tbuckley/cabot-search huggingface dataset:
Activation sequence during atrial flutter in dogs with surgically induced right atrial enlargement: I. Observations during sustained rhythms.
Authors: P A Boyden
Journal: Circulation Research (1988)

The atrial activation sequences during 15 episodes of sustained atrial flutters were determined in the isolated hearts of four dogs with surgically induced right atrial enlargement (TI/PS dogs). These sequences were compared with the activation sequences of six episodes of nonsustained atrial tachyarrhythmias induced in three control hearts. Total endocardial activation of both atria during normal sinus rhythm and during the arrhythmias was determined first by recording simultaneously from 192 pairs of recording electrodes positioned into egg-shaped electrode arrays, and then by determining the moment of activation from each of the recorded electrograms. Isochronal maps of total activation were constructed by computer. Nonsustained atrial rhythms inducible in control hearts were due to circus movement excitation either in the left atrium (two episodes) or in the right atrium (four episodes). On the other hand, all 15 episodes of sustained atrial flutter induced and mapped in the TI/PS dog hearts were due to reentrant excitation in the enlarged right atrium. The reentrant pattern could be in a clockwise or counterclockwise pattern. In these episodes of stable flutter an area of functional block was an essential component to the reentrant excitation.
Healthcare outsourcing from NHS to independent sector rose from 4.8% of market in 2009 to 7% in 2014, report shows
Authors: A. O'Dowd
Journal: BMJ (2015)

The role of the private sector in the NHS has been growing steadily under the coalition government, concludes a report by LaingBuisson, a healthcare consultancy.

The latest edition of LaingBuisson’s Healthcare Market Review ,1 published on 26 February, contained figures detailing the growth of outsourced NHS services in the independent sector.

Despite what LaingBuisson called “continuing rough terrain” for independent sector involvement in the UK health and care sectors, it found that growth …
Posture and nocturnal asthma.
Authors: K F Whyte, N J Douglas
Journal: Thorax (1989)

To investigate whether the supine posture caused sustained bronchoconstriction and could thus contribute to the development of nocturnal asthma, nine patients with nocturnal asthma were studied on two consecutive days, lying supine for four hours on one day and sitting upright for four hours on the other, the order of the two postures being randomised. Peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) were measured immediately before and after the four hours and over the subsequent hour. There was no significant difference between the erect and supine posture for PEF (248 v 248 l/min), FEV1 (1.31 v 1.22 l), or FVC (2.34 v 2.28 l) at the end of the four hours, nor did any significant change develop subsequently. Thus the supine posture is not associated with prolonged bronchoconstriction. As each patient had previously shown an average overnight fall in PEF of more than 20%, this study strongly suggests that the supine posture is not an important cause of overnight bronchoconstriction.
Effect of Aging on Glucose Homeostasis
Authors: Ervin Szoke, Muhammad Z. Shrayyef, Susan Messing, Hans J. Woerle, Timon W. van Haeften, Christian Meyer, Asimina Mitrakou, Walkyria Pimenta, John E. Gerich
Journal: Diabetes Care (2008)

To examine the effect of aging on insulin secretion (first- and second-phase insulin release) and insulin sensitivity in people with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT).First- and second-phase insulin secretion and insulin sensitivity were assessed in hyperglycemic clamp experiments in 266 individuals with NGT and 130 individuals with IGT, ranging in age from approximately 20 to approximately 70 years. Changes in beta-cell function were compared using the disposition index to adjust for differences in insulin sensitivity.As expected, both phases of insulin release and insulin sensitivity were reduced in individuals with IGT (all P < 0.01). Insulin sensitivity was not independently correlated with age in either group. In people with NGT, the disposition index for first- and second-phase insulin release decreased similarly at a rate of approximately 0.7% per year. In people with IGT, the disposition indexes for first- and second-phase insulin release decreased at greater rates ( approximately 2.2 and 1.4% per year, P = 0.002 and 0.009, respectively, vs. NGT), with the decrease in first phase being greater than that of second phase (P = 0.025).Insulin secretion (both first and second phase) normally decreases at a rate of approximately 0.7% per year with aging; this decrease in beta-cell function is accelerated about two-fold in people with impaired glucose tolerance-first phase to a greater extent than second phase. Finally, aging per se has no effect on insulin sensitivity independent of changes in body composition.
Accuracy of teledermatology for pigmented neoplasms
Authors: Erin M. Warshaw, Frank A. Lederle, Joseph P. Grill, Amy A. Gravely, Ann K. Bangerter, Lawrence A. Fortier, Kimberly A. Bohjanen, Karen Chen, Peter K. Lee, Harold S. Rabinovitz, Robert H. Johr, Valda N. Kaye, Sacharitha Bowers, Rachel Wenner, Sharone K. Askari, Deborah A. Kedrowski, David B. Nelson
Journal: Journal of the American Academy of Dermatology (2009)
Expansion and function of Foxp3-expressing T regulatory cells during tuberculosis
Authors: James P. Scott-Browne, Shahin Shafiani, Glady's Tucker-Heard, Kumiko Ishida-Tsubota, Jason D. Fontenot, Alexander Y. Rudensky, Michael J. Bevan, Kevin B. Urdahl
Journal: The Journal of Experimental Medicine (2007)

Mycobacterium tuberculosis (Mtb) frequently establishes persistent infections that may be facilitated by mechanisms that dampen immunity. T regulatory (T reg) cells, a subset of CD4+ T cells that are essential for preventing autoimmunity, can also suppress antimicrobial immune responses. We use Foxp3-GFP mice to track the activity of T reg cells after aerosol infection with Mtb. We report that during tuberculosis, T reg cells proliferate in the pulmonary lymph nodes (pLNs), change their cell surface phenotype, and accumulate in the pLNs and lung at a rate parallel to the accumulation of effector T cells. In the Mtb-infected lung, T reg cells accumulate in high numbers in all sites where CD4+ T cells are found, including perivascular/peribronchiolar regions and within lymphoid aggregates of granulomas. To determine the role of T reg cells in the immune response to tuberculosis, we generated mixed bone marrow chimeric mice in which all cells capable of expressing Foxp3 expressed Thy1.1. When T reg cells were depleted by administration of anti-Thy1.1 before aerosol infection with Mtb, we observed ∼1 log less of colony-forming units of Mtb in the lungs. Thus, after aerosol infection, T reg cells proliferate and accumulate at sites of infection, and have the capacity to suppress immune responses that contribute to the control of Mtb.
Bioactivity in an Aggrecan 32‐mer Fragment Is Mediated via Toll‐like Receptor 2
Authors: Sophie Lees, Suzanne B. Golub, Karena Last, Weiguang Zeng, David C. Jackson, Philip Sutton, Amanda J. Fosang
Journal: Arthritis & Rheumatology (2015)

To determine whether an aggrecan 32-mer fragment derived from dual ADAMTS and matrix metalloproteinase (MMP) cleavage in the aggrecan interglobular domain was bioactive and, if so, to elucidate its mechanism of action.Mouse primary chondrocytes, synovial fibroblasts, or peritoneal macrophages, human primary chondrocytes, and cells or cell lines from myeloid differentiation factor 88 (MyD88)-deficient and Toll-like receptor 2 (TLR-2)-deficient mice were stimulated with synthetic mouse 32-mer peptide, human 32-mer peptide, a 32-mer scrambled peptide, or native, glycosylated 32-mer peptide. Cells stimulated with 32-mer peptide were analyzed for changes in messenger RNA (mRNA) expression by quantitative polymerase chain reaction. Conditioned medium was analyzed for levels of interleukin-6 protein by an AlphaLISA or for levels of MMP-3 and MMP-13 protein by Western blotting. NF-κB activation was measured in a luciferase reporter assay.Treatment of mouse cells or cartilage explants with 32-mer peptide or scrambled peptide revealed that the 32-mer peptide, but not the scrambled peptide, had antianabolic, procatabolic, and proinflammatory bioactivity in vitro. Chondrocytes, synovial fibroblasts, and macrophages from MyD88-deficient mice failed to respond to 32-mer peptide stimulation. A macrophage cell line derived from TLR-2-deficient mice also failed to respond to 32-mer peptide stimulation. Stimulation of human chondrocytes with human 32-mer peptide increased the expression of catabolic markers at the mRNA and protein levels. Mouse and human 32-mer peptide stimulated NF-κB activation in a TLR-2-dependent reporter assay, and the response of chondrocytes from both species to native, glycosylated 32-mer peptide was similar to the response to synthetic peptides.The aggrecan 32-mer fragment is a novel endogenous ligand of TLR-2 with the potential to accelerate cartilage destruction in vivo.
PHYSIOLOGICAL AND PHARMACOLOGICAL INVESTIGATIONS ON THE NATURE OF HYPOTHALAMIC EXCITATION
Authors: ERNST GELLHORN
Journal: American Journal of Psychiatry (1941)

1. Experiments are briefly cited in which in narcotized cats, the hypothalamus was stimulated and the contraction of the nictitating membrane on the same side recorded. In addition to this the cephalad end of the cervical sympathetic was stimulated on the contralateral side, and the contractions of the corresponding nictitating membrane were recorded also. This preparation allows one to distinguish between central and peripheral effects. It was shown that anoxia, inhalation of excess carbon dioxide and various convulsant drugs, such as metrazol, coramine, picrotoxin and coriamyrtin, increase the excitability of sympathetic hypothalamic centers on intravenous injection. The most effective drug is metrazol, which may produce signs of increased sympathetic discharges as measured by the height of the contraction of the nictitating membrane for long periods of time. 2. The effects of anoxia and of metrazol convulsions were investigated on normal rats and animals in which the adrenals had been removed. Furthermore, rats were used in which, in addition to the removal of the adrenals, the vagi had been divided below the diaphragm. It was found that anoxia and metrazol, while producing a hyperglycemia in the normal animal, lower the blood sugar level in the adrenalectomized rat. If, however, the vagi are divided in adrenalectomized animals, anoxia and metrazol no longer produce a hypoglycemia, but call forth merely a slight and delayed rise in blood sugar. The experiments are interpretated to mean that anoxia and metrazol produce a simultaneous excitation of the sympathetico-adrenal and vago-insulin system in the normal animal, but that the excitation of the latter does not become apparent on account of the predominance of the sympatheticoadrenal system. 3. It is shown that electrical excitation of the hypothalamus leading to a typical rage response produces a rise in the blood sugar in the normal, but a fall in blood sugar in animals with adrenals eliminated and liver denervated. If, however, the vagi are cut, the hypoglycemic effect disappears and a delayed slight hyperglycemia (due to sympathin?) occurs. It is inferred that the process of sham rage is characterized by a simultaneous discharge over both divisions of the autonomic nervous system. 4. If cats in which the spinal cord had been divided at the sixth cervical segment, in order to eliminate excitation of the sympathetico-adrenal system, are exposed to a barking dog they react with reversible hypoglycemia. This reaction is absent when the vagi are cut below the diaphragm. It is inferred that emotion involves both vagal and sympathetic excitation. The former leads to increased secretion of insulin, the latter enhances the secretion of adrenalin.
Role of Endothelium-Derived Nitric Oxide in the Regulation of Cardiac Oxygen Metabolism
Authors: Jean-Noël Trochu, Jean-Brieuc Bouhour, Gabor Kaley, Thomas H. Hintze
Journal: Circulation Research (2000)

Endothelium-derived NO is considered to be primarily an important determinant of vascular tone and platelet activity; however, the modulation of myocardial metabolism by NO may be one of its most important roles. This modulation may be critical for the regulation of tissue metabolism. Several physiological processes act in concert to make endothelial NO synthase-derived NO potentially important in the regulation of mitochondrial respiration in cardiac tissue, including (1) the nature of the capillary network in the myocardium, (2) the diffusion distance for NO, (3) the low toxicity of NO at physiological (nanomolar) concentrations, (4) the fact that low PO(2) in tissue facilitates the action of NO on cytochrome oxidase, and (5) the formation of oxygen free radicals. A decrease in NO production is involved in the pathophysiological modifications that occur in heart failure and diabetes, disease states associated with altered cardiac metabolism that contributes to the evolution of the disease process. In contrast, several drugs (eg, angiotensin-converting enzyme inhibitors, amlodipine, and statins) can restore or maintain endogenous production of NO by endothelial cells, and this mechanism may explain part of their therapeutic efficiency. Thus, the purpose of this review is to critically evaluate the role of NO in the control of mitochondrial respiration, with special emphasis on its effect on cardiac metabolism.
Relationship between exposure to domestic allergens and bronchial hyperresponsiveness in non-sensitised, atopic asthmatic subjects
Authors: S J Langley
Journal: Thorax (2004)

<b>Background:</b> The effect of exposure to allergens not causing sensitisation in atopic asthmatic subjects has not previously been studied. A study was undertaken to assess the degree of asthma severity (measured by spirometry, airway reactivity and exhaled nitric oxide) in atopic asthmatic patients not sensitised to the domestic allergen to which they were exposed. <b>Methods:</b> Dust samples were collected from the living room carpet and mattress in the homes of 248 subjects and dust mite, cat and dog allergen concentrations were measured. Spirometry, non-specific bronchial reactivity (BR), and exhaled nitric oxide (eNO) were ascertained. Patients’ sensitisation status was assessed by skin prick testing. <b>Results:</b> Adult atopic asthmatics not sensitised to mite but exposed to high levels of mite allergen had significantly more severe BR than subjects not exposed to high levels of mite (PD<sub>20</sub>, geometric mean (GM) 0.21 mg (95% CI 0.09 to 0.47) <i>v</i> 0.86 mg (95% CI 0.44 to 1.67), mean ratio difference 4.1 (95% CI 1.5 to 11.4), p = 0.008). Subjects not sensitised but exposed to high levels of dog allergen also had significantly more severe BR than subjects not exposed (PD<sub>20</sub> GM 0.16 <i>v</i> 0.52 mg, mean ratio difference 3.3 (95% CI 1.2 to 9.2), p = 0.01). The differences in BR between these groups were still significant after adjusting for confounding factors. This effect of greater airway reactivity was not seen in subjects exposed but not sensitised to cat allergens. <b>Conclusion:</b> Atopic asthmatic subjects who are exposed to high levels of dust mite or dog allergens but not sensitised to these allergens have evidence of increased airway reactivity.
The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock
Authors: Brian H. Cuthbertson, Charles L. Sprung, Djillali Annane, Sylvie Chevret, Mark Garfield, Serge Goodman, Pierre-Francois Laterre, Jean Louis Vincent, Klaus Freivogel, Konrad Reinhart, Mervyn Singer, Didier Payen, Yoram G. Weiss
Journal: Intensive Care Medicine (2009)
Predicted normal values for maximal respiratory pressures in caucasian adults and children.
Authors: S H Wilson, N T Cooke, R H Edwards, S G Spiro
Journal: Thorax (1984)

Maximal respiratory pressures at the mouth (PEmax and PImax) have been measured in 370 normal caucasian children and adults. Age, height, and weight were recorded for all subjects and incorporated in a stepwise multiple regression analysis to determine prediction equations for the maximal respiratory pressures in the children and adults for both sexes. In men PImax and PEmax were significantly correlated only with age (p less than 0.001 and less than 0.035 respectively), whereas in women they were correlated with height (p less than 0.035 and less than 0.03). In both boys and girls PImax was related to weight (p less than 0.0001 and less than 0.01 respectively) and PEmax to age (p less than 0.001 for both). The values for PImax and PEmax in adults were lower than in previously reported series, but in children the values obtained were similar to those reported for several smaller series.
Does cannabis use predispose to chronic airflow obstruction?
Authors: D. P. Tashkin
Journal: European Respiratory Journal (2009)

Cannabis (derived from the ubiquitous plant, Cannabis sativa , and also known as marijuana) is the most widely used illicit drug worldwide, as well as the second most commonly smoked substance after tobacco, with an estimated 166 million users (3.9% of 15–64 yr olds) 1. Its wide popularity is due to the euphoric effects of its major psychoactive ingredient, Δ9-tetrahydrocannabinol (THC). Since the gas and particulate phase constituents of the smoke of marijuana are at least qualitatively similar to those of tobacco, the major exception being the nicotine in tobacco and the ∼60 cannabinoid (THC-like) components in marijuana 2, 3, there has long been concern that regular smoking of marijuana might increase the risk of developing chronic airflow obstruction and chronic obstructive pulmonary disease (COPD), by analogy with the well-known detrimental effects of tobacco. Several studies have documented that smokers of marijuana, even in the absence of tobacco smoking, show a higher prevalence of symptoms of chronic bronchitis than nonsmokers 4–7. However, the association between marijuana smoking and airflow obstruction is less clear. Several groups of investigators have addressed the latter question by measuring lung function in convenience samples or stratified random population samples of users and nonusers of marijuana and/or tobacco both cross-sectionally 4–6, 8–10 and longitudinally 11–13. The most recent study of the possible association of marijuana use with lung function abnormality appears in this issue of the European Respiratory Journal 14.

Previously published studies have yielded conflicting results relating to marijuana use and lung function. An early cross-sectional study of 74 young (mean age 24 yrs) habitual marijuana smokers showed no differences in either spirometric indices or sensitive measures of small airways function (closing volume or percentage change in nitrogen concentration …
Palliative pamidronate treatment in patients with bone metastases from breast cancer.
Authors: A T van Holten-Verzantvoort, H M Kroon, O L Bijvoet, F J Cleton, L V Beex, G Blijham, J Hermans, J P Neijt, S E Papapoulos, H P Sleeboom
Journal: Journal of Clinical Oncology (1993)

PURPOSE An open, randomized study was performed to assess the effects of supportive pamidronate treatment on morbidity from bone metastases in breast cancer patients. PATIENTS AND METHODS Eighty-one pamidronate patients and 80 control patients were monitored for a median of 18 and 21 months, respectively, for events of skeletal morbidity and the radiologic course of metastatic bone disease. The oral pamidronate dose was 600 mg/d (high dose [HD]) during the earliest study years, then changed to 300 mg/d (low dose [LD]) because of gastrointestinal toxicity. Twenty-nine of 81 pamidronate (HD/LD) patients first received 600 mg/d and were then changed to 300 mg/d; 52 of 81 pamidronate LD patients received 300 mg/d throughout the study. Tumor treatment was unrestricted. RESULTS An overall intent-to-treat analysis was performed. In the pamidronate group, the occurrence of hypercalcemia, severe bone pain, and symptomatic impending fractures decreased by 65%, 30%, and 50%, respectively; event-rates of systemic treatment and radiotherapy decreased by 35% (P &lt; or = .02). The event-free period (EFP), radiologic course of disease, and survival did not improve. Subgroup analyses suggested a dose-dependent treatment effect. Compared with their controls, in pamidronate HD/LD patients, events occurred 60% to 90% less frequently (P &lt; or = .03) and the EFP was prolonged (P = .002). In pamidronate LD patients, event-rates decreased by 15% to 45% (P &lt; or = .04). Gastrointestinal toxicity of pamidronate caused a 23% drop-out rate, but other cancer-associated factors seemed to contribute to this toxicity. CONCLUSION Pamidronate treatment of breast cancer patients efficaciously reduced skeletal morbidity. The effect appeared to be dose-dependent. Further research on dose and mode of treatment is mandatory.
Intravenous immunoglobulin for recurrent Clostridium difficile diarrhoea
Authors: I L P Beales
Journal: Gut (2002)

I enjoyed reading Kyne and Kelly's therapy update concerning treatments for recurrent Clostridium difficile diarrhoea ( Gut 2001; 49 :152–3). Recurrence after a single episode of diarrhoea can occur in up to 50% of cases1 and following recurrent bouts further relapse is even more likely. The authors have demonstrated that a serum antibody response to C difficile toxin A during an initial attack is associated with protection against recurrence1 and suggested that intravenous immunoglobulin may be useful in treating refractory recurrent disease. Here I report successful treatment of four adult patients with recurrent C difficile infection using intravenous immunoglobulin in order to increase the number of reported cases.

A 77 year old female with chronic obstructive pulmonary disease …
Stress fracture of the proximal humeral epiphysis in an elite junior badminton player.
Authors: K T Boyd, M E Batt
Journal: British Journal of Sports Medicine (1997)

An elite junior badminton player presented with a chronic painful dominant shoulder after an intense training course. An acute stress fracture to the proximal humeral epiphysis was found. Two-plane radiography will identify abnormalities of the growth plate but comparative films of the unaffected side may also be required to differentiate subtle changes. Rest with subsequent rehabilitation is the appropriate management of these injuries although ideally they should be subjected to primary prevention.
Lehrbuch der Ohrenheilkunde.
Authors: Victor. Urbantschitsch
Journal: JAMA (1910)

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