tbuckley/cabot-search huggingface dataset:
Stool Electrolyte and Osmolality Measurements in the Evaluation of Diarrheal Disorders
Authors: YIH-FU SHIAU
Journal: Annals of Internal Medicine (1985)

Stool osmolality and electrolyte measurements were obtained from 12 patients with diarrheal disorders. Osmolality of diarrheal stool (285 to 330 mosmol) regardless of the cause is less than the reported osmolality of normal stool. Storage of stool at room temperature can artifactually increase stool osmolality as the result of bacterial metabolism. When stool samples are fresh, a negative osmotic gap (measured osmolality - 2 X [Na + K]) is commonly associated with secretory diarrhea, whereas a high osmotic gap (greater than 160 mosmol) is seen in patients with osmotic diarrhea. In many conditions fasting does not resolve diarrhea completely, and when the stool osmotic gap is greater than 50 mosmol, the pathogenesis of diarrhea is difficult to define.
Thromboembolic Disease Associated With Norethynodrel
Authors: Irwin J. Schatz, Roger F. Smith, Gerald M. Breneman, George C. Bower
Journal: JAMA (1964)

In the Henry Ford Hospital during a 14-month period thromboembolic d isease occurred in 6 women who had been taking norethynodrel (Enovid). Thrombophlebitis was observed in 3 and pulmonary infarction in 2. An arterial occlusion in 1 patient resulted in the loss of a leg below the knee. Mild diabetes also existed in this patient. Another patient has worn a cast for fracture until 3 weeks prior to admission. Although no local signs of thrombophlebitis were elicited, x-ray of the chest showed a pleural effusion considered typical of pulmonary infarction. During a pregnancy 6 months previously 1 patient may have had a thrombophlebitis. In the other 3 cases no predisposing cause was detected. Although statistical and experimental evidence is lacking, cl inical experience suggests that a possible etologic relationship exists in susceptible individuals.
TRANSPLANTATION IN MASS OF THE KIDNEYS
Authors: Alexis Carrel
Journal: The Journal of Experimental Medicine (1908)

Among so many etiological factors, it is impossible to discriminate which are responsible for the complications which took place in our experiments. An attempt to explain the occurrence of nephritis, cedema or calcification of the arterial system, for instance, will not be made, but the technique of the operations will be modified in order to suppress as much as possible the causes which may originate these secondary changes. The purpose of this article was not to analyze minutely the physiological or pathological character of the functions of transplanted kidneys, but merely to ascertain whether these functions are efficiently reëstablished. It is to be concluded that an animal which has undergone a double nephrectomy and the grafting of both kidneys from another animal can secrete almost normal urine with his new organs, and live in good health at least for a few weeks. This demonstrates that it is possible to reëstablish efficiently the functions of transplanted kidneys.
NHS faces 10bn funding gap by 2014-15, government advisers warn
Authors: N. Hawkes
Journal: BMJ (2010)

Doubts about the ability of the NHS to combine reform and cost saving have been laid bare by the publication of a letter warning of a possible £10bn (€11.6bn; $15.5bn) funding gap.

The letter was sent to Danny Alexander, chief secretary to the Treasury, by the Independent Challenge Group, a 39 strong committee set up in June and comprising leading civil servants plus a few external experts. It was charged with bringing an independent view to the spending review process.

Its sceptical view of NHS reform was written in September, but emerged only this week, in a leak in the Guardian . Among the members of the group is Richard Douglas, finance and chief operating officer of the Department of Health.

The group’s central warning is that the NHS is likely to face “an unpalatable trade off” between a massive increase in NHS funding and a cut in services leading to longer waiting lists.

The arithmetic outlined in the letter is that …
Role of intercellular adhesion molecule-1 and lymphocyte function-associated antigen-1 during nonsuppurative destructive cholangitis in a mouse graft-versus-host disease model
Authors: Charles D. Howell, Jian Li, Weiran Chen
Journal: Hepatology (1999)

Intercellular adhesion molecule–1(ICAM–1) is expressed abnormally on the bile duct epithelium during the course of primary biliary cirrhosis (PBC), but the importance of ICAM–1 and its lymphocyte function–associated antigen–1 (LFA–1) receptor during the course of nonsuppurative destructive cholangitis (NSDC) has not been defined. To address this question, we defined the relationship between ICAM–1 on the intrahepatic bile duct epithelium and the evolution of NSDC lesions in a mouse graft–versus–host disease (GVHD) model. We also determined the effects of anti-ICAM–1 and anti-LFA–1 treatments on NSDC, intrahepatic lymphokine production, and the homing of lymphocytes to the livers of GVHD mice. ICAM–1 was initially detected on the bile duct epithelium and portal vein endothelium on day 7 of GVHD. There was a significant positive correlation between the intensity of ICAM–1 staining and histological bile duct damage ( r = .58, P &lt; .05) between day 3 and 28. Treatment with anti-ICAM–1 (but not anti-LFA–1) decreased both the mean grades of portal inflammation ( P = .003) and NSDC ( P = .002) lesions compared with control immunoglobulin G (IgG) treatments. Combined treatment with anti-ICAM–1 and anti-LFA–1 caused a further decrease in the amount of portal inflammation and bile duct damage compared with anti-ICAM–1, alone ( P = .02). Anti-ICAM–1 treatment also decreased both the percentage of T cells and the production of interleukin–2 (IL–2) and IL–12 in the liver ( P &lt; .01), but had no effect on IL–4, IL–10, and interferon gamma. Neither anti-ICAM–1 nor anti-LFA–1 prevented lymphocytes from homing to the liver. These results indicate that both ICAM–1 and LFA–1 are important to the pathogenesis of NSDC
Gender Difference in the Impact of Type 2 Diabetes on Coronary Heart Disease Risk
Authors: Auni Juutilainen, Saara Kortelainen, Seppo Lehto, Tapani Rönnemaa, Kalevi Pyörälä, Markku Laakso
Journal: Diabetes Care (2004)

OBJECTIVE—To explain the stronger effect of type 2 diabetes on the risk of coronary heart disease (CHD) in women compared with men. RESEARCH DESIGN AND METHODS—The study population consisted of 1,296 nondiabetic subjects and 835 type 2 diabetic subjects aged 45–64 years without cardiovascular disease. The end points were CHD death and a major CHD event (CHD death or nonfatal myocardial infarction). The follow-up time was 13 years. RESULTS—Major CHD event rate per 1,000 person-years was 11.6 in nondiabetic men, 1.8 in nondiabetic women, 36.3 in diabetic men, and 31.6 in diabetic women. The diabetes-related hazard ratio for a major CHD event from the Cox model, adjusted for age and area of residence, was 2.9 (95% CI 2.2–3.9) in men and 14.4 (8.4–24.5) in women, and after further adjustment for cardiovascular risk factors, 2.8 (2.0–3.7) and 9.5 (5.5–16.9), respectively. The burden of conventional risk factors in the presence of diabetes was greater in women than in men at baseline. Prospectively, elevated blood pressure, low HDL cholesterol, and high triglycerides contributed to diabetes-related CHD risk more in women than in men. However, after adjusting for conventional risk factors, a substantial proportion of diabetes-related CHD risk remained unexplained in both genders. CONCLUSIONS—The stronger effect of type 2 diabetes on the risk of CHD in women compared with men was in part explained by a heavier risk factor burden and a greater effect of blood pressure and atherogenic dyslipidemia in diabetic women.
AIDS Commission's Next Report Focuses on Four Critical Issues
Authors: Charles Marwick
Journal: JAMA (1988)

THE PRESIDENTIAL Commission on the Human Immunodeficiency Virus (HIV) Epidemic plans to issue a report next month that addresses key issues. In the meantime, it has issued its first report and sent it to the White House. Essentially, this first report is—as the commission puts it—a road map intended to guide the members' work over the next six months to the end of June, when it will issue still another report-its final one. In his letter transmitting the first interim report, the commission's chair, Admiral (Retired) James D. Watkins, identified four critical issues that, he says, "cry for early resolution." Watkins says the commission will continue to take testimony on these issues (the latest round of public hearings began Dec 10) in the next few weeks. It will form the topic of the further interim report that the commission intends to issue next month. These issues are as follows: (1)
An animal model for studying endoscopic ultrasound changes of early chronic pancreatitis with histologic correlation: a pilot study
Authors: M. Bhutani, I. Ahmed, D. Verma, S. Xiao, D. Brining
Journal: Endoscopy (2009)

Background and study aims: Due to the difficulty in obtaining pancreatic tissue for histology in humans, we developed an animal model for studying endoscopic ultrasound (EUS) changes of early chronic pancreatitis. This report on the animal model describes the serial changes of early chronic pancreatitis by EUS and correlates results with histology.
Reduction of Amphotericin B Nephrotoxicity With Mannitol
Authors: Jeffrey M. Rosch, George J. Pazin, Philip Fireman
Journal: JAMA (1976)

Amphotericin B in combination with mannitol was given to a patient who had mucocutaneous candidiasis and moderate renal insufficiency. Previously, amphotericin B alone had induced an abrupt increase in serum creatinine and urea nitrogen, but when mannitol was given concurrently there was no worsening of renal function. Thus, amphotericin B with mannitol appears to offer a less nephrotoxic but equally candicidal therapeutic regimen in the renal compromised patient requiring parenteral candicidal therapy. (<i>JAMA</i>235:1995-1996, 1976)
Deficiency of phosphofructo-1-kinase/muscle subtype in humans impairs insulin secretion and causes insulin resistance.
Authors: M Ristow, M Vorgerd, M Möhlig, H Schatz, A Pfeiffer
Journal: Journal of Clinical Investigation (1997)

Non-insulin-dependent diabetes mellitus (NIDDM) is caused by peripheral insulin resistance and impaired beta cell function. Phosphofructo-1-kinase (PFK1) is a rate-limiting enzyme in glycolysis, and its muscle subtype (PFK1-M) deficiency leads to the autosomal recessively inherited glycogenosis type VII Tarui's disease. It was evaluated whether PFK1-M deficiency leads to alterations in insulin action or secretion in humans. A core family of four members was evaluated for PFK1-M deficiency by DNA and enzyme-activity analyses. All members underwent oral and intravenous glucose tolerance tests (oGTT and ivGTT) and an insulin-sensitivity test (IST) using octreotide. Enzyme activity determinations in red blood cells showed that the father (46 yr, body mass index [BMI] 22. 4 kg/m2) and older son (19 yr, BMI 17.8 kg/m2) had a homozygous, while the mother (47 yr, BMI 28.4 kg/m2) and younger son (13 yr, BMI 16.5 kg/m2) had a heterozygous PFK1-M deficiency. DNA analyses revealed an exon 5 missense mutation causing missplicing of one allele in all four family members, and an exon 22 frameshift mutation of the other allele of the two homozygously affected individuals. The father showed impaired glucose tolerance, and the mother showed NIDDM. By ivGTT, both parents and the older son had decreased first-phase insulin secretion and a diminished glucose disappearance rate. The IST showed marked insulin resistance in both parents and the older, homozygous son, and moderate resistance in the younger son. PFK1-M deficiency causes impaired insulin secretion in response to glucose, demonstrating its participation in islet glucose metabolism, and peripheral insulin resistance. These combined metabolic sequelae of PFK-1 deficiency identify it as a candidate gene predisposing to NIDDM.
Sensitive in vivo imaging of T cells using a membrane-bound Gaussia princeps luciferase
Authors: Elmer B Santos, Raymond Yeh, James Lee, Yan Nikhamin, Blesida Punzalan, Blesserene Punzalan, Krista La Perle, Steven M Larson, Michel Sadelain, Renier J Brentjens
Journal: Nature Medicine (2009)
Simplified computer-aided diagnosis of acute abdominal pain.
Authors: P D Wilson, J C Horrocks, P J Lyndon, C K Yeung, R E Page, F T De Dombal
Journal: BMJ (1975)

A simplified version of a system for computer-aided diagnosis of acute abdominal pain has been tested by "new" personnel unfamiliar with the previous system. After a two-month learning period the system proved more accurate in its diagnoses than the unaided clinician, and during the first five months of using the system the unaided clinicians9 accuracy rose from 73% to 84%. When computer "feedback" was withdrawn the clinicians9 diagnostic accuracy reverted towards the previous, "unaided" level. These findings further validate the concept of the computer as a potentially valuable diagnostic aid but indicate that a training period and computer feedback are important factors in its 4 use.
Rituximab in patients with recalcitrant autoimmune blistering diseases: experience in a cohort of 22 patients
Authors: D. Tomsitz, R. Stefaniak, M. Worm
Journal: British Journal of Dermatology (2014)

Funding source: none. Conflicts of interest: none declared. Dear Editor, Autoimmune blistering diseases are rare disorders that are defined by autoantibody production targeting different skin structures. The primary treatment options are systemic steroids in combination with immunosuppressive agents.1 2 Although therapy regimens for autoimmune blistering diseases are well established, recalcitrant disease is a possible complication, which could lead to serious impairment or even death. Rituximab, a monoclonal antibody directed against the CD20 antigen on B lymphocytes, has been used to treat patients with autoimmune blistering diseases and is considered to be a safe and effective treatment.3 4 5 Between 2007 and 2013, 22 patients diagnosed with an autoimmune blistering disease [11 patients with pemphigus vulgaris (PV); four patients with pemphigus foliaceus (PF); one patient with bullous pemphigoid (BP); one patient with antilaminin‐γ1 pemphigoid; five patients with mucous membrane pemphigoid (MMP)] and a treatment‐refractory disease progression, were treated off label with adjuvant rituximab (MabThera, Roche, Basel, Switzerland) (Table 1). After giving informed consent, patients received a premedication of 100 mg intravenous methylprednisolone and rituximab (1000 mg) was administered intravenously twice at a 2‐week interval in accordance with the rheumatoid arthritis protocol.6 One patient received an adjusted dose of 500 mg due to a low total body weight. The patients who experienced a relapse received an additional cycle of 2 × 1000 mg rituximab at least 6 months later. The patients were followed up on a regular basis for up to 65 months (mean follow‐up time 19·7 ± 17·8 months) in our outpatient clinic. Concomitant immunosuppressive therapy was adjusted in relation to disease activity and adverse events.
Lack of Endothelial Nitric Oxide Synthase Promotes Endothelin-Induced Hypertension
Authors: Thomas Quaschning, Florian Voss, Katharina Relle, Philipp Kalk, Nicolas Vignon-Zellweger, Thiemo Pfab, Christian Bauer, Franziska Theilig, Sebastian Bachmann, Annette Kraemer-Guth, Christoph Wanner, Franz Theuring, Jan Galle, Berthold Hocher
Journal: Journal of the American Society of Nephrology (2007)

Endothelin-1 (ET-1) is one of the most potent biologic vasoconstrictors. Nevertheless, transgenic mice that overexpress ET-1 exhibit normal BP. It was hypothesized that vascular effects of ET-1 may be antagonized by an increase of the endothelial counterpart of ET-1, nitric oxide (NO), which is produced by the endothelial NO synthase (eNOS). Therefore, cross-bred animals of ET transgenic mice (ET+/+) and eNOS knockout (eNOS-/-) mice and were generated, and BP and endothelial function were evaluated in these animals. Endothelium-dependent and -independent vascular function was assessed as relaxation/contraction of isolated preconstricted aortic rings. The tissue ET and NO system was determined in aortic rings by quantitative real-time PCR and Western blotting. Systolic BP was similar in ET+/+ and wild-type (WT) mice but was significantly elevated in eNOS-/- mice (117 +/- 4 mmHg versus 94 +/- 6 mmHg in WT mice; P < 0.001) and even more elevated in ET+/+ eNOS-/- cross-bred mice (130 +/- 4 mmHg; P < 0.05 versus eNOS-/-). Maximum endothelium-dependent relaxation was enhanced in ET+/+ mice (103 +/- 6 versus 87 +/- 4% of preconstriction in WT littermates; P < 0.05) and was completely blunted in eNOS-/- (-3 +/- 4%) and ET+/+ eNOS-/- mice (-4 +/- 4%), respectively. Endothelium-independent relaxation was comparable among all groups. Quantitative real-time PCR as well as Western blotting revealed an upregulation of the aortic ET(A) and ET(B) receptors in ET+/+ eNOS-/-, whereas eNOS was absent in aortic rings of eNOS-/- and ET+/+ eNOS-/- mice. ET-1 aortic tissue concentrations were similar in WT mice and ET+/+ eNOS-/- mice most probably as a result of an enhanced clearance of ET-1 by the upregulated ET(B) receptor. These data show for the first time that in transgenic mice that overexpress human ET-1, additional knockout of eNOS results in a further enhancement of BP as compared with eNOS-/- mice. The human ET+/+ eNOS-/- mice therefore represent a novel model of hypertension as a result of an imbalance between the vascular ET-1 and NO systems.
Science and the Quiet Art: The Role of Medical Research in Health Care
Authors: Larry R. Kirkland
Journal: JAMA (1995)

For starters, it was refreshing to learn that there are yet specialists with as good a grasp of the "big picture" as Sir David Weatherall demonstrates in this book. As regius professor of medicine at the University of Oxford (Osler's old job) and a busy world authority on thalassemia and human genetics, he initially resisted the entreaties of the late Lewis Thomas to write a book for the Commonwealth Fund Book Program about his work "in a way that would be comprehensible to the nonspecialist reader." The time required for such a project must have been intimidating, but "deepening concern about the current medical scene" overcame his earlier resistance. The result, a scholarly contribution to the debate over a complicated subject, was worth his effort. The subtitle of the book implies its main topic but not its message, which is aimed at countering society's increasing disillusionment with medicine and science.
TiO 2 nanoparticles tested in a novel screening whole human blood model of toxicity trigger adverse activation of the kallikrein system at low concentrations
Authors: Barbro Ekstrand-Hammarström, Jaan Hong, Padideh Davoodpour, Kerstin Sandholm, Kristina N. Ekdahl, Anders Bucht, Bo Nilsson
Journal: Biomaterials (2015)
Physiology of the Kidney
Authors: Richard J. Glassock
Journal: JAMA (1983)

This compact and frugally written soft-cover text has many appealing virtues. First, it represents the distillation of knowledge from a well-seasoned teacher of basic medical physiology. Second, it adds the judgment and disease-oriented approach of an experienced clinical nephrologist who is also well versed in fundamental aspects of renal function and pathophysiology. The two authors have provided their reading audience, primarily medical students and other physicians and scientists interested in reviewing the fundamentals of renal physiology, with an up-to-date, well-illustrated, and eminently readable volume.  The well-chosen illustrations and line drawings supplement the textual material in a useful and instructive way. The acid-base sections might have been improved by incorporating the well-known nomograms for predicting the physiological adjustments in plasma bicarbonate concentration and pH that occur with acute and chronic changes in alveolar ventilation, as well as the changes in ventilation that are predicted following a primary disturbance in plasma bicarbonate
Critical Perfusion Pressure for Renal Function in Patients with Bilateral Atherosclerotic Renal Vascular Disease
Authors: Stephen C. Textor, Andrew C. Novick, Robert C. Tarazi, Victor Klimas, Donald G. Vidt, Marc Pohl
Journal: Annals of Internal Medicine (1985)

We studied renal plasma flow and glomerular filtration rate during graded blood pressure reduction induced with sodium nitroprusside infusion in 16 hypertensive patients with atherosclerotic renovascular disease. Eight patients with unilateral disease tolerated pressure reduction from 205 ± 9(SE)/103 ± 2 mm Hg to 146 ± 6/84 ± 3 mm Hg(p < 0.01) with no change in total renal function. In 8 other patients with bilateral renal arterial stenosis (all arteries 70% or more stenosed), similar pressure reduction produced marked but reversible decrements in plasma flow (152 ± 28 mL/min to 66 ± 13 mL/min; p < 0.01) and glomerular filtration rate (38 ± 8 mL/min to 16 ± mL/min; p < 0.01). In 4 patients restudied after revascularization, sensitivity of renal function to pressure changes was no longer present. These data indicate that vascular stenosis to the entire renal mass may limit function and provide a means for evaluating patients at risk for loss of renal function during antihypertensive therapy.
THE "HIGH CALORIC" DIET
Authors: A. J. BEAMS
Journal: JAMA (1930)

Atony of the stomach with gastroptosis, we believe, is often the result of undernutrition. It is observed usually in nervous individuals who have been the subject of worry, excitement or mental depression and it may occur as the result of bad habits of eating and the consumption of indigestible foods. It is also often secondary to certain chronic diseases such as tuberculosis and typhoid in which there occurs great loss of weight.  Since undernutrition appears to be an important cause in this condition, the diet indicated for remedial purposes should provide meals of moderate bulk, but of foods easily and readily digested and such as will cause little gastric disturbance. We wish to include a high measure of fat and to restore tone to the gastric tract.  The method used for making up suggested menus for reducing diets might also be used for cases of gastric atony, although the aim
Dexrazoxane is cardioprotective against doxorubicin cardiotoxicity
Authors: Steven E. Lipshultz, Nader Rifai, Virginia Dalton, Donna Levy, Stuart R. Lipsitz, Richard D. Gelber, Steven D. Colan, Seema Shaikh, Stephen E. Sallan
Journal: Journal of the American College of Cardiology (2002)
Preventing needlestick injuries.
Authors: D C Anderson, A L Blower, J M Packer, L A Ganguli
Journal: BMJ (1991)

BMJ 1991;302:769-70 The use of needles is an essential part of providing medical care but is potentially hazardous to staff. Awareness of hazards, use of the correct equipment, and a consistent and careful technique are all of great importance in preventing needlestick injuries. To date 13 cases of occupationally contracted AIDS caused by needlestick injuries with hollow bore needles have been documented worldwide (N Gill, K Porter, personal communication). Nevertheless the overall risk of contracting HIV infection after a simple needle? stick injury with a needle known to be contaminated is estimated to be less than 0-5%,' ? whereas the risk of hepatitis B virus infection has been estimated to be 3 16%.2 Although the risk of hepatitis B virus infection can be eliminated by vaccination,4 vaccination of all staff at risk is probably unattainable. The recent Department of Health guidelines state: