tbuckley/cabot-search huggingface dataset:
Emergence of Polyproline II-Like Structure at Early Stages of Experimental Evolution from Random Polypeptides
Authors: Hitoshi Toyota, Masato Hosokawa, Itaru Urabe, Tetsuya Yomo
Journal: Molecular Biology and Evolution (2008)

To examine whether a primordial functional protein at the early stages of evolution has structural features, we carried out experimental evolution consisting of 25 cycles (generations) of mutation and selection toward DNA-binding function using a random-sequence polypeptide of 139 amino acid residues with no secondary structure as the initial sequence. In each generation, 16 clones were sampled arbitrarily for sequence analysis, and a phylogenetic tree was constructed. Polypeptide evolution proceeded from the initial point on branch I in 2 main directions of branches II and III. The initial and 2 evolved polypeptides (one at the 24th generation on branch III and the other at the 25th generation on branch II) were purified to examine their functional and structural properties. Although binding of the initial polypeptide to the target DNA was not detected by surface plasmon resonance measurements, the 2 evolved polypeptides bound to the DNA with dissociation constants of 1.6 and 1.0 μM, respectively, indicating an increase in affinity during the experimental evolution. Circular dichroism spectra of the evolved polypeptides, but not of the initial polypeptide, showed features characteristic of the polyproline II (PPII)–like structure, a left-handed helical structure commonly found in natural proteins, suggesting that the structure emerged through the experimental evolution. The same structural feature was found in another experimental evolution toward catalytic activity. These results demonstrate that the PPII-like structure is one of the common features that could have appeared in the early evolutionary stages of primordial functional protein.
Flexible Implant Resection Arthroplasty in the Hand and the Extremities
Authors: J. V. Jeffs
Journal: Annals of the Rheumatic Diseases (1975)

This book on the treatment of chronic pain will be of great value to studenits at any stage of their career and doctors both in hospitals and general practice.Dr. Dudley Hart writes with great authority and has gathered a team of exceptional ability to help
Prevalence of Malnutrition in General Medical Patients
Authors: Bruce R. Bistrian
Journal: JAMA (1976)

Three, single-day nutritional surveys at weekly intervals were conducted in the general medical wards of an urban municipal teaching hospital. The techniques of nutritional assessment included anthropometric measures (weight/height, triceps skin fold, arm-muscle circumference, serum albumin, and hematocrit). The prevalence of protein-calorie malnutrition was 44% or greater by these criteria (weight/height, 45%; triceps skin fold, 76%; arm-muscle circumference, 55%; serum albumin, 44%; and hematocrit, 48%). These results were reproducible without significant variation between surveys. In 34% of patients, a lymphopenia of 1,200 cells/cu mm or less was found, a level likely to be associated with diminished cell-mediated immunity. Compared with a similar survey among surgical patients, the medical patients were more depleted calorically (weight/height, triceps skin fold) but had better protein status (arm-muscle circumference, serum albumin). Significant protein-calorie malnutrition occurs commonly in municipal hospitals in both medical and surgical services. (<i>JAMA</i>235:1567-1570, 1976)
Comparison of intravenous nitroglycerin and sodium nitroprusside for treatment of acute hypertension developing after coronary artery bypass surgery.
Authors: J T Flaherty, P A Magee, T L Gardner, A Potter, N P MacAllister
Journal: Circulation (1982)

The present study was designed to test the hypothesis that i.v. nitroglycerin is as effective as sodium nitroprusside for managing acute hypertension early after coronary artery bypass surgery. Seventeen patients received both nitroglycerin and nitroprusside in a randomized crossover protocol. Infusion rates were increased stepwise to lower mean arterial pressures comparably with each drug. In 14 of 17 patients, similar infusion rates of the two vasodilators resulted in equal lowering of both blood pressure and systemic vascular resistance. In the remaining three patients, very high infusion rates of nitroglycerin were required and achieved only 20-50% of nitroprusside's response in two of three. Hemodynamic responses to the two vasodilators were similar, except that nitroglycerin increased cardiac output more than nitroprusside did. In contrast, pulmonary gas exchange responses differed in that nitroglycerin improved intrapulmonary shunting, while nitroprusside worsened it. Similarly, nitroglycerin resulted in a significantly smaller increase in the alveolar arterial oxygen gradient than did nitroprusside. These results suggest that in the majority of patients, i.v. nitroglycerin was as effective as nitroprusside in controlling acute hypertension after coronary artery bypass surgery. In addition, nitroglycerin appeared to have more favorable effects on pulmonary gas exchange. Because nitroglycerin has more beneficial effects on intercoronary collateral blood flow in the setting of regional ischemia, it may be preferable to nitroprusside in patients with ischemic heart disease.
THE ROLE OF THE MAST-CELLS IN ACUTE AND CHRONIC INFECTIONS.
Authors: HERBERT U. WILLIAMS
Journal: JAMA (1901)

In discussing the relation of the mast-cells to infections, it will be proper first to consider what knowledge we have of their composition and their various properties that may have a bearing on this question. It has been maintained that their granules are composed of mucin, on the ground that the metachromism displayed by these granules with thionin and other dyes is similar to that shown by mucin. This seems to be the principal argument for the theory, although some also state that mast-cells are numerous in mucous membranes during catarrhs and in tumors containing mucin. In the writer's experience, while the mast-cells may be abundant in inflamed mucous membranes, they are few or wanting in tumors containing mucin and in the umbilical cord. They may be much increased in structures where mucin seems scanty, as in scirrhous carcinoma. However, since chemists state that there are certainly a number of
THE TRAINING IN MIDWIFERY OF MEDICAL STUDENTS AND NURSES: SOME REFLECTIONS AND A SCHEME
Authors: D. W. Roy
Journal: BMJ (1930)

IN thlese days wN-hten tile Dii is lilumimi1il , -ig witht schemes.some of thleml doctrinaire athler tll a practical, fol the iililjro-eiaelt of tile maternitvscrvi(e of tlhe(colitrv-y it is perhas tiile for those of uls; Who liave leen formany years o01 the active staffs of ung-in llhospitals, and are still -active and not colnsultant, to maklie snine observatiois b)ase(l oH lpractical experience ald refl ection.Otlherwxisc it may very easily be too late to pick ouit a practicable plani ia the pletlora that will exist.It is iiot myv intention to write anything mucheli abouit the genieral practitioner's part ill a miiaterniiitv service, excep)t as regrllds his early tlailiig.Mv mlai conl(ce is witl any imieasures that exist, or tlhat may be l)lopose(l, for the imiipr ovem e eient of tlhe teaciliiig i illidwifery of nmiedical stlidelitsaiidimidwives.
Lichen Planus of the Mouth
Authors: R. P. Warin, H. S. M. Crabb, A. I. Darling
Journal: BMJ (1958)

Prostatic "threads," and flakes of epithelial debris in female urine, were found to give locally positive reactions if caught on the test strip. Stability of the StripsAfter four hours' exposure in an air oven at 1000 C. the strips showed no difference in sensitivity or colour reaction.Exposure to laboratory air for 24 hours produced pale-blue discoloration, apparently due to ammonia; but, surprisingly, such strips reacted normally to urine.Similarly, prior exposure to HC1 fumes apparently caused no permanent damage.Brief exposure to steam or dipping in water did not interfere with subsequent indications, although more prolonged steaming, or washing in running water, resulted in subsequent false positives due to removal of the citrate buffer.For the same reason it appears inadvisable to attempt to use a strip to test more than one urine.
Prolonged Tolbutamide-Induced Hypoglycemia
Authors: Rachmel Cherner
Journal: JAMA (1963)

THE VALUE of the sulfonylurea compounds as effective hypoglycemic agents, with a relatively low incidence of side effects, has been well established. However, prolonged hypoglycemia accompanying the use of these agents in diabetic, as well as nondiabetic, patients recently has been emphasized.<sup>1-4</sup>It is the purpose of this communication to record another instance of prolonged tolbutamide-induced hypoglycemia characterized by persistent high serum levels of the sulfonylurea after discontinuation of the medication. <h3>Report of a Case</h3> A 72-year-old white male was admitted to Jefferson Medical College Hospital on March 4, 1962, in a comatose state. The patient had been a mild diabetic for at least 17 years and had been well maintained on 20 units of isophane insulin suspension and diet. Six months previously, following admission of the patient for hydroarthrosis of the right knee, insulin was withdrawn and the patient was treated with tolbutamide in doses of 500 mg
Coping with a Stoma - A Comparative Study of Patients with Rectal Carcinoma or Inflammatory Bowel Diseases
Authors: J. Küchenhoff, M. Wirsching, H.U. Drüner, G. Herrmann, C. Köhler
Journal: Psychotherapy and Psychosomatics (1981)

409 patients who had either an implantation of a stoma or a bowel resection for either colorectal carcinoma or colitis/ileitis answered a 200-item questionnaire. A discriminant analysis revealed a higher degree of pre- and postoperative depression and a decrease of social activities for stoma patients who also more often lived in rural areas in comparison with patients with the same diagnosis who only had a resection. A comparison of operated cancer patients with patients operated for ulcerative colitis or Crohn's disease showed less depression before and after surgery in cancer patients. Cancer patients also frequently ceased sexual activities after the operation, and they came from much more remote rural areas than the comparison group, irrespective of the type of operation performed.
Catheter ablation of permanent junctional reciprocating tachycardia with radiofrequency current
Authors: Fiorenzo Gaita, Michel Haissaguerre, Carla Giustetto, Bruno Fischer, Riccardo Riccardi, Elena Richiardi, Marco Scaglione, Filippo Lamberti, Jean-François Warin
Journal: Journal of the American College of Cardiology (1995)
The "Duty to Warn" a Patient's Family Members About Hereditary Disease Risks
Authors: Kenneth Offit
Journal: JAMA (2004)

Genetic tests for adult-onset disorders, including common forms of cancer, are now commercially available, and tests for genetic polymorphisms that predict drug effects or toxicity after treatment are under development. For each of these circumstances, testing of 1 individual may imply an increased risk to his/her relative. The obligation, if any, to warn family members of the identification of a genetic mutation has generated concerns regarding the conflict between the physician's ethical obligations to respect the privacy of genetic information vs the potential liabilities resulting from the physician's failure to notify at-risk relatives. A duty to warn relatives about risks due to some infectious agents has been assumed by state and local health agencies, and the duty to breach confidentiality to warn of imminent harm has been the subject of case law. In general, the special nature of genetic tests has been viewed as a barrier to physicians' breaching the confidentiality of personal genetic information. However, the failure to warn family members about hereditary disease risks has already resulted in 3 lawsuits against physicians in the United States. While the findings of case law and the state and federal statutes that bear on the issue of "duty to warn" of inherited health risk are still being defined, we believe that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
Increased Plasma Endothelin-1 in Pulmonary Hypertension: Marker or Mediator of Disease?
Authors: D J Stewart, R D Levy, P Cernacek, D Langleben
Journal: Annals of Internal Medicine (1991)

To explore the role of endothelin-1, a potent endothelial-derived vasoconstrictor peptide, in pulmonary hypertension, by measuring its concentration in arterial and venous plasma.A survey, case series study.University-affiliated hospitals and outpatient clinics.Twenty-seven patients with pulmonary hypertension: 7 with primary, and 20 with secondary pulmonary hypertension of various causes. The control groups (n = 16) comprised 8 healthy volunteers and 8 patients with coronary artery disease but without evidence of pulmonary hypertension.Pulmonary artery pressure was markedly increased (94/43 +/- 23/13 mm Hg) in the patients with pulmonary hypertension. Venous plasma immunoreactive endothelin-1, measured by a specific radioimmunoassay, was significantly higher in patients with pulmonary hypertension (3.5 +/- 2.5 pg/mL, P less than 0.001) than in normal subjects (1.45 +/- 0.45 pg/mL), or patients with coronary disease (0.75 +/- 0.64 pg/mL). The arterial-to-venous ratio of immunoreactive endothelin-1 was significantly greater than unity in primary pulmonary hypertension (2.21 +/- 0.72, P = 0.01), whereas the patients with secondary pulmonary hypertension had a mean ratio not different from 1 (0.97 +/- 0.42). In contrast, the mean arterial-to-venous ratios were significantly less than unity in both control groups (0.59 +/- 0.35, and 0.54 +/- 0.64; P less than 0.02, for normal subjects and coronary disease patients, respectively), indicating a possible clearance of endothelin-1 across the healthy lung.Patient with pulmonary hypertension have substantial alterations in plasma immunoreactive endothelin-1, which may reflect changes in net release or clearance of endothelin-1 by the lung. In patients with primary pulmonary hypertension, the high levels in arterial compared with venous plasma suggest pulmonary production of endothelin-1, which may contribute to elevated pulmonary vascular resistance.
Strikingly high false positivity of surveillance FDG‐PET/CT scanning among patients with diffuse large cell lymphoma in the rituximab era
Authors: Irit Avivi, Ariel Zilberlicht, Eldad J. Dann, Ronit Leiba, Tal Faibish, Jacob M. Rowe, Rachel Bar‐Shalom
Journal: American Journal of Hematology (2013)

Predictive value (PV) of surveillance fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with diffuse large B-cell lymphoma (DLBCL) treated with chemotherapy-rituximab (R) versus chemotherapy only, remains unclear. The aim of the current study was to compare the performance of surveillance PET in DLBCL patients receiving CHOP (cyclophosphamide, hydroxydaunorubicin hydrochloride, vincristine, and prednisone) alone versus CHOP-R. Institutional database was retrospectively searched for adults with newly diagnosed DLBCL, receiving CHOP or CHOP-R, who achieved complete remission and underwent surveillance PETs. Follow-up (FU) PET was considered positive for recurrence in case of an uptake unrelated to physiological or known benign process. Results were confirmed by biopsy, imaging and clinical FU. One hundred nineteen patients, 35 receiving CHOP and 84 CHOP-R, who underwent 422 FU-PETs, were analyzed. At a median PET-FU of 3.4 years, 31 patients relapsed (17 vs. 14, respectively; P = 0.02). PET detected all relapses, with no false-negative studies. Specificity and positive PV (PPV) were significantly lower for patients receiving CHOP-R vs. CHOP (84% vs. 87%, P = 0.023; 23% vs. 74%, P < 0.0001), reflecting a higher false-positive (FP) rate in subjects receiving CHOP-R (77% vs. 26%, P < 0.001). In the latter group, FP-rate remained persistently high up to 3 years post-therapy. Multivariate analysis confirmed rituximab to be the most significant predictor for FP-PET. In conclusion, routine surveillance FDG-PET is not recommended in DLBCL treated with rituximab; strict criteria identifying patients in whom FU-PET is beneficial are required.
SCINTIGRAPHIC DETECTION OF COMMON BILE DUCT (CBO) OBSTRUCTION
Authors: G. T. Krishnamurthy, David A. Lieberman, Harindar S. Brar
Journal: Clinical Nuclear Medicine (1984)

The purpose of the study was to critically assess the role of Tc-99m-IDA scintigraphy in 25 patients with either partial (n=14) or complete (n=11) CBD obstruction and to correlate results with the cholangiogram. After a minimum 4 hour fast, each patient received 3 to 8 mCi of Tc-99m-IDA intravenously and the serial hepatobiliary images were obtained at 2 minute intervals for 60 minutes and at 3 and 24 hours when needed. Nine patients with partial CBO obstruction received OP-CCK for quantitative assessment of biliary dynamics. Scintigraphically, the partial CBD obstruction was characterized by either segmental narrowing or intraluminal filling defect (13/14), intrahepatic bile pooling in area and segmental ducts (7/14) and markedly reduced gallbladder ejection fraction (8/9) and ejection rate (6/9). The obstruction was distal in 8, mid to distal in 5 and the level of obstruction correlated well with Rholangiogram. Complete CBD obstruction was characterized by relatively good hepatic uptake but no secretion into bile of Tc-99m-IDA resulting in total non-visualization of entire biliary system (including GB and CBD) and small intestine in 10 of 11 patients. CBD was faintly seen in one patient. Localization could not be made in any with complete CBD obstruction. It is concluded that Tc-99m-IDA scintigraphy is an accurate test for detection of CBD obstruction and localization can be accomplished in partial but not total CBD obstruction. Thus scintigraphy may service as an ideal non-invasive screening test in assessing CBD obstruction.
Symposium on Operating Room Fatalities
Authors: Jay Jacoby
Journal: JAMA (1961)

When a fatality occurs in an operating room, the term cardiac arrest is not diagnostic. A pathologic lesion or physiologic derangement should provide the diagnosis. A case is reported of successful resuscitation without cardiac massage. It is postulated, and animal experiments show, that artificial respiration with high positive pressures of oxygen can cause blood to circulate. The clinical usefulness of this technique remains to be established; standard resuscitation measures should continue to be used.
The Man, His Family and Friends
Authors: James M. Faulkner
Journal: New England Journal of Medicine (1973)

Joseph Garland's life as he described it so delightfully in "A Time for Remembering" began in the setting of a closely knit family in Gloucester, where his father and grandfather were both practicing medicine. As he put it, "Even with three generations freely intermingling I cannot recall any noticeably awkward generation gap in our family, or any sustained emotion other than affection and even reverence."His own marriage with Mira Crowell, a trained nurse, was about as happy a union of kindred souls as could be imagined. Mira accompanied him on his professional travels sharing his interests and the many . . .
The Impact of Endoscopists' Experience and Learning Curves and Interendoscopist Variation on Colonoscopy Completion Rates
Authors: G. Dafnis, F. Granath, L. Påhlman, H. Hannuksela, A. Ekbom, P. Blomqvist
Journal: Endoscopy (2001)

Background and Study Aims: Since its introduction in the late 1960s, the technology of colonoscopy has developed rapidly and the competence of endoscopists has increased. Nevertheless, it is not always possible to perform a complete colonoscopy. The aim of this study was to assess, in a population-based setting, the endoscopist-related factors influencing the completion rate, taking into account patient characteristics and changes in the technology over time.
No resistance to tenofovir disoproxil fumarate detected after up to 144 weeks of therapy in patients monoinfected with chronic hepatitis B virus
Authors: Andrea Snow-Lampart, Brandi Chappell, Maria Curtis, Yuao Zhu, Florence Myrick, James Schawalder, Kathryn Kitrinos, Evguenia S. Svarovskaia, Michael D. Miller, Jeff Sorbel, Jenny Heathcote, Patrick Marcellin, Katyna Borroto-Esoda
Journal: Hepatology (2010)

Abstract Tenofovir disoproxil fumarate (TDF) is a nucleotide analogue with potent activity against human immunodeficiency virus type 1 and hepatitis B virus (HBV). To date, no reports of HBV clinical resistance to TDF have been confirmed. In two phase 3 studies (GS-US-174-0102 and GS-US-174-0103), 375 hepatitis B e antigen–negative (HBeAg−) patients and 266 HBeAg+ patients with chronic hepatitis B (some nucleoside-naive and some lamivudine-experienced) were randomized 2:1 to receive TDF (n = 426) or adefovir dipivoxil (ADV; n = 215) for 48 weeks. After week 48, eligible patients received open-label TDF with no interruption. The studies are being continued through week 384/year 8; week 144 data are presented here. Per protocol, viremic patients (HBV DNA level ≥ 400 copies/mL or 69 IU/mL) had the option of adding emtricitabine (FTC) at or after week 72. Resistance analyses of HBV polymerase/reverse transcriptase (pol/RT) were based on population dideoxy sequencing. Phenotypic analyses were conducted in HepG2 cells with recombinant HBV derived from patient serum. Most patients maintained TDF monotherapy treatment across both studies (607/641, 95%). A resistance analysis of HBV pol/RT was performed at the baseline for all patients, for viremic patients at week 144 or at the last time when they were on TDF monotherapy (34 on TDF and 19 on ADV-TDF), and for patients who remained viremic after the addition of FTC (7/20 on TDF and 5/14 on ADV-TDF). No patient developed amino acid substitutions associated with resistance to TDF. Virological breakthrough on TDF monotherapy was infrequent over 144 weeks (13/426, 3%) and was attributed to documented nonadherence in most cases (11/13, 85%). Persistent viremia (≥400 copies/mL) through week 144 was rare (5/641, 0.8%) and was not associated with virological resistance to TDF by population or clonal analyses. Conclusion: No nucleoside-naive or nucleoside-experienced patient developed HBV pol/RT mutations associated with TDF resistance after up to 144 weeks of exposure to TDF monotherapy. (HEPATOLOGY 2010)
PDR Drug Interactions and Side Effects Diskettes
Authors: Daniel Levinson
Journal: JAMA (1991)

Medications are the cornerstone of specific therapy in most clinical practices.<i>PDR Drug Interactions and Side Effects Diskettes</i>provides the experienced clinician a pharmacologic utility of exceptional usefulness. As the title implies, the program identifies potential drug-drug (and drug-food) interactions. As many as 20 medications and 10 foods can be evaluated at one time. When a medication poses a risk, the program will suggest alternatives. In addition to evaluating multidrug regimens, the program lists side effects for any one medication: the user can retrieve all side effects associated with a particular drug or can limit the listing to those with an incidence of 3% or greater. Additional features are a comprehensive list of symptoms to aid in the diagnosis of medication-related conditions and an "Indications" feature—enter a diagnosis, and the program will suggest appropriate medications. Particularly useful is the program's "Patient Records" feature, which stores medication profiles for as many