tbuckley/cabot-search huggingface dataset:
Effects on myocardial contractility of blood-borne material released from the feline small intestine in simulated shock.
Authors: O Lundgren, U Haglund, O Isaksson, T Abe
Journal: Circulation Research (1976)

There is a pronounced derangement in cardiovascular function in the cat after a 2- or 3-hour period during which shock is simulated in the small intestine by regional hypotension (BP = 30-35 mm Hg) during activation of vasoconstrictor nerve fibers. It has been proposed that these effects are caused by blood-borne cardiode-pressant substance(s) released from the "shocked" small intestine. To obtain further evidence for this hypothesis we performed a study on two heart preparations in vitro. Rabbit papillary muscles or isolated beating rat hearts were exposed to intestinal venous plasma obtained from control cats and from cats subjected to simulated intestinal shock for 2 or 3 hours. while control plasma induced only a slight depression of myocardial contractility, plasma from "shocked" intestine caused a significant decrease in peak isometric tension of the papillary muscles or a fall in systolic pressure of the rat hearts. Since the experiments on papillary muscle indicated that time to peak tension was largely unaffected by the plasma samples, we conclude that the feline intestine in shock releases material into blood that exerts a negative inotropic effect on the myocardium.
Optimized Antidepressant Therapy and Pain Self-management in Primary Care Patients With Depression and Musculoskeletal Pain
Authors: Kurt Kroenke, Matthew J. Bair, Teresa M. Damush, Jingwei Wu, Shawn Hoke, Jason Sutherland, Wanzhu Tu
Journal: JAMA (2009)

Pain and depression are the most common physical and psychological symptoms in primary care, respectively. Moreover, they co-occur 30% to 50% of the time and have adverse effects on quality of life, disability, and health care costs.
Hereditary Hemolytic Anemia with Human Erythrocyte Pyrimidine 5′-Nucleotidase Deficiency
Authors: William N. Valentine, Kay Fink, Donald E. Paglia, Susan R. Harris, William S. Adams
Journal: Journal of Clinical Investigation (1974)

A severe deficiency of a red cell pyrimidine 5′-nucleotidase was found to be associated with hereditary hemolytic anemia in four members of three kindreds. The syndrome was characterized by marked increases above normal in red cell basophilic stippling, total nucleotides, and GSH and by a fairly severe deficiency of ribosephosphate pyrophosphokinase (EC 2.7.6.1.). Patient erythrocytes uniquely contained large amounts of pyrimidine 5′-ribonucleotides. In earlier studies, these were erroneously considered to be adenosine phosphates, since all previous investigations of the nucleotides of human red cells and reticulocytes have shown 97% or more to contain adenine. Total nucleotides in patient cells were present in amounts 3-6 times greater than normal, and approximately 80% contained pyrimidine. The ultraviolet spectral curves of deproteinized red cell extracts exhibited a shift in maximum absorbance from the usual 256-257 nm to approximately 266-270 nm, and absorbance at 250, 270, 280, and 290 nm, expressed as a ratio of that at 260 nm, differed greatly from normal. The spectral characteristics of extracts provide the basis of a readily performed screening procedure, which does not require enzyme assay. The nucleotidase activity in deficient red cells assayed less than 14%, and usually less than 10%, of normal and much less in terms of reticulocyte-rich blood, where it was consistently found to be increased. The enzyme has a pH optimum of 7.5-8.0, is inhibited by EDTA, and does not utilize purine 5′-ribonucleotides or β-glycerophosphate as substrates. While comparatively few family members have been available thus far for study, initial data are compatible with an autosomal, recessive mode of transmission of the deficiency. The pyrimidine 5′-ribonucleotides are presumably derived from RNA degradation and, not being diffusible, accumulate when the enzyme catalyzing their dephosphorylation is deficient. It is postulated that the prominent basophilic stippling results from retarded ribosomal RNA degradation secondary to accumulation of degradation products, namely pyrimidine 5′-ribonucleotides. Ribosephosphate pyrophosphokinase deficiency is considered to be an epiphenomenon. The mechanism responsible for increased red cell GSH is unknown.
Factors Influencing Families' Consent for Donation of Solid Organs for Transplantation
Authors: Laura A. Siminoff
Journal: JAMA (2001)

ContextTransplantation has become the therapy of choice for patients with organ failure. However, the low rate of consent by families of donor-eligible patients is a major limiting factor in the success of organ transplantation.ObjectiveTo explore factors associated with the decision to donate among families of potential solid organ donors.Design and SettingData collection via chart reviews, telephone interviews with health care practitioners (HCPs) or organ procurement organization (OPO) staff, and face-to-face interviews with family for all donor-eligible deaths at 9 trauma hospitals in southwestern Pennsylvania and northeastern Ohio from 1994 to 1999.ParticipantsFamily members, HCPs, and OPO staff involved in the donation decision for 420 donor-eligible patients.Main Outcome MeasureFactors associated with family decision to donate or not donate organs for transplantation.ResultsA total of 238 of the 420 cases led to organ donation; 182 did not. Univariate analysis revealed numerous factors associated with the donation decision. Multivariable analysis of associated variables revealed that family and patient sociodemographics (ethnicity, patient's age and cause of death) and prior knowledge of the patients' wishes were significantly associated with willingness to donate (adjusted odds ratio [OR], 7.68; 95% confidence interval [CI], 6.55-9.01). Families who discussed more topics and had more conversations about organ donation were more likely to donate (adjusted OR, 5.22; 95% CI, 4.32-6.30), as were families with more contact with OPO staff (adjusted OR, 3.08; 95% CI, 2.63-3.60) and those who experienced an optimal request pattern (adjusted OR, 2.96; 95% CI, 2.58-3.40). Socioemotional and communication variables acted as intervening variables.ConclusionsPublic education is needed to modify attitudes about organ donation prior to a donation opportunity. Specific steps can be taken by HCPs and OPO staff to maximize the opportunity to persuade families to donate their relatives' organs.
Deficiencies in rehabilitation after traumatic brain injury
Authors: Peter J Hutchinson, John D Pickard
Journal: BMJ (2006)

Good quality monitoring is crucial for informed choiceEditor-In accordance with the patient choice scheme, all 303 primary care trusts in England were obliged from January 2005 to offer patients a choice of at least two providers for cataract surgery. 1 The scheme allows patients to be involved in how, where, and when they are treated.Providers can be NHS trusts, diagnostic and treatment centres, or independent sector providers from the UK or overseas.By February 2005 13 000 extra operations had already been performed under the independent sector treatment programme. 2However, concern was raised about variations in clinical safety between different providers. 3 We sent a postal questionnaire to the leaders of patient choice for each of the primary care trusts in England asking how they monitor the quality of care from their providers.The table shows the replies from 125 trusts.The quality monitoring of providers by primary care trusts is poorly structured and variable.Who then should monitor standards and what variables should they use?Traditionally, NHS providers have used audit and clinical governance to measure their performance.Should it now be the role of the Strategic Health Authority, the provider, or the purchaser in the form of primary care trusts to monitor the product offered to the patient?Information technology exists to collect accurate data about adverse events in addition to visual acuity and refractive outcomes.The public expect that safe cataract care should be commissioned for them, 4 and robust methods of monitoring need to be agreed and implemented so that patients can make a truly informed choice.These decisions need to be made not only for cataract surgery but also for other elective procedures that will increasingly be made available to patients through the patient choice scheme.
Skin Tests With Measles and Poliomyelitis Vaccines in Recipients of Inactivated Measles Virus Vaccine
Authors: Richard G. Lennon
Journal: JAMA (1967)

Fifty subjects who had received monkey-kidney culturegrown, alum-precipitated inactivated measles virus vaccine were given an intradermal injection of live measles virus vaccine. Twenty-nine showed 4-mm or greater local induration 48 hours later. Induration of this degree also occurred in one of eight previous recipients of live measles virus vaccine, but not in six measles susceptibles or 32 subjects with previous natural measles. Reactions were elicited with heat-inactivated and viable live measles virus vaccine, prepared from either chick embryo or canine renal cell cultures. Intradermally administered poliomyelitis vaccine also elicited 4-mm or greater induration reactions in previous recipients of inactivated measles virus vaccine, but not in subjects without prior measles vaccination. Dermal reactions to inactivated poliomyelitis vaccine were not related to prior parenterally administered poliomyelitis immunizations, but were dependent on previous sensitization with inactivated measles virus vaccine.
Report backs research on non-human primates but demands closer scrutiny
Authors: G. Watts
Journal: BMJ (2011)

An independent panel of distinguished scientists and animal welfare experts chaired by the Cambridge ethologist Patrick Bateson has given qualified approval to the research use of non-human primates in Britain. But the panel’s report emphasises the need for continuing and even closer scrutiny of the scientific and social justification for experimenting on these animals.

The report was commissioned by the Medical Research Council, the Wellcome Trust, and the Biotechnology and Biological Sciences Research Council, each of which funds work on primates. All three declared their support for the broad thrust of the report, and said that some of its 15 recommendations …
Understanding organizational culture in reforming the National Health Service
Authors: H. T O Davies
Journal: Journal of the Royal Society of Medicine (2002)

If ‘education, education, education’ was the mantra of the incoming Labour government in 1997, ‘delivery, delivery, delivery’ has been the refrain from 2001. Reforming and modernizing the NHS to deliver the scale and quality of health services required for a demanding 21st century public has been one of Labour's biggest policy pledges. It remains perhaps its most serious challenge in its second term of office. Failure here will both seriously undermine the New Labour project and inflict serious damage on the arguments for publicly financed, publicly provided, health services with universal access.

Achievement of a modernized health service and radical improvements in delivery are seen to require more than just the planned large cash injection: they also require health system reform. Major reforms of the health systems of developed nations over the past two decades have been largely structural in content. Through the 1970s and 1980s, changes to the hierarchical arrangements of the NHS presaged more radical plans for a rearrangement of players into purchasers and providers and the introduction of the internal market. This reaching for competition—created by structural rearrangement—mirrored upheavals in healthcare elsewhere in the world. Various combinations of managed competition and managed care have been tried and are evolving in the USA, Australia, New Zealand and many parts of Europe.

In opposition, Labour decried the internal market. Once in power they kept many of its structural elements (the crucial separation between operational and strategic responsibilities) while updating the rhetoric (eschewing the language of competition, embracing instead cooperation and partnerships). Their major reform effort focused on quality issues1, developing a plethora of agencies such as the National Institute for Clinical Excellence, the Commission for Health Improvement, the National Clinical Assessment Authority, and the Modernization Agency. The latest round of NHS reforms (‘Shifting the Balance’2) again emphasizes structural changes as a means of driving improvements in delivery.
IFN-γ Suppresses IL-10 Production and Synergizes with TLR2 by Regulating GSK3 and CREB/AP-1 Proteins
Authors: Xiaoyu Hu, Paul K. Paik, Janice Chen, Anna Yarilina, Lisa Kockeritz, Theresa T. Lu, James R. Woodgett, Lionel B. Ivashkiv
Journal: Immunity (2006)
Effect of ileal autotransplantation on cholesterol, bile acids, and biliary lipids in pigs with proximal small bowel resection
Authors: M Pakarinen, T A Miettinen, P Kuusanmaki, P Vento, T Kivisto, J Halttunen
Journal: Hepatology (1997)

Our major aim was to investigate the consequences of ileal autotransplantation in pigs with proximal small intestinal resection on biliary lipids and metabolism of bile acids. Biliary lipid secretion rates and bile acid absorption were assessed by measuring dietary and biliary lipids, fractional cholesterol absorption, and fecal excretion of cholesterol and bile acids. In addition, serum bile acids and cholesterol, biliary and fecal bile acid species, and ileal villus height were determined after resection of the proximal 75% of the jejunoileum (n = 15) and autotransplantation of the remaining ileum with systemic venous drainage (n = 15) or transection (n = 5). Autotransplantation further increased fecal excretion of neutral and acidic steroids and serum concentration of bile acids after proximal resection ( P &lt; .05 for all); autotransplantation significantly decreased serum cholesterol, ileal villus height, fractional bile acid and cholesterol absorption, and biliary molar percentage of total and primary bile acids, whereas biliary secretion of bile acids, enriched by secondary bile acids, and cholesterol remained unchanged. At 14 weeks, ileal villus height, fractional bile acid and cholesterol absorption, biliary molar percentage of bile acids, and proportion of secondary biliary bile acids were altered by transplantation from the respective postresection values of 864 ± 22 μm, 97.9 ± 0.6%, 26.9 ± 3.9%, 91.8 ± 1.2% and 9.2 ± 1.3% to 428 ± 21 μm, 91.1 ± 1.5%, 9.5 ± 1.1%, 83.9 ± 1.4% and 52.5 ± 3.5% ( P &lt; .005 for all). Posttransplantation biliary bile acid secretion correlated positively with fractional reabsorption (r = .70) and biliary molar percentage (r = .73) of bile acids and ileal villus height (r = .65; P &lt; .01 for all). Decreased absorption efficiency and biliary molar percentage of bile acids, increased biliary secondary bile acids, and short ileal villi point to bacterial overgrowth-induced bile acid malabsorption, which with decreased absorptive area may contribute to malabsorption of other lipids after ileal autotransplantation. Compensatory increase in cholesterol synthesis in the pigs with autotransplanted ileum appeared sufficient for constant biliary secretion of cholesterol and bile acids.
Salt Loss in Chronic Renal Disease
Authors: A. E. Read
Journal: BMJ (1956)

_~~~~~~~~~~~~~EIA JORA It may be that further study of electroencephalographic changes will help to elucidate the nature of the specific changes in cerebral metabolism met in hypopituitarism, and serve as a guide to the tvpe of coma present in difficult cases. SummaryA case of chronic anterior hypopituitarism is described in which two distinct episodes of coma occurred due to differing metabolic disturbances on ea^h occasion.Th2 first episode was associated with hypothermia and hypo- glycaemia, and recovery followed direct treatment of these abnormalities successively.On the second occa- sion coma was due to water-retention, precipitated by a water load, and was again associated with hypo- glycaemia.No improvement in clinical state occurred until a diuresis followed the administration of cortisone.Electroencephalography was carried out until reversion to normal rhythm occurred.This reversion was delayed in relation to the clinical state of the patient, but this reversion is further evidence that these changes are secondary to endocrine deficiency rather than to local brain damage.Four metabolic states associated with coma in hypo- pituitarism are discussed-namely, hypothermia, hypo- glycaemia, water-retention, and sodium depletion with dehydration.The danger of water-retention following oral or parenteral fluids is emphasized.I am grateful to Dr. S. R.
Effect of statin versus fibrate on postprandial endothelial dysfunction: role of remnant-like particles
Authors: H Wilmink
Journal: Cardiovascular Research (2001)

Background: Postprandial lipemia is associated with endothelial dysfunction. Remnant-like particles (RLP) have been suggested to contribute to these adverse vascular effects. We investigated the effect of cerivastatin and gemfibrozil upon oral fat load induced changes in endothelial function and postprandial lipid profile in vivo. Methods: In a randomized cross-over trial, 15 healthy volunteers received cerivastatin (0.4 mg once daily), gemfibrozil (900 mg once daily) or placebo for 3 weeks. Lipid profiles and flow mediated dilation (FMD) were assessed before and 4 h after an oral fat load. Endothelium-independent dilation was tested after nitroglycerine 0.4 mg sublingual spray. Results: After the placebo period, the oral fat load induced an increase in triglycerides (TG) and RLP-cholesterol (RLP-C) (0.9±0.7 and 0.08±0.04 mmol/l, respectively) and a significant decrease in FMD (9.1±3.4 to 4.3±3.3%, P<0.05). After gemfibrozil, TG increase was attenuated (0.5±0.5 mmol/l), whereas RLP-C increase (0.05±0.09 mmol/l) and FMD decrease (9.0±3.8 to 5.2±2.6%, P<0.05) were not different from placebo therapy. Cerivastatin did not affect TG increase (0.7±0.8 mmol/l). RLP-C increase (0.02±0.07 mmol/l) and FMD (7.9±2.6 to 8.4±2.8%) change were attenuated significantly compared to placebo. Endothelium-independent vasodilatation remained unaltered throughout the protocol. Conclusion: Cerivastatin, but not gemfibrozil significantly reduces RLP-C increase after an oral fat load in combination with a reversal of fat-load induced endothelial dysfunction. The present data imply that lowering of RLP-C, rather than lowering of total TG levels, may contributes to the prevention of endothelial dysfunction after an oral fat load during statin use.
Prescribing intravenous immunoglobulin: summary of Department of Health guidelines
Authors: D. Provan, H. M Chapel, W A C. Sewell, D. O'Shaughnessy
Journal: BMJ (2008)

Therapeutic immunoglobulin, a preparation of normal human polyclonal immunoglobulin G derived from pooled human plasma, has become an important treatment option in a range of medical conditions beyond its use in immune deficiencies, particularly autoimmune and acute inflammatory diseases.1 For some time, concern has been expressed over the availability of immunoglobulin. Severe global supply shortages began in the late 1990s, when demand exceeded supply by up to 30%,2 and production problems specific to the United Kingdom have curtailed supply. This supply shortage has been compounded by increasing use in established indications3 and widespread off-label prescribing.4 To ensure that supply is maintained, even in times of acute shortage, for the patients considered to be the highest priority because of a risk to life without treatment, potential prescribers of immunoglobulin need help in identifying treatment indications for which its use is appropriate. This article summarises the most recent Department of Health guidelines on prescribing intravenous immunoglobulin, published in May 2008.5

Recommendations are based on systematic review of evidence based guidelines and Cochrane reviews, supplemented by expert opinion. The level of evidence for each indication is indicated as Ia, Ib, IIa, IIb, III, or IV; the grade of recommendation is given as A, B, C, or D. Our approach was adapted from the system used by the Agency for Healthcare Policy and Research (US Department of Health and Human Services).6

Recommendations are colour coded to reflect treatment prioritisation. Red indicates conditions for which treatment is considered the highest priority because of a risk to life without treatment, and blue indicates conditions for which, although the evidence base is reasonable, the priority is moderate because other treatments are available (see figure⇓). Box 1 lists those conditions for which the evidence base is weak (these are known as …
High Incidence of Tacrolimus-Associated Posttransplantation Diabetes in the Korean Renal Allograft Recipients According to American Diabetes Association Criteria
Authors: Young Min Cho, Kyong Soo Park, Hye Seung Jung, Hyun Jung Jeon, Curie Ahn, Jongwon Ha, Sang Joon Kim, Byoung Doo Rhee, Seong Yeon Kim, Hong Kyu Lee
Journal: Diabetes Care (2003)

OBJECTIVE—The incidence of posttransplantation diabetes mellitus (PTDM) has been reported to vary according to different study populations or different definitions. In this study, using American Diabetes Association criteria, the incidence and clinical characteristics of PTDM in Korean renal allograft recipients undergoing tacrolimus-based immunosuppression were examined. RESEARCH DESIGN AND METHODS—A total of 21 patients taking tacrolimus as primary immunosuppressant were recruited and tested with a serial 75-g oral glucose tolerance test at 0, 1, 3, and 6 months after renal transplantation. RESULTS—The cumulative incidence of PTDM was 52.4% at 1 month and 57.1% at 3 and 6 months. The baseline characteristics of the PTDM group were old age (especially &amp;gt;40 years), a high BMI, a high fasting glucose level, a high plasma insulin level, and increased insulin resistance. Among these parameters, old age was the only independent risk factor. The insulin secretory capacity in the PTDM group was maximally suppressed 3 months after transplantation. Thereafter, it was gradually restored along with dose reduction of tacrolimus. CONCLUSIONS—Routine screening for PTDM is necessary in patients over 40 years of age who are undergoing a relatively higher dose tacrolimus therapy during the early course of postrenal transplantation.
Osteoblastic Metastasis of Rib Cage Causing Attenuation on Liver Scan
Authors: LALITHA RAMANNA, MICHAEL B. BRACHMAN, DOINE E. TANASESCU, ALAN D. WAXMAN
Journal: Clinical Nuclear Medicine (1985)

An unusual case of prominent rib attenuation was seen on a liver scan performed in a patient with prostatic carcinoma. This finding subsequently was explained by the increased density of the bone secondary to blastic metastasis causing attenuation on the liver scan.