S. Booker
Journal: BMJ (1939)

allow penetration of chemicals through itself; (g) be able to prevent heat-insulating effects by providing low-surface tension and a capacity to mix with water (h) if possible be to some slight extent absorbed into the skin, and inuiist certainly fill the hair follicles with inert but easily removed substance; (i) should be easy to remove without the use
313 A 1/2phase study to evaluate the pharmacokinetics, safety, tolerability, immunogenicity, and pharmacodynamics of albuferon™ in the treatment experienced subjects with chronic hepatitis C
Authors: V BALAN, M SULKOWSKI, D NELSON, G EVERSON, T BAMBURY, J RECTA, J ZHONG, H MESGHALI, J MURRAY, B OSBORN
Journal: Hepatology (2003)

Cattle that are not pregnant to first fixed-time artificial insemination (TAI) may be resynchronized for a second TAI if they are found nonpregnant at pregnancy diagnosis. The specific interval between first and second TAI ranges from 4 to 8 wk. The selected interval depends on the available method of pregnancy diagnosis and the efficiency of the resynchronization program. The objective of this experiment was to evaluate a pregnancy diagnosis and resynchronization system that achieved a 21-d interval between TAI. This 21-d interval approximates the natural return-to-service interval. It also enables resynchronization to be implemented within the same estrous cycle in which cattle are first inseminated. Holstein heifers were randomly assigned to a 21-d resynchronization program (21d_resynch; n = 40) or a control group in which estrus was observed for the purpose of re-insemination (control; n = 29). The 21d_resynch heifers were diagnosed for pregnancy on d 18 after a TAI (d 0) by using predetermined cut-off values for 2′-5′ oligoadenylate synthetase 1 (Oas1) gene expression in leukocytes and plasma progesterone concentration. Heifers that were not pregnant to first TAI had greater expression of Oas1 at the time of PGF2α (d −3) than pregnant heifers, but this relationship was reversed on d 18 after TAI: the heifers that were pregnant to first TAI had almost 5-fold greater expression of Oas1 compared with nonpregnant heifers. Nonpregnant heifers in the 21d_resynch group were injected with a luteolytic dose of PGF2α on d 19 and were injected with GnRH on d 21 and submitted to TAI. The pregnancy per AI after first insemination was similar for 21d_resynch (50.0%; pregnancy diagnosis on d 18) and control (51.7%; pregnancy diagnosis on d 27). Likewise, no difference was detected in second insemination pregnancy per AI for 21d_resynch (36.8%; nonpregnant heifers TAI on d 21) and control (35.7%; nonpregnant heifers inseminated at return to estrus or after nonpregnant diagnosis on d 27). The interval between first and second insemination was shorter for 21d_resynch compared with control (21.0 ± 0 and 27.5 ± 2.1 d). The conclusion is that a TAI resynchronization can be programmed within 21 d of previous TAI when a d 18 pregnancy test and a rapid resynchronization are used.
Effects of PEEP on acinar gas transfer in healthy and lung-injured dogs.
Authors: G M Barnas, P L Donahue, C S Kong, I G Ryder, D H Choi, B H Hoff, C F Mackenzie
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

We measured cardiorespiratory variables and 133xenon washout from a nonperfused lung region (XeW) in six anesthetized/paralyzed dogs, mechanically ventilated with 60% O2 at different positive end-expiratory pressures (PEEP). XeW in this technique represents directly measured acinar gas transfer (3). Measurements were repeated after induction of lung injury by lavaging the lungs 11 to 13 times with 600 ml saline. In control dogs, lung compliance (CL), alveolar ventilation (Valv), and XeW all decreased with increasing PEEP from 0 to 25 cm H2O (p < 0.05), while lung resistance (RL) did not change. After lavage, CL, Valv, and XeW below 15 cm H2O PEEP were all less than control values (p < 0.05), while RL was higher than control values. As PEEP increased from 0 to 20 cm H2O, Valv and XeW increased, but CL did not change; RL decreased only from 0 to 5 cm H2O. At 20 cm H2O PEEP, Valv and CL were not different from control values (p > 0.05), and XeW was higher than control values (p < 0.05). At estimated alveolar volumes above 400 ml, values for XeW before and after lavage were similar. We conclude that, during severe lung injury: (1) increasing PEEP to moderate levels will increase acinar gas transfer but, after a certain lung volume is reached, further increases in PEEP will have effects similar to the healthy condition; (2) overall mechanical properties of the lung do not reflect the responses to PEEP of the lung periphery.
Simvastatin, an HMG–Coenzyme A Reductase Inhibitor, Improves Endothelial Function Within 1 Month
Authors: Gerard O'Driscoll, Danny Green, Roger R. Taylor
Journal: Circulation (1997)

Background Cholesterol-lowering therapy can improve cardiovascular morbidity and mortality in patients with atherosclerosis. Although the mechanisms responsible are unclear, these benefits precede macroscopic changes in the vasculature. Emerging evidence that improvement in endothelial function may occur requires substantiation; in particular, it is unclear how early any such improvement would be detectable after initiation of therapy. Methods and Results This randomized, double-blind, placebo-controlled crossover study evaluated the effect of simvastatin (20 mg daily for 4 weeks) on endothelium-dependent and endothelium-independent vasodilation and on the response to the inhibitor of nitric oxide synthesis, N G -monomethyl- l -arginine (L-NMMA), in the forearm vasculature of subjects with moderate elevation of total serum cholesterol (6.0 to 10.0 mmol/L) by use of strain-gauge plethysmography. Studies were repeated after 3 more months of open therapy. When the results are expressed as percentage changes in flow in the infused arm relative to the noninfused arm, the vasodilator response to acetylcholine was significantly increased after 4 weeks of treatment with simvastatin ( P &lt;.0005), and this improvement was further enhanced after 3 months ( P &lt;.005). Concurrently, simvastatin augmented the vasoconstrictor response to L-NMMA, an effect that was maintained at 3 months ( P &lt;.0005). The response to the endothelium-independent vasodilator sodium nitroprusside was unaltered. Conclusions These observations indicate that within 1 month of treatment with simvastatin, both the stimulated and basal nitric oxide dilator functions of the endothelium are augmented, and the benefits of this HMG–coenzyme A reductase inhibitor persist with continued therapy.
Demonstration of Aortic Root Aneurysm on First-pass Study of the Right Heart
Authors: JAY R. KASNER, PARAMJIT BAMRAH, JAMES GLISCH, KATHLEEN BOUCH??, MARY HRUSKA
Journal: Clinical Nuclear Medicine (1987)

The use of a gated first-pass study in an RAO projection allows for the assessment of right heart function and anatomy. The case reported is of a 68-year-old female with Marfan's syndrome and a large aortic root aneurysm secondary to the cystic medio-necrosis seen in this rare connective tissue disorder. This aneurysm was first recognized through its distortion of right heart anatomy.
THE SPECIALIST: WHAT SHALL WE DO WITH HIM?
Authors: S. S. GOLDWATER
Journal: JAMA (1927)

The specialist is at once the hope and the despair of modern medicine. That he has contributed much to medical progress is generally acknowledged, and there is at least a reasonable probability that his scientific contributions will continue. Let us hope, at all events, that they will. In everyday practice, the specialist's knowledge is often indispensable to a correct understanding of obscure diseases, his skill a necessary means to the restoration of bodily function or the saving of life. His successes, often impressively dramatic and hence widely advertised, have won for him an astonishing influence. Strange diseases are made fashionable by his simple ukase, only to be banished from society when new favorites win his approval. The specialist is the prop of debilitated men, the idol of neurotic women, the restorer of undernourished children. He is admired for his industry, and is sometimes envied for his wealth. But with every
Systolic thickening and thinning of the septum and posterior wall in patients with coronary artery disease, congestive cardiomyopathy, and atrial septal defect.
Authors: B C Corya, S Rasmussen, H Feigenbaum, S B Knoebel, M J Black
Journal: Circulation (1977)

Echocardiographic septal and posterior wall thicknesses and the percent change with systole were measured in 146 patients with the following diagnoses: acute myocardial infarction (40), chronic coronary artery disease (49), congestive cardiomyopathy (8), atrial septal defect (20), and no cardiac disease (29). Mean diastolic thicknesses for the groups of patients with coronary artery disease and congestive cardiomyopathy were not significantly different from normal although there were abnormal values for individual patients within each group. Mean diastolic thickness of the septum was greater than normal for the group with atrial septal defect (P less than 0.02). Wall thinning with systole was associated with acute infarction or ischemia (P less than 0.0001); decreased thickening (less than normal) commonly occurred in patients with acute myocardial infarction, chronic coronary artery disease, and congestive cardiomyopathy. Patients with atrial septal defect had normal thickening with abnormal motion. Results of this study show that 1) systolic thinning is indicative of an acute event; 2) abnormal changes in systolic wall thickening occur commonly in patients with coronary artery disease or congestive cardiomyopathy; and 3) abnormal wall motion may occur without abnormal wall thickening, as the echoes of patients with atrial septal defect indicate.
Through the Nose Gastroscopy for the Placement of Feeding Tubes
Authors: D. Fregonese, G. Di Falco
Journal: Endoscopy (1993)

Following local anesthesia to the nose, through-the-nose (TTN) passage of a paediatric gastroscope was successful and well tolerated in 82 of 92 patients on whom it was attempted in order to place nasogastric feeding tubes. This technique allows for guidewire placement to be used for insertion tubes or dilators. The ten failures we observed occurred in patients with bilateral narrow turbinates. We conclude that the TTN approach is quicker and easier than conventional methods of feeding tube placement allowing for an additional endoscopic evaluation of the upper GI tract.
Unilocular Hydatid Cyst Disease in the Mid-South
Authors: James J. Daly
Journal: JAMA (1984)

UNILOCULAR hydatid disease is caused by the larval stage of the canine intestinal tapeworm,<i>Echinococcus granulosus</i>. The disease is usually found as a solitary, fluid-filled bladder type of cyst situated in the liver, although localization may occur in other organs, especially the lungs. Such a cyst can grow and become large enough to cause a variety of clinical signs related, in part, to the pressure exerted by the cyst. Humans usually obtain this infection by ingesting the<i>Echinococcus</i>ova that have been passed with the feces of dogs. Sheep are excellent intermediate hosts for<i>E granulosus</i>, and the sheep dog that has been fed the entrails of infected animals has been implicated as an important source of human infections. The majority of medical references published in the United States consider locally acquired hydatid disease to be uncommon in humans in the 48 contiguous states, with the infection most likely to
The student physician as psychotherapist
Authors: Louis D. Boshes
Journal: JAMA (1963)

Recognizing the need for an expanded psychiatric course which would increase teaching time as well as introduce this discipline early in the freshman year, the University of Chicago embarked on an ambitious plan in 1956 to give psychiatry a major role in the curriculum. Careful planning and implementation involved each of the four years of schooling.  After an initial didactic survey course, supplemented by demonstrations, the freshman is assigned his first case, a pregnant patient whom he interviews during gestation, hospitalization, before and after delivery, and later in her household. This initial experience is carefully supervised, as are his other psychiatric sequences during the balance of his medical-school training.  This volume, well organized and easy to read, begins with the rationale for the teaching of psychotherapy to the medical student, and then takes up the sequence which brings the reader to the goals and formal objectives of the senior program.
Downregulation of Matrix Metalloproteinases and Reduction in Collagen Damage in the Failing Human Heart After Support With Left Ventricular Assist Devices
Authors: Yun You Li, Yiqin Feng, Charles F. McTiernan, Wei Pei, Christine S. Moravec, Ping Wang, Warren Rosenblum, Robert L. Kormos, Arthur M. Feldman
Journal: Circulation (2001)

Left ventricular assist device (LVAD) support of the failing heart induces salutary changes in myocardial structure and function. Matrix metalloproteinases (MMPs) are increased in the failing heart and are induced by stretch in cardiac cells in vitro. We hypothesized that mechanical unloading may affect LV plasticity by regulating MMPs and their substrates.LV samples were collected from patients with dilated cardiomyopathy (DCM, n=14) or ischemic cardiomyopathy (ICM, n=16) at the time of implantation of the LVAD and again during cardiac transplantation. MMP-1, -3, and -9 were measured by ELISA, MMP-2 and -9 gelatinolytic activity by gelatin zymography, and tissue inhibitors of metalloproteinases (TIMPs) by Western blot. Total soluble and insoluble collagens were separated by pepsin solubilization, and the contents were determined by quantification of hydroxyproline. The undenatured soluble collagen was measured by Sircol collagen assay. The results showed that MMP-1 and -9 were decreased, whereas TIMP-1 and -3 were increased, but there was no change in MMP-2 and -3 and TIMP-2 and -4 after LVAD support. The undenatured collagen was increased, with the ratio of undenatured to total soluble collagens increased in ICM and that of insoluble to total soluble collagens increased in DCM after LVAD support.The reduced MMPs and increased TIMPs and ratios of undenatured to total soluble collagens and insoluble to total soluble collagens after LVAD support suggest that reduced MMP activity diminished damage to the matrix. These changes may contribute to the functional recovery and LV plasticity after LVAD support.
Surgery of the Anus, Rectum and Colon
Authors: John R. Hilsabeck
Journal: JAMA (1984)

Those familiar with previous editions will recognize a major revision and will not be disappointed. All previous 28 chapters are updated through autumn 1982, a few as late as middle 1983, and several are substantively revised to reflect recent conceptual changes in pathogenesis or management (or both). Five new chapters (megacolon and idiopathic constipation in adults, irradiation damage, angiodysplasia and ischemic colitis, and nonspecific colorectal ulceration including the solitary rectal ulcer syndrome) and 150 new illustrations (particularly photographs of colorectal specimens from Morson's collection and drawings of operative procedures including new techniques for stapling and for ileoanal anastomoses, eg, the J-pouch) notably enhance the text. Three chapters remain coauthored, but the remainder are entirely the author's. One thousand new references are added.  The book is best described by listing its sections to fully appreciate its scope and comprehensiveness. First considered are basic regional surgical anatomy, general methods of diagnosis, and
SOX2 regulates the hypothalamic-pituitary axis at multiple levels
Authors: Sujatha A. Jayakody, Cynthia L. Andoniadou, Carles Gaston-Massuet, Massimo Signore, Anna Cariboni, Pierre M. Bouloux, Paul Le Tissier, Larysa H. Pevny, Mehul T. Dattani, Juan P. Martinez-Barbera
Journal: Journal of Clinical Investigation (2012)

Sex-determining region Y (SRY) box 2 (SOX2) haploinsufficiency causes a form of hypopituitarism in humans that is characterized by gonadotrophin deficiency known as hypogonadotrophic hypogonadism. Here, we conditionally deleted Sox2 in mice to investigate the pathogenesis of hypogonadotrophic hypogonadism. First, we found that absence of SOX2 in the developing Rathke pouch of conditional embryos led to severe anterior lobe hypoplasia with drastically reduced expression of the pituitary-specific transcription factor POU class 1 homeobox 1 (POU1F1) as well as severe disruption of somatotroph and thyrotroph differentiation. In contrast, corticotrophs, rostral-tip POU1F1-independent thyrotrophs, and, interestingly, lactotrophs and gonadotrophs were less affected. Second, we identified a requirement for SOX2 in normal proliferation of periluminal progenitors; in its absence, insufficient precursors were available to produce all cell lineages of the anterior pituitary. Differentiated cells derived from precursors exiting cell cycle at early stages, including corticotrophs, rostral-tip thyrotrophs, and gonadotrophs, were generated, while hormone-producing cells originating from late-born precursors, such as somatotrophs and POU1F1-dependent thyrotrophs, were severely reduced. Finally, we found that 2 previously characterized patients with SOX2 haploinsufficiency and associated hypogonadotrophic hypogonadism had a measurable response to gonadotropin-releasing hormone (GnRH) stimulation, suggesting that it is not the absence of gonadotroph differentiation, but rather the deficient hypothalamic stimulation of gonadotrophs, that underlies typical hypogonadotrophic hypogonadism.
Abnormal Glucose Tolerance in Transfusion-Dependent β-Thalassemic Patients
Authors: Jimmy P.S. Chern, Kai-Hsin Lin, Meng-Yao Lu, Dong-Tsam Lin, Kuo-Sin Lin, Jong-Dar Chen, Cheng-Chung Fu
Journal: Diabetes Care (2001)

OBJECTIVE—To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent β-thalassemic patients. RESEARCH DESIGN AND METHODS—A total of 89 transfusion-dependent β-thalassemic patients were interviewed. Diabetes was previously diagnosed in 14 of them. In the remaining 75 patients, 68 participated in an oral glucose tolerance test. Potential risk factors were identified using the independent t test, χ2 test, and Fisher’s exact test. Logistic regression analysis was used to select the independent risk factors that best predicted abnormal glucose tolerance. A two-tailed P value of &amp;lt;0.05 was considered to be statistically significant. RESULTS—The prevalence of impaired glucose tolerance was 8.5% (7 of 82) and that of diabetes was 19.5% (16 of 82). Presentation with diabetic ketoacidosis was 31.1% (5 of 16). The risk factors for abnormal glucose tolerance found in transfusion-dependent β-thalassemic patients were serum ferritin concentration and hepatitis C infection. CONCLUSIONS—The interaction of iron overload and hepatitis C infection worsened the prognosis of thalassemic patients. Aggressive iron-chelation therapy as well as prevention and treatment of hepatitis C infection should be mandatory in managing glucose homeostasis in transfusion-dependent β-thalassemic patients in Taiwan.
Open Meetings for Medical-School Admissions Committees
Authors: William J. Curran
Journal: New England Journal of Medicine (1980)

A SURPRISING decision has been passed down by the Supreme Court of Oklahoma. Reversing the decision of a trial court, this ruling requires the admissions committee of the College of Medicine of the University of Oklahoma to open to the public all its meetings and deliberations, including committee review of personal factors in the candidates' back-grounds, discussion of personal interviews, and other subjective data.1 The decision is important as a case of first impression from the highest court of a state on the issue of confidentiality in the admissions process. It provides medical-school administrators and faculty with further difficulties in . . .