tbuckley/cabot-search huggingface dataset:
Pravastatin increases survival and suppresses an increase in myocardial matrix metalloproteinase activity in a rat model of heart failure
Authors: S ICHIHARA, A NODA, K NAGATA, K OBATA, J XU, G ICHIHARA, S OIKAWA, S KAWANISHI, Y YAMADA, M YOKOTA
Journal: Cardiovascular Research (2005)

Oxidative stress is implicated in the pathogenesis of heart failure and affects the activity of matrix metalloproteinases (MMPs). We have now investigated the role of MMPs and their tissue inhibitors (TIMPs) in the transition from compensated left ventricular (LV) hypertrophy to heart failure as well as the effects of pravastatin on this transition in a rat model.Dahl salt-sensitive rats were fed a high-salt (8% NaCl) diet and treated with pravastatin (50 or 100 mg/kg per day) or vehicle from 7 weeks of age.Pravastatin did not attenuate LV hypertrophy apparent at 12 or 18 weeks of age. However, the high dose of this drug markedly improved indices of diastolic function (early diastolic myocardial velocity) and systolic function (LV fractional shortening) at 18 weeks of age and increased the survival rate. It also prevented a decrease in the ratio of reduced to oxidized glutathione and an increase in NADPH oxidase activity in the left ventricle induced by the high-salt diet. The activities of MMP2 and MMP9 and the abundance of TIMP1 and TIMP2 in LV tissue were increased at 18 weeks of age, and pravastatin also prevented these changes.Although pravastatin did not attenuate LV hypertrophy, it prevented the transition from compensated hypertrophy to heart failure in this rat model. This effect of pravastatin may result from a reduction both in the level of oxidative stress and in MMP activity in the heart.
Optimization of Evening Insulin Dose in Patients Using the Short-Acting Insulin Analog Lispro
Authors: Abu Baker E Ahmed, John Mallias, Philip D Home
Journal: Diabetes Care (1998)

OBJECTIVE A three-way, crossover, open-label, randomized study was designed to compare the evening and night (1800–0800) glycemic control when the evening premeal lispro dose was reduced by 20% and the bedtime basal NPH dose increased by 25%, or when the basal NPH dose was moved to before dinner at 1800, compared with the control arm on standard premeal human regular insulin and pre-bedtime NPH insulin. RESEARCH DESIGN AND METHODS A total of 13 type 1 diabetic patients who use a premeal plus basal insulin regimen were studied on three separate days, with identical meals and snacks at the same times on each study day. On the control study day, patients received human regular insulin before dinner and NPH at bedtime in their usual doses. On another day, lispro was given before dinner with a dose reduction of 20%, and NPH at bedtime at 125% of usual dose. In the third regimen, the lispro and NPH were administered together in their usual dose before the evening meal by separate injections. The three regimens were tested in random order. RESULTS Postprandial (1800–2200) blood glucose concentrations were lower after reduced-dose lispro compared with human regular insulin (6.0 ± 0.3 [SEM] vs. 7.4 ± 0.3 mmol/1, P &amp;lt; 0.05). Nighttime (2400–0400) blood glucose concentrations were not different (8.6 ± 0.3 vs. 9.2 ± 0.3 mmol/1, NS), and prebreakfast concentrations were also unchanged (7.7 ± 0.9 vs. 8.7 ± 0.8 mmol/1) after lispro with increased-dose NPH compared with standard insulin. By contrast, both nighttime (10.0 ± 0.3 mmol/1, P &amp;lt; 0.05) and fasting glucose concentrations (10.8 ± 0.6 mmol/1, P &amp;lt; 0.05) were significantly higher with dinnertime usual-dose lispro plus dinnertime usual-dose NPH compared with standard human insulin. Hypoglycemia at night (blood glucose &amp;lt;3.0 mmol/1) did not differ between study days, but it was more frequent postprandially after dinner usual-dose lispro plus early NPH (2 vs. 7 patients, P = 0.062). CONCLUSIONS With lower mealtime and higher basal bedtime insulin doses, patients using insulin lispro may be able to gain an overall improvement in evening blood glucose control without deteriorated nighttime glucose levels. Earlier basal NPH dosage alone does not ameliorate the nighttime hyperglycemia of short-acting insulin analog regimens.
Gossypiboma in a man with persistent cough
Authors: M J Rijken
Journal: Thorax (2005)

Gossypiboma in a man with persistent cough A 68 year old man was referred with a persistent productive cough but no haemoptysis.He did not complain of weight loss or fever and denied tobacco use or recent travel.An open lung biopsy had been performed at another hospital 8 years previously to confirm the diagnosis of tuberculosis; treatment was started but cultures remained negative.Chest radiographs revealed a ball in a 5 cm large thin walled cavity in the right lower lobe (fig 1).When the patient was asked to bend forward the ball moved.A CT scan of the chest confirmed the radiographic findings (fig 2).Sputum examinations were negative for tuberculosis and bacteria.Precipitins against aspergillus were positive, but IgE aspergillus was negative although total IgE was slightly raised to 276 (normal range 150).The patient was admitted for surgical removal of an aspergilloma, but surgical exploration revealed a well encapsulated surgical sponge in the right lower lobe.The postoperative course was satisfactory and the patient was discharged 2 weeks after surgery.Pathological examination showed the surgical sponge in a cavity covered with squamous cells.No granulomas or echinococcal cysts were found.To our knowledge only a few cases of thoracotomy for aspergilloma that revealed a gossypiboma (masses of retained cotton materials) have been reported. 1 2Intrathoracic gossy- pibomas may also produce chest masses that radiologically resemble echinococcal cyst disease, intrapulmonary abscess, or malignant disease.
Anne Cecilia Metten
Authors: Lesley Baker
Journal: BMJ (2006)

​FormerFormer general practitioner Eastwood (b 1932; q Sheffield 1956; DCH), died from pancreatic carcinoma on 26 July 2005.



Figure 1



After qualifying Anne spent 10 years working in hospitals, her main interest being paediatrics, and she worked at Great Ormond Street, in Edinburgh and Inverness, and at Derby Children's Hospital. In 1966 she became a partner in Eastwood, then senior partner until she retired in 1994. Anne found recent changes and attitudes in general practice difficult. Her faith in the medical and nursing profession was restored by her care from the oncology department and the nursing team who looked after her at home, where she died.
Murder of nine polio workers in Nigeria threatens eradication efforts
Authors: S. Arie
Journal: BMJ (2013)

At least nine polio immunisation workers have been shot dead in Nigeria, sparking concern that violent Islamist resistance to vaccination programmes is increasingly threatening efforts to eradicate the disease.

The health workers, all thought to have been women, were killed at two different health centres in the predominantly Muslim Kano region of northern Nigeria. Most were found with bullet wounds in the back of the head, according to local reports. Several others were injured, and one told journalists the attackers tried to lock her and others inside a building and burn them alive.

The attack, on 8 …
A pathophysiological interpretation of unresponsiveness to spironolactone in a stepped-care approach to the diuretic treatment of ascites in nonazotemic cirrhotic patients
Authors: Angelo Gatta, Paolo Angeli, Lorenza Caregaro, Francesca Menon, David Sacerdoti, Carlo Merkel
Journal: Hepatology (1991)

It has been hypothesized that the magnitude of proximal sodium reabsorption affects the response to aldosterone antagonists in nonazotemic cirrhotic patients with ascites. To verify this hypothesis, we evaluated intrarenal sodium handling by lithium clearance in 51 nonazotemic ascitic cirrhotic patients and in 23 controls who were maintained on the same low-sodium diet (80 mmol/day). Seven of 51 cirrhotic patients underwent spontaneous diuresis, whereas 44 required diuretic treatment. Treatment was started with spironolactone at a dose of 150 mg once daily. The dose was increased to 300 mg and then to 500 mg once daily if no response ensued. Cirrhotic patients who did not experience ascites mobilization with 500 mg spironolactone were then treated with a combined diuretic regimen that included spironolactone at a fixed dose (500 mg once daily) and furosemide at an initial dose of 50 mg once daily. The dose was increased to 100, 150 and 200 mg once daily if no response was noticed. Response to diuretic treatment was defined as body weight loss greater than 700 gm every 3 days until ascites became clinically undetectable. Nonresponders (43%) to spironolactone showed lower sodium fractional excretion (0.34% +/- 0.28% vs. 0.80% +/- 0.50%; p less than 0.001) because of a lower fractional sodium delivery to the distal tubule (18.2% +/- 5.8% vs. 23.4% +/- 7.2%; p less than 0.025) than responders.(ABSTRACT TRUNCATED AT 250 WORDS)
Serum steroid sulphates in ichthyosis
Authors: A. RUOKONEN, A. OIKARINEN, R. PALATSI, I. HUHTANIEMI
Journal: British Journal of Dermatology (1980)

Journal Article Serum steroid sulphates in ichthyosis Get access A. RUOKONEN, A. RUOKONEN Department of Clinical Chemistry, University of Oulu, SF‐90220 Oulu 22, Finland Search for other works by this author on: Oxford Academic Google Scholar A. OIKARINEN, A. OIKARINEN Department of Dermatology, University of Oulu, SF‐90220 Oulu 22, Finland Search for other works by this author on: Oxford Academic Google Scholar R. PALATSI, R. PALATSI Department of Dermatology, University of Oulu, SF‐90220 Oulu 22, Finland Search for other works by this author on: Oxford Academic Google Scholar I. HUHTANIEMI I. HUHTANIEMI Department of Clinical Chemistry, University of Oulu, SF‐90220 Oulu 22, Finland Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 103, Issue 3, 1 September 1980, Pages 245–248, https://doi.org/10.1111/j.1365-2133.1980.tb07240.x Published: 01 September 1980
Doctor who injected her sister with unlicensed drug is struck off register
Authors: C. Dyer
Journal: BMJ (2011)

A doctor who injected her sister with an unlicensed drug that caused her to have an anaphylactic reaction and die has been struck off the UK medical register.

Yvonne Pambakian, medical director of a biotechnology company, also injected her mother and a terminally ill cancer patient with the drug, known as B-71. Her mother, Arpi Matossian-Rogers, had set up Amro Biotech and developed the drug, which was intended to reduce insulin concentrations.

B-71 had been tested on just 41 diabetic patients in the Netherlands, at a dose of 2 mg, when Dr Pambakian gave her sister …
The Science of Health Care Reform
Authors: Robert H. Brook
Journal: JAMA (2009)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Development of a Program to Train Physician Extenders to Perform Transnasal Esophagoscopy and Screen for Barrett's Esophagus
Authors: Bronia Alashkar, Ashley L. Faulx, Ashley Hepner, Richard Pulice, Srikrishna Vemana, Katarina B. Greer, Gerard A. Isenberg, Yngve Falck–Ytter, Amitabh Chak
Journal: Clinical Gastroenterology and Hepatology (2013)
Best laid plans
Authors: Petra M Boynton
Journal: BMJ (2004)

My grandmother, Nina Mary Hannaford, recently died after a long, productive, and inspirational life. A highly organised woman, she prepared for her death with detailed instructions for her funeral. She specified that she would prefer charitable donations rather than flowers, but that if flowers were to be sent these should be in bouquet form so they could easily be distributed to local care homes and hospices for others to enjoy.

Many beautiful floral …
Headache, migraine, and structural brain lesions and function: population based Epidemiology of Vascular Ageing-MRI study
Authors: T. Kurth, S. Mohamed, P. Maillard, Y.-C. Zhu, H. Chabriat, B. Mazoyer, M.-G. Bousser, C. Dufouil, C. Tzourio
Journal: BMJ (2011)

To evaluate the association of overall and specific headaches with volume of white matter hyperintensities, brain infarcts, and cognition.Population based, cross sectional study.Epidemiology of Vascular Ageing study, Nantes, France.780 participants (mean age 69, 58.5% women) with detailed headache assessment.Brain scans were evaluated for volume of white matter hyperintensities (by fully automated imaging processing) and for classification of infarcts (by visual reading with a standardised assessment grid). Cognitive function was assessed by a battery of tests including the mini-mental state examination.163 (20.9%) participants reported a history of severe headache and 116 had migraine, of whom 17 (14.7%) reported aura symptoms. An association was found between any history of severe headache and increasing volume of white matter hyperintensities. The adjusted odds ratio of being in the highest third for total volume of white matter hyperintensities was 2.0 (95% confidence interval 1.3 to 3.1, P for trend 0.002) for participants with any history of severe headache when compared with participants without severe headache being in the lowest third. The association pattern was similar for all headache types. Migraine with aura was the only headache type strongly associated with volume of deep white matter hyperintensities (highest third odds ratio 12.4, 1.6 to 99.4, P for trend 0.005) and with brain infarcts (3.4, 1.2 to 9.3). The location of infarcts was predominantly outside the cerebellum and brain stem. Evidence was lacking for cognitive impairment for any headache type with or without brain lesions.In this population based study, any history of severe headache was associated with an increased volume of white matter hyperintensities. Migraine with aura was the only headache type associated with brain infarcts. Evidence that headache of any type by itself or in combination with brain lesions was associated with cognitive impairment was lacking.
Alcohol and response to treatment of gout
Authors: S. H Ralston, H. A Capell, R. D Sturrock
Journal: BMJ (1988)

abnormality.Histological, microbiological, and chemical pathological examination yielded unremarkable results, and the sudden infant death syndrome was diagnosed by exclusion.A few months later at a confidential survey of postperinatal mortality we were informed of the high rectal temperature and the fact that the child had slept in a carry cot placed on an uncarpeted floor equipped with off peak heating controlled with a time switch.As one of us (MAG) had experience of severe burns sustained by adults lying unconscious on uncarpeted floors with underfloor heating we decided to determine the ambient temperatures reached in a carry cot placed on such a floor.In a maisonette equipped with similar underfloor heating the thermostat was set at 16°C, and temperature was measured with a pen recorder continuously for four days.The recorder was placed in the cot and covered with two blankets as the child had been, though the child had also been wearing a vest, a nappy, and a babysuit.The lowest temperature recorded under the blankets in the carry cot was 31°C at noon, when the heating had been off for several hours.Peak temperatures of 42°C were reached when the heating was on, and temperatures ranged from 34°C to 38°C for several hours at a time.Temperatures where the cot base touched the floor reached a maximum of 44°C and were often above 40°C. CommentThese findings suggest that placing a carry cot directly on a heated floor is dangerous.We can find no studies or reports of similar accidents.The hazards of placing carry cots directly on floors with underfloor heating should be more widely known.This type of heating is common in council properties throughout the United Kingdom.We thank Her Majesty's coroner for West Yorkshire for permission to report the case.
Chronic Dizziness in Older Adults
Authors: Athanasios Katsarkas
Journal: Annals of Internal Medicine (2000)

Letters1 August 2000Chronic Dizziness in Older AdultsAthanasios Katsarkas, MSc, MD, FRCSAthanasios Katsarkas, MSc, MD, FRCSMcGill University Health Centre; Montreal, Quebec H3A 1A1, Canada (Katsarkas)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-3-200008010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Using a mailed questionnaire and statistical analysis, Tinetti and colleagues (1) “discovered” a syndrome called “geriatric dizziness.” They also imply that authors (2) who attributed dizziness to one disease process in elderly patients may have been wrong.A vestibular dysfunction may be compensated more slowly and a vascular episode or postural hypotension may be more of a problem in elderly patients than in young adults. These differences, however, do not constitute a new syndrome and do not change the fact that a condition may have been induced by one pathophysiologic process or many disorders occurring simultaneously.It ...References1. Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000;132:337-44. LinkGoogle Scholar2. Katsarkas A. Dizziness in aging: a retrospective study of 1194 cases. Otolaryngol Head Neck Surg. 1994;110:296-301. CrossrefMedlineGoogle Scholar3. Katsarkas A. Dizziness and vertigo.. In: Conn R, Borer W, Snyder J, eds. Current Diagnosis 9. Philadelphia: WB Saunders; 1997:809-13. Google Scholar4. Drachman DA. Occam's razor, geriatric syndromes, and the dizzy patient [Editorial]. Ann Intern Med. 2000;132:403-5. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Athanasios Katsarkas, MSc, MD, FRCSAffiliations: McGill University Health Centre; Montreal, Quebec H3A 1A1, Canada (Katsarkas) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDizziness among Older Adults: A Possible Geriatric Syndrome Mary E. Tinetti , Christianna S. Williams , and Thomas M. Gill Occam's Razor, Geriatric Syndromes, and the Dizzy Patient David A. Drachman Chronic Dizziness in Older Adults Jose S. Cheng Some Considerations regarding Geriatric Syndromes Elizabeth A. Phelan , Elizabeth K. Vig , and Itamar B. Abrass Metrics Cited byPresbivertigem como causa de tontura no idosoSynkope und SchwindelSome Considerations regarding Geriatric SyndromesElizabeth A. Phelan, MD, MS, Elizabeth K. Vig, MD, MPH, and Itamar B. Abrass, MD 1 August 2000Volume 133, Issue 3Page: 236KeywordsAgingElderlyGeriatricsHypotensionQuestionnairesVertigoYoung adults ePublished: 15 August 2000 Issue Published: 1 August 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Phenformin and Hyperamylasemia in Lactic Acidosis
Authors: Lydia A. Conlay, Joseph E. Loewenstein
Journal: Annals of Internal Medicine (1977)

All cases of lactic acidosis occurring during a 23-month period in a metropolitan teaching hospital were reviewed to ascertain the frequency of hyperamylasemia. Serum amylase activity had been measured in 12 of 26 patients and was elevated in eight (67%). Hyperamylasemia was not significantly more frequent in patients with phenformin-associated lactic acidosis than in patients with lactic acidosis who had not received phenformin. Serum amylase activity did not correlate with the severity of acidosis (arterial pH) or with renal function (serum creatinine).
A Comparison of the Duration of Action of Various Long-Acting ACTH Preparations in Human Subjects
Authors: William Q. Wolfson, Stefan S. Fajans
Journal: New England Journal of Medicine (1952)

ONE criterion of the effectiveness of long-acting ACTH preparations is their duration of action. Using a simple technic, we have compared the duration of action of two types of aluminum phosphate adsorbed ACTH preparations (Adactar and Adactar Tannate) with that of certain nonadsorbed ACTH preparations. The residual eosinopenia persisting twenty-four hours after a single dose of 100 USP units of these ACTH preparations has been used as a semiquantitative method of comparing their duration of action. This type of assay may be used only in subjects who are not already receiving ACTH or cortisone. For subjects under such treatment, other . . .
Clare Gerada: "It's like the wild west in healthcare"
Authors: G. Iacobucci
Journal: BMJ (2013)

As the national figurehead for UK general practitioners during a huge period of upheaval, Clare Gerada has barely been out of the news in recent years. Here, as she prepares to move on to new challenges, she gives a typically honest exit interview to <b>Gareth Iacobucci</b>
Gentamicin effects on renal ischemia/reperfusion injury.
Authors: R A Zager
Journal: Circulation Research (1992)

This study assessed gentamicin's effects on ischemia/reperfusion renal injury to better understand when and how it worsens postischemic acute renal failure. Rats were subjected to 25 minutes of renal pedicle occlusion with and without preischemic (15-minute) or postischemic (15-minute or 8-hour) gentamicin treatment (100 mg/kg, by itself a subtoxic dose). Gentamicin's impact on hypoxia/reoxygenation injury to isolated rat proximal tubular segments was also assessed. Preischemic and postischemic gentamicin worsened the severity of acute renal failure to the same degree, suggesting that pretreatment induces its effect in the reperfusion period. Gentamicin paradoxically lessened hypoxic damage to proximal tubular segments (assessed by lactate dehydrogenase release), again implying no adverse impact on oxygen deprivation-induced tubular injury. From 0-4 hours of reperfusion, gentamicin approximately halved ATP/ADP ratios (due to increased ADP), indicating a drug-induced defect in cellular energetics. This abnormality temporally correlated with evolving morphological damage. Although antioxidants (deferoxamine and sodium benzoate) have been reported to protect against pure aminoglycoside nephrotoxicity, they did not mitigate gentamicin's adverse impact on postischemic acute renal failure. Gentamicin did not influence ischemia/immediate reperfusion deacylation/reacylation (assessed by renal free fatty acid content) despite its known antiphospholipase activity. Although in the normal kidney gentamicin preferentially accumulated in cortex, in the postischemic kidney, both cortex and outer medullary stripe developed striking (approximately threefold to fivefold) and comparable gentamicin increments. In conclusion, gentamicin appears to exacerbate postischemic acute renal failure by adversely influencing the reperfusion, not the ischemic injury, process. This may occur because increased gentamicin accumulation negatively impacts on reperfusion cellular energetics.