tbuckley/cabot-search huggingface dataset:
Intracisternal cyclodextrin prevents cerebellar dysfunction and Purkinje cell death in feline Niemann-Pick type C1 disease
Authors: Charles H. Vite, Jessica H. Bagel, Gary P. Swain, Maria Prociuk, Tracey U. Sikora, Veronika M. Stein, Patricia O’Donnell, Therese Ruane, Sarah Ward, Alexandra Crooks, Su Li, Elizabeth Mauldin, Susan Stellar, Marc De Meulder, Mark L. Kao, Daniel S. Ory, Cristin Davidson, Marie T. Vanier, Steven U. Walkley
Journal: Science Translational Medicine (2015)

Intracisternal injection of cyclodextrin into cats with Niemann-Pick type C1 disease results in Purkinje cell survival and normal neurological function, suggesting its usefulness for treating the human disease.
Breast Abscess as a Threat to Surgical Units in a General Hospital
Authors: J. G. P. Hutchison
Journal: BMJ (1959)

urine, observed by Cohen et al. (1957).But the simple mechanical effect of tubular blockage is obviously not ruled out, and the solution of the problem must await further observation on similar cases, if possible with renal biopsy at the height of the hypercalcaemia.The reason for the mental confusion and the E.E.G. changes is not clear.Mental changes, in the shape of confusion and hallucinations, have been occasionally described in hypercalcaemic states, but they are decidedly uncommon.Fitz and Hallman (1952) have given a particularly clear description of two cases of hyperparathyroidism in which mental abnormalities were present.Mental changes are common, however, in the combination of alkalosis and hypercalcaemia which may complicate the medical treatment of peptic ulcer (Wenger, Kirsner, and Palmer, 1957).Alkalosis alone causes no mental change (van Goidsenhoven, Gray, Price, and Sanderson, 1954).The present patient, besides hypercalcaemia, had a mild alkalosis, and it is possible that it is the combination of these two factors which is capable of causing mental abnormalities.Summary A case of carcinoma of the breast with secondary deposits in bone, in which the condition was made worse by testosterone therapy, is described.Hypercalcaemia, mental confusion, and uraemia developed; the abnor- malities of renal function were studied in some detail.I am grateful to Sir Arthur Porritt for
Acidic polyamino acids inhibit human eosinophil granule major basic protein toxicity. Evidence of a functional role for ProMBP.
Authors: R L Barker, R H Gundel, G J Gleich, J L Checkel, D A Loegering, L R Pease, K J Hamann
Journal: Journal of Clinical Investigation (1991)

Eosinophil granule major basic protein (MBP), a potent toxin for helminths and mammalian cells in vitro, is a single polypeptide chain rich in arginine. MBP has been localized on damaged helminths and tissues in hypersensitivity diseases including bronchial asthma. The MBP cDNA indicates that MBP is translated as a slightly acidic preproprotein with an acidic propart. To test the hypothesis that the acidic pro-part of proMBP inhibits the toxicity of mature MBP, acidic polyamino acids (aa) were used as antagonists of MBP toxicity to K562 cells and guinea pig tracheal epithelium and used as antagonists of MBP airway hyperresponsiveness in primates. The acidic poly aa inhibited MBP toxicity and MBP airway hyperresposiveness. The acidic poly aa inhibited MBP toxicity in a charge-dependent manner similar to that proposed for proMBP, suggesting that the acidic pro-part of proMBP functions to mask mature MBP toxicity. This inhibition was not limited to MBP, but also applied to polyarginine and eosinophil cationic protein. These acidic poly aa may be useful to inhibit the actions of a number of cationic toxins released by the eosinophil in numerous hypersensitivity diseases.
A-V Nodal Reentrance
Authors: KENNETH M. ROSEN
Journal: Circulation (1973)

Electrophysiologic studies were performed in a patient with type B preexcitation and recurrent paroxysmal supraventricular tachycardia (PSVT). Atrial pacing at rates of 80/min and faster produced QRS normalization suggesting failure of the anomalous pathway. At a paced rate of 120/min, Wenckebach periods proximal to the His bundle as well as episodes of PSVT were noted. These episodes all occurred when a critical P-H interval of 300 msec was achieved. PSVT was also induced by coupled atrial pacing. At coupling intervals of 800-530 msec, anomalous pathway conduction was intact. At coupling intervals of 520 msec or shorter, QRS normalization occurred. At intervals of 480-280 msec, PSVT was induced. The P-H interval of the coupled beat inducing PSVT was always between 300 and 350 msec. Intraatrial recording revealed atrial echoes following each QRS of the PSVT. In summary, critical A-V nodal delay appeared necessary for induction of PSVT. This delay was achieved either by coupled pacing or during pacing-induced Wenckebach periods. The PSVT occurred at rates at which the anomalous pathway would seem to be inoperative. These findings strongly support A-V nodal reentry as the mechanism of PSVT in this patient without participation of the anomalous pathway. In this patient and other patients with similar fiindngs, surgical ablation of the anomalous pathway would probably not be useful in prevention of recurrent PSVT.
Screening for Kidney Disease in Adults With Diabetes
Authors: Holly Kramer, Mark E. Molitch
Journal: Diabetes Care (2005)

Screening programs are generally aimed at conditions with a substantial public health impact and which benefit from early interventions. Chronic kidney disease (CKD), especially CKD attributed to diabetes, certainly fits this criterion. Diabetes remains the leading cause of end-stage renal disease (ESRD) in most countries in the world, accounting for 40–50% of incident ESRD cases (1–4). Due to the epidemic of diabetes secondary to obesity and the aging of the population, rates of kidney disease secondary to diabetes are on the rise. Within the past 2 decades, the incidence of ESRD secondary to diabetes in the U.S. has doubled while the prevalence of CKD among general Medicare patients diagnosed with both diabetes and hypertension has increased fourfold (1). Annual expenditures are highest for patients with ESRD secondary to diabetes compared with all other primary ESRD diagnoses (1). Thus, the epidemic of diabetes will certainly drive up health care costs for ESRD, which in the U.S. are projected to exceed $28 billion by 2010 (5). To prevent ESRD in individuals with diabetes, we must first do an adequate job of screening and detecting CKD. Unfortunately, the enormous burden of CKD remains undetected among adults with diabetes.

The early detection of CKD among patients with diabetes has primarily involved the measurement of urinary albumin excretion. A timed urine collection confirmed on at least two of three occasions over a 6-month period was the initial method of screening. The acceptance of the use of the albumin (in milligrams)-to-creatinine (in grams) ratio measured in a random urine specimen has greatly expanded screening efforts due to the test’s convenience for both patients and physicians. Persistently increased levels of urine albumin excretion ≥30–299 mg/24 h or spot urine albumin-to-creatinine ratios ≥30–299 mg/g indicate the presence of microalbuminuria while urine albumin excretion levels higher than …
Impact of Concomitant Administration of Mometasone Furoate and Oxymetazoline Nasal Sprays vs Either Drug Alone or Placebo on Quality of Life in Patients with Seasonal Allergic Rhinitis
Authors: G. Gross, E.O. Meltzer, D. Gates, T. Shekar, A. Teper
Journal: Journal of Allergy and Clinical Immunology (2010)
Tribulations and Rewards of Academic Medicine — Where Does Teaching Fit?
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1996)

For decades, teaching has been the Cinderella of academic medicine. As a stepchild, it has garnered little respect in comparison with that accorded its sister tasks of research and patient care. In recent years, as full-time academic physicians have been given a fourth major responsibility — namely, the management of resources by more direct and intensive involvement in patient care — teaching duties have not accumulated much more esteem.New pressures are adding to the burdens of full-time faculty members. They are asked to teach far from the hospital wards in less convenient settings and to develop and teach courses . . .
Understanding confidence intervals
Authors: P. Sedgwick
Journal: BMJ (2014)

Researchers investigated the effects of controlled cord traction in the third stage of labour on postpartum haemorrhage when carried out in a high resource setting. A randomised controlled trial study design was used. Control treatment was standard placenta expulsion (awaiting spontaneous placental separation before facilitating expulsion). The setting was university hospital maternity units in France. Participants were women aged 18 or older with a singleton fetus at 35 or more weeks’ gestation and planned vaginal delivery. Women in both treatments groups received prophylactic oxytocin just after birth.1

The primary outcome was postpartum haemorrhage, defined as blood loss of 500 mL or more. Of 2005 women allocated to intervention, 196 (9.8%) experienced postpartum haemorrhage compared with 206 of 2008 allocated to control (10.3%). The reduction in risk of postpartum haemorrhage associated with intervention was not significant (relative risk 0.95; 95% confidence interval 0.79 to 1.15). The researchers concluded that in a high resource setting, the use of controlled cord traction for the management of placenta expulsion had no significant effect on the incidence of postpartum haemorrhage.

Which of the following statements, if any, are true?

a) The 95% confidence interval represents the inaccuracy of the sample in estimating the population parameter of the relative risk of postpartum haemorrhage.

b) If the sample size of the trial was increased, the width of the 95% confidence would decrease.

c) A 99% confidence interval for the population relative risk would be narrower than the 95% confidence interval presented.

d) It can be inferred that 95% of the intervention group lost between 0.79 and 1.15 times as much blood as the control group.

Statements a and b are true, whereas c and d are false.

The aim of the trial was to investigate the effects of controlled cord traction in the third stage of …
Cerebrovascular Accidents
Authors: Henry Eisenberg, John T. Morrison, Paul Sullivan, Franklin M. Foote
Journal: JAMA (1964)

The Connecticut State Department of Health determined rates of stroke incidence and survival for one year in one county. Five-year survival data were obtained for all patients. Strokes afflicted 191 persons, giving an incidence rate of 2.3/1,000/year (crude) or 1.7/1,000/year (adjusted to the US age distribution). Four persons had an embolism; 28, undetermined type; 68, hemorrhage; and 91, thrombosis. Survival rates for all stroke types were low and dropped most rapidly within the first two weeks. Hemorrhage was more lethal than thrombosis. There was little difference in survival rate between patients who suffered a first or subsequent stroke. Survival rate decreased with advancing age in men but not in women.
Hospitals, Doctors, and the Public Interest
Authors: David Littauer
Journal: JAMA (1966)

In 1964 the Lowell Institute sponsored a series of lectures at the Massachusetts General Hospital on "The Hospital's Responsibility to the Community." During the same period<i>The New England Journal of Medicine</i>published a series of articles on "The Social and Organizational Aspects of Medical Care." These concurrent explorations into the social, cultural, economic, and organizational aspects of medical and institutional practice are in the long tradition of inquiry that we have come to expect of<i>The New England Journal</i>and the "M.G.H." John H. Knowles, MD, General Director of the Massachusetts General Hospital, has gathered the Lowell Lectures into a provocative and timely volume,<i>Hospitals, Doctors, and the Public Interest</i>. The 15 authors have been drawn principally from the ranks of hospital and medical care administrators and Harvard professors of various medical specialties, who in their own careers have demonstrated the facility to combine practical accomplishment with theoretical conception.
The promise and perils of interpreting genetic associations in Crohn's disease
Authors: T T Trinh
Journal: Gut (2005)

Extended analyses of inflammatory bowel disease susceptibility loci is advisable before definitive conclusions about their causative role can be drawn

Genome wide linkage analysis has been an extremely successful method for mapping rare but highly penetrant genes in monogenic disorders.1 Its applications to common diseases have achieved limited success, however, due to the individually low heritability of each contributing gene.2 Alternatively, association based genetic studies, as described by Risch and Merikangas,3 can be powerful tools for identifying causal genes in common human diseases.1,4 To date, these methods have been used to follow up on linkage regions and to test for candidate genes and therefore have been limited by the previous linkage analyses or by the assumptions made regarding disease pathogenesis. Both of these factors can greatly diminish our ability to detect all possible causal variants contributing to complex disease traits. Over the last decade, however, technology and genetic resources have evolved dramatically. With the completion of the human genome sequence, recent development of high throughput genotyping technologies and knowledge of the patterns of genetic variation, it is now possible to perform genome wide association studies for common human diseases. Such genome wide approaches, although comprehensive, still face the analytical challenges of identifying true causal disease alleles. The prospects of identifying potentially significant associations must therefore be tempered by the perils of inaccurately drawn conclusions. Specifically, the progresses made in this new frontier will rely critically on proper execution and interpretation of genetic studies that are able to: (1) detect true positive from false positives; (2) distinguish causal variation from that which is in linkage disequilibrium (LD) (that is, cosegregation or non-random association of nearby alleles within a population); and (3) explain gene-function, gene-gene, and genotype-phenotype relationships.

The challenges presented by these three goals are nicely …
The Womanly Art of Breastfeeding
Authors: Katherine K. Christoffel
Journal: JAMA (1982)

This is in many ways a splendid book. Among its virtues are ample and well-presented information about the advantages of breast-feeding for mothers and babies and about breastfeeding techniques. Also included are practical hints not well covered elsewhere concerning ways to care for a household and older children while absorbed in nursing a baby. In comparison with the previous edition, this volume has strengthened sections concerning the role of fathers and some topics not directly related to nursing, such as injury prevention, discipline, and infant nutrition after the introduction of solids. The large and varied collection of photographs of women nursing babies is a welcome addition. Despite its considerable strengths, the book's tone is a major weakness, which unfortunately limits its usefulness to many mothers. The La Leche League International (LLLI) has evolved what is almost a subcultural life-style in which family organization and relations center around breast-feeding and the
Implementation of a Hospitalist System in a Large Health Maintenance Organization: The Kaiser Permanente Experience
Authors: Diane E. Craig
Journal: Annals of Internal Medicine (1999)

This paper presents preliminary quality and utilization data from a hospitalist system that is being implemented at Kaiser Permanente, a large health maintenance organization with 16 hospitals in northern California. Hospitalist programs, which are staffed by clinicians highly skilled in caring for inpatients, are being launched with the aim of delivering high-quality, efficient medical care in an increasingly competitive health care delivery environment. This paper also describes, in some detail, the process of implementation at one hospital. Challenges to implementation included 1) overcoming the reluctance of clinic physicians to relinquish inpatient care responsibilities, 2) developing sustainable work schedules, 3) creating effective channels of communication between staff in inpatient and outpatient settings, and 4) designing appropriate compensation scales for hospitalists. Mean length of stay, patient-day rates, admission rates, consultation request rates, costs, and readmission rates were examined for patients discharged from adult medicine services at all 16 hospitals between 1 January 1994 and 30 June 1997. These preliminary resource utilization data seem promising, but further analysis is needed to assess how hospitalist programs may affect clinical quality of care, costs, and patient and provider satisfaction.
In vitro evaluation of the role of antibodies against Helicobacter pylori in inhibiting adherence of the organism to gastric cells.
Authors: M Clyne, J Thomas, L Weaver, B Drumm
Journal: Gut (1997)

BACKGROUND: Once Helicobacter pylori infection is established, it is difficult to eradicate despite a persistent systemic and local immune response. It is not known whether immunisation can be used to prevent H pylori infection in humans. AIMS: To evaluate the effect of the human immune response on adherence of H pylori to gastric cells. METHODS: Human milk from a woman infected with H pylori and milk from a non-infected woman were each fractionated by chromatography on DEAE cellulose. Bacteria were incubated with either serum, human milk, human milk fractions, or secretory IgA before incubation with Kato III cells (cells from a gastric adenocarcinoma cell line). Bacterial adherence to the cells was assessed using flow cytometry. RESULTS: Serum from both the H pylori infected and non-infected women killed H pylori. This resulted from the action of complement as heating the serum to 56 degrees C for 30 minutes abolished the bactericidal activity. Immunoglobulin fractions from serum of both infected and non-infected women did not inhibit H pylori adherence to Kato III cells. Human milk from the woman infected with H pylori and from the non-infected woman inhibited binding of H pylori to Kato III cells by 50 to 70%. Secretory IgA isolated from human milk had minimal inhibitory effect on adherence and this was notably less than the inhibitory effect of whole human milk. CONCLUSIONS: Human milk inhibits adherence of H pylori to Kato III cells and this inhibition is independent of whether or not the donor is infected with H pylori. Secretory IgA has minimal inhibitory effect on H pylori adherence.
Antibiotic Activity in Surgical Incisions
Authors: Jere W. Lord
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The BRIEF REPORT by Polk and co-workers (1980;244:1353) concludes that minimum inhibitory concentration in wound samples following preoperatively administered antibiotics is achieved with intravenous cefazolin sodium and intramuscular cephaloridine but is not maintained beyond one hour with intravenous cephalothin. Polk and Lopez-Mayor<sup>1</sup>earlier demonstrated that preoperatively administered antibiotics in selected patients reduce the incidence of postoperative wound infection, especially after procedures on the gastrointestinal tract. Stone et al<sup>2</sup>confirmed the value of intravenous cefazolin administered preoperatively and demonstrated its lack of effect when initiated postoperatively. They also found that the average concentration in the wound was in the order of 12 μg/mL. In the<i>JAMA</i>report, wound samples at the time of fascial closure approximated 10 μg/mL for cephaloridine over a period of three hours and somewhat higher levels for cefazolin. I have for 11 years employed intraoperative antibiotic lavage. From 1969 to 1971 neomycin
Subclinical Regional Myocardial Dysfunction Assessed by Two-Dimensional Speckle Tracking Echocardiography in Systemic Sclerosis Patients with Fragmented QRS Complexes
Authors: Murat Sunbul, Kursat Tigen, Gulsen Ozen, Erdal Durmus, Tarik Kivrak, Altug Cincin, Beste Ozben, Halil Atas, Haner Direskeneli, Yelda Basaran
Journal: Journal of the American College of Cardiology (2013)
The association of HBV core promoter double mutations (A1762T and G1764A) with viral load differs between HBeAg positive and anti-HBe positive individuals: A longitudinal analysis
Authors: Zhong-Liao Fang, Caroline A Sabin, Bai-Qing Dong, Shao-Chao Wei, Qin-Yan Chen, Kong-Xiong Fang, Jin-Ye Yang, Xue-Yan Wang, Tim J. Harrison
Journal: Journal of Hepatology (2008)

Although there have been a few reports regarding the effect of basal core promoter (BCP) double mutations (A1762T and G1764A) on hepatitis B viral loads, the association remains uncertain. We aim to determine the association after controlling for HBeAg - a strong confounding factor.We selected randomly 190 individuals from a Chinese cohort of 2258 subjects for cross-sectional analysis and 56 of the 190 for longitudinal analysis of viral loads.In multivariable analysis of the cross-sectional data, BCP double mutations are significantly associated with lower viral loads in HBeAg positive subjects but no difference was found in anti-HBe positive subjects. Triple mutations at nucleotide (nt) 1753, 1762 and 1764 and mutations between nt 1809 and 1817, precore stop mutation (nt 1896) and genotype are not associated with viral loads in either HBeAg or anti-HBe positive subjects. Analysis of the longitudinal data yielded similar results to the cross-sectional data. Viral loads differ significantly between individuals infected with wild-type and BCP double mutations prior to HBeAg seroconversion but this difference is lost after seroconversion.BCP double mutations are associated with lower viral loads in HBeAg positive individuals but have no effect on the viral loads of anti-HBe positive individuals.
TUBERCULOSIS OF THE MALE GENITAL ORGANS.
Authors: NICHOLAS SENN
Journal: JAMA (1896)

The male genital organs are the seat of as yet imperfectly understood conditions which predispose them to tubercular infection. The literature on tuberculosis of these organs is scanty as compared with tubercular affections of other organs, such as the lungs, pleurae, peritoneum, lymphatic glands, bones, joints, meninges and skin. A careful search of what has been written on tuberculosis of the male genital organs will convince the searcher for truth and instruction that this subject has not received the attention its importance demands. The observations of many clinicians in this comparatively new field of surgical pathology present no uniform and many times diametrically opposite results. The deductions drawn in the postmortem room by professional pathologists likewise lack uniformity, and the different results obtained have often been taken as a basis to fortify the opinion of individual surgeons. This department of surgical tuberculosis is in its primitive stage and offers many
Aneurysm of the Distal Popliteal Artery and Its Relationship to the Arcuate Popliteal Ligament
Authors: STAFFORD W. GEDGE, JOHN A. SPITTEL, JOHN C. IVINS
Journal: Circulation (1961)

Two cases presenting complications of popliteal aneurysm requiring amputation have been presented. Dissection of these limbs showed proximal popliteal aneurysms located immediately beyond the adductor magnus tendinous hiatus and, in addition, distal popliteal aneurysms immediately below the arcuate popliteal ligament. Another case is described in which bilateral popliteal aneurysms were located in the distal popliteal artery—that is, immediately below the arcuate popliteal ligament. These findings support the concept that post-stenotic dilation may be one of the causal factors in the pathogenesis not only of proximal but also of distal popliteal aneurysms.