tbuckley/cabot-search huggingface dataset:
Erythrokinetics in Diagnosis of Anemia
Authors: Clement A. Finch
Journal: JAMA (1961)

THE DIAGNOSIS of anemia is dependent on the correct use and interpretation of laboratory procedures. While these have been in large part morphologic, in recent years measurements of blood production and destruction have led to an understanding of the alterations in marrow function in anemia. These erythrokinetic measurements are sufficiently quantitative and practical to receive general clinical application. The purpose of this discussion is to integrate erythrokinetics with the morphologic approach to anemia.  Morphology  Anemias have been classified as microcytic, macrocytic, or normocytic (Table I). The alterations in cell size are identified either by examinationof the stained blood smear or by calculation of the mean cell volume from the red blood cell count and hematocrit. Hemoglobin constitutes most of the erythrocyte's fixed mass, and the size of the mature cell is largely determined by its hemoglobin content. Thus, microcytosis reflects a quantitative impairment in hemoglobin synthesis. This
The Global Health System: Linking Knowledge with Action—Learning from Malaria
Authors: Gerald T. Keusch, Wen L. Kilama, Suerie Moon, Nicole A. Szlezák, Catherine M. Michaud
Journal: PLoS Medicine (2010)

This is the third in a series of four articles that highlight the changing nature of global health institutions.The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies.
The Internship and Residency Application Hassle
Authors: PAUL M. NESS
Journal: Annals of Internal Medicine (1974)

Two applicants describe their experiences in applying for training in internal medicine. Information sent to the applicants about training programs was frequently inadequate to make an informed decision. Often institutions did not make clear their policies on interviews, and frequently the interviews themselves were unsatisfactory in purpose and conduct. The opportunity for applicants to meet with house staff members to discuss the training program varied greatly. Recommendations are offered to improve the application procedure, for the benefit of both the applicant and the training institution.
Systemic vasoconstriction induced by inhibition of nitric oxide synthesis is attenuated in conscious dogs with heart failure
Authors: D. Eisner, A. Muntze, E. P Kromer, G. A J Riegger
Journal: Cardiovascular Research (1991)

The aim was to test the hypothesis that endothelium dependent vasomotor control is impaired in heart failure.The haemodynamic effects of NG-nitro-L-arginine (NNA), an inhibitor of nitric oxide synthesis, were studied in five dogs with and without pacing induced heart failure.In healthy dogs, NNA increased total peripheral resistance and arterial pressure, decreasing cardiac output and heart rate. These effects were partially reversed by L-arginine. In dogs with heart failure, NNA did not change any haemodynamic variable. However, L-arginine decreased total peripheral resistance.These findings support a physiological role for endothelium derived nitric oxide in control of vascular resistance and are in agreement with the hypothesis that endothelium dependent vasomotion may be impaired in heart failure.
High court upholds General Medical Council's rejection of case against neurologist
Authors: Clare Dyer
Journal: BMJ (2007)

The General Medical Council has comprehensively defeated a challenge in the High Court by the Singapore Medical Council to the GMC's decision to drop a disciplinary case against the British neurologist Simon Shorvon over a research project he headed in Singapore ( BMJ 2003;326:839). 

The Singapore council found Professor Shorvon guilty of serious professional misconduct in 2004 over the $S10m (£3.3m; €5m; $6.5m) project, which was halted amid allegations that researchers breached confidentiality, failed to obtain informed consent, and disregarded the best interests of vulnerable patients. 

The GMC, which was originally alerted to the allegations by an article in the Guardian newspaper in January 2003 (www.guardian.co.uk/uk_news/story/0,,878047,00.html), started investigating possible disciplinary action. But when the case reached the investigation committee of the fitness to practice panel, …
Tellurium-123m-labeled-9-telluraheptadecanoic acid: a possible cardiac imaging agent.
Authors: R D Okada, F F Knapp, D R Elmaleh, T Yasuda, C A Boucher, H W Strauss
Journal: Circulation (1982)

To study the value of the fatty acid analog tellurium-123m-labeled-9-telluraheptadecanoic acid (123mTe-THDA) as a cardiac imaging agent, five dogs had partial occlusion of the left anterior descending cor- onary artery.One hour later, scandium-46 ("Sc) microspheres were injected into the left atrium, followed im- mediately by the i.v.121mTe-THDA.After injection, regional myocardial 2'SmTe activity was monitored con- tinuously with implanted miniature cadmium telluride radiation detectors in both ischemic and nonischemic zones.After 4 hours, stannum-113 microspheres were injected into the left atrium and the dogs were killed.Ischemic and nonischemic areas of myocardium were sectioned and counted in a well counter.Nonischemic myocardial 123mTe activity reached 88 ± 10% (mean ± SD) of peak activity within 1 minute after injection, peaked in 8 ± 9 minutes, then decreased 2 ± 8% over the next 4 hours.Ischemic myocardial 123mTe activity reached 97 ± 4% of peak activity within 1 minute after injection, peaked in 5 ± 5 minutes, then decreased 5 ± 7% over the next 4 hours.There was a linear correlation between 121mTe activity at 1 hour and at 4 hours and the initial "OSc microsphere-determined regional myocardial blood flow (r = 0.93-0.96).Ischemic and nonischemic zone myocardial blood flows did not change significantly during the experiment.Cardiac im- ages of excellent quality were obtained after 123mTe-THDA administration in three additional dogs with left anterior descending occlusions and two additional dogs with no occlusions using a conventional gamma scin- tillation camera and a low-energy collimator.The linear relationship with regional myocardial blood flow, the minimal myocardial washout after a rapid peak, and the 159-keV gamma make lSSmTe-THDA a promising new cardiac perfusion imaging agent.UNDER AEROBIC CONDITIONS, nonesterified long-chain fatty acids are the' major substrate for myocardial energy production.1' 2 As a result of the high utilization by the heart, rapid turnover from the blood, and minimal concentration in normal lung, fat- ty acids labeled with gamma-emitting radioisotopes might be excellent myocardial imaging agents.How- ever, most of these radiopharmaceuticals are rapidly
Prostaglandins mediate arteriolar dilation to increased blood flow velocity in skeletal muscle microcirculation.
Authors: A Koller, G Kaley
Journal: Circulation Research (1990)

In cremaster muscle of pentobarbital-anesthetized rats, temporary occlusion of an arteriole increased red blood cell velocity (mean increase, 8.2 +/- 1.0 mm/sec from a control velocity of 7.9 +/- 0.7 mm/sec) in proximal parallel arteriolar branches (mean control diameter, 19.4 +/- 0.6 microns). Increases in flow velocity were consistently followed by proportional delayed (6-15 seconds) increases in arteriolar diameter (5.8 +/- 0.7 microns). Administration of NG-monomethyl-L-arginine (200 microM), an inhibitor of the synthesis of endothelium-derived relaxing factor that blocked the arteriolar responses to acetylcholine (1 microM) but not to arachidonic acid (10 microM), did not affect the dilation (mean increase, 8.9 +/- 1.1 microns) due to increases in red blood cell velocity (13.4 +/- 1.5 mm/sec). However, the cyclooxygenase inhibitor indomethacin (or meclofenamate), which completely blocked the dilator response to arachidonic acid but did not change the response to acetylcholine, inhibited the arteriolar dilation (mean increase, 0.3 +/- 0.2 micron) due to increases in red blood cell velocity (9.3 +/- 1.0 mm/sec). Inhibition of prostaglandin synthesis also reduced the increase in calculated blood flow by 57% during occlusion. These results suggest that the arterioles are sensitive to increases in blood flow velocity (wall shear stress), in response to which they release prostaglandins, eliciting vasodilation. The existence of this phenomenon in the skeletal muscle microcirculation suggests a new regulatory mechanism that, by modulation of vascular resistance in the microvascular network, has the role of normalizing wall shear stress and providing for substantial increases in tissue blood flow.
VALIDATING THE 3-STEP RETURN TO PLAY DECISION MAKING MODEL
Authors: I Shrier, G Matheson, M Boudier-Reveret, R Steele
Journal: British Journal of Sports Medicine (2014)

Background A recent return to play decision-making (RTP-DM) model for sport medicine has organized the underlying concepts into 3 steps but has not yet been validated. Objective To examine the validity of the 3-step RTP-DM model recently proposed. Design Repeated measures cross-over survey design. Setting World-wide. Participants American College of Sports Medicine clinicians involved in RTP-DM. Risk factor assessment We provided clinical vignettes of injuries and illnesses in athletes to participants through an online survey. Each vignette included examples of 3 factor types: increasing injury severity, changing risk associated with sport (e.g. different positions), and changing non-injury risk factors (e.g. financial considerations). Main Outcome Measurements For each vignette, participants indicated the level of activity restriction they would recommend (6 options from No Restrictions to No Activity) in accordance with the risk they placed on continued participation. We analyzed the data using multiple regression, adjusting for the correlated participant outcomes, to measure how changes in factors affected individual participants. Results The estimated participation rate for those involved in RTP decisions was 24.7%. As expected, we found that clinicians increase restrictions as injury severity increases. We also found that changing factors related to sport risk, and changing factors that are unrelated to sport risk will affect RTP decisions, although the effect is context-dependent and does not occur equally across all injury severities and clinical cases. The effect was also observed in each subgroup examined that included sex, age, specialty, region of training, academic status, and years of experience making RTP decisions. Conclusions Our findings that clinicians from a wide variety of backgrounds will change RTP recommendations based on clinical vignettes with changing injury severity, sport risk modifiers and decision modifiers provides evidentiary support for the 3-step model for RTP decision making recently proposed.
Decision Aids for Advance Care Planning: An Overview of the State of the Science
Authors: Mary Butler, Edward Ratner, Ellen McCreedy, Nathan Shippee, Robert L. Kane
Journal: Annals of Internal Medicine (2014)

Advance care planning honors patients’ goals and preferences for future care by creating a plan for when illness or injury impedes the ability to think or communicate about health decisions. Fewer than 50% of severely or terminally ill patients have an advance directive in their medical record, and physicians are accurate only about 65% of the time when predicting patient preferences for intensive care. Decision aids can support the advance care planning process by providing a structured approach to informing patients about care options and prompting them to document and communicate their preferences. This review, commissioned as a technical brief by the Agency for Healthcare Research and Quality Effective Health Care Program, provides a broad overview of current use of and research related to decision aids for adult advance care planning. Using interviews of key informants and a search of the gray and published literature from January 1990 to May 2014, the authors found that many decision aids are widely available but are not assessed in the empirical literature. The 16 published studies testing decision aids as interventions for adult advance care planning found that most are proprietary or not publicly available. Some are constructed for the general population, whereas others address disease-specific conditions that have more predictable end-of-life scenarios and, therefore, more discrete choices. New decision aids should be designed that are responsive to diverse philosophical perspectives and flexible enough to change as patients gain experience with their personal illness courses. Future efforts should include further research, training of advance care planning facilitators, dissemination and access, and tapping potential opportunities in social media or other technologies.
Lack of Effect of Direct-Current Cardioversion on Fibrinolysis
Authors: Ugur M. Derman
Journal: JAMA (1966)

As direct-current conversion of cardiac arrhythmias is attaining ever increasing popularity, it is important to establish the effect of this procedure on the blood coagulation. The effect of electro-shock therapy on fibrinolysis<sup>1,2</sup>has been studied, but we are not aware of any previous coagulation studies on patients who have undergone closed "cardioversion." In order to evaluate this problem, euglobulin clot lysis<sup>3</sup>determinations were done before and after direct-current cardioversion in 12 patients. <h3>Materials and Methods.—</h3> Twelve patients, who received direct-current shocks for the conversion of cardiac arrhythmias were included in this study. In all cases the same apparatus was used to deliver the electrical shock. The capacitor discharge was synchronized with the electrical activity of the heart and programmed to be delivered on the downstroke of the R wave. One electrode was placed over the sternum, and the other in the left midaxillary line. Routinely, 100 watt-seconds of
Book Review Congenital Heart Disease: Textbook of angiocardiography Edited by Robert M. Freedom, John B. Mawson, Shi-Joon Yoo, and Leland N. Benson, with contributions by four others. 1432 pp. in two volumes, illustrated. Armonk, N.Y., Futura, 1997. $275. 0-87993-656-8
Authors: James E. Lock
Journal: New England Journal of Medicine (1998)
THE USE OF FORMALIN IN INFECTED WOUNDS.
Authors: A. L. CORY
Journal: JAMA (1897)

My attention was called some time since to the use of a mixture of formalin and gelatin in infected wounds. A German firm placed the mixture on the market under the name of "glutol." Formalin is mixed with gelatin, which forms a solid mass; this is grated, forming a fine gray powder, in which state it is sold, to be dusted on the wound as we have been doing heretofore with iodoform or boric acid. An American firm have recently put the same thing on the market under its proper name, "formal-gelatin." It was claimed for it that when pus was present the gelatin would gradually dissolve in the secretions and liberate the formalin, which is a strong disinfectant, and thus keep up a continual action while any of the powder remained. On trial I failed to realize the good results except in superficial injuries, for instance in two cases
Allergy testing in children: why, who, when and how?
Authors: A. Høst, S. Andrae, S. Charkin, C. Diaz‐Vázquez, S. Dreborg, P. A. Eigenmann, F. Friedrichs, P. Grinsted, G. Lack, G. Meylan, P. Miglioranzi, A. Muraro, A. Nieto, B. Niggemann, C. Pascual, M‐G. Pouech, F. Rancé, E. Rietschel, M. Wickman
Journal: Allergy (2003)
Geigy Scientific Tables
Authors: D H BERGEL
Journal: Cardiovascular Research (1991)

Journal Article Geigy Scientific Tables Get access D H BERGEL D H BERGEL Ed C Lenmer. (£17.50) Portland Press, Colchester, United Kingdom, 1990. ISBN 0-914168-54-1. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 25, Issue 8, August 1991, Page 704, https://doi.org/10.1093/cvr/25.8.704 Published: 01 August 1991
Puncture of thoracic lesions under sonographic guidance.
Authors: M Afschrift, P Nachtegaele, D Voet, L Noens, W Van Hove, M van der Straeten, G Verdonk
Journal: Thorax (1982)

Thirty-six punctures of thoracic lesions have been performed with a compound B-scanner or a real-time linear-array scanner for guidance. Twenty-three fluid collections were punctured and aspiration biopsies were performed on 13 echogenic lesions. All the punctures were successful at the first attempt. No complications occurred. The results confirm the usefulness of sonography for guiding punctures of thoracic fluid effusions and solid masses. Usually a static B-scanner is sufficient, but when masses are small or surrounded by vital structures puncture may be controlled by a real-time scanner.
Answering the call
Authors: P. Gunby
Journal: JAMA (1991)

The medical community—indeed, the entire nation—can be proud of the physicians, nurses, and other members of US military medicine's team who are serving in Operation Desert Storm. From the aid stations close to the front lines to the various ships offshore, US military physicians and their coworkers have been living and working within range of Iraq's arsenal of weapons for up to 6 months. Armed with professional skills, realism engendered by military medical training and caring for the troops in a hostile environment,<sup>1</sup>equipment and supplies transported halfway around the world, and—for some— experience in treating casualties of past armed conflicts, they continue to demonstrate their dedication in the face of many hardships, dangers, uncertainties, and therapeutic challenges. One physician may already be a prisoner of war. Like the thousands of other US military men and women who have been pouring into the Persian Gulf region since Iraq invaded
Antagonism of T-type calcium channels inhibits high-fat diet–induced weight gain in mice
Authors: Victor N. Uebele, Anthony L. Gotter, Cindy E. Nuss, Richard L. Kraus, Scott M. Doran, Susan L. Garson, Duane R. Reiss, Yuxing Li, James C. Barrow, Thomas S. Reger, Zhi-Qiang Yang, Jeanine E. Ballard, Cuyue Tang, Joseph M. Metzger, Sheng-Ping Wang, Kenneth S. Koblan, John J. Renger
Journal: Journal of Clinical Investigation (2009)

The epidemics of obesity and metabolic disorders have well-recognized health and economic burdens. Pharmacologic treatments for these diseases remain unsatisfactory with respect to both efficacy and side-effect profiles. Here, we have identified a potential central role for T-type calcium channels in regulating body weight maintenance and sleep. Previously, it was shown that mice lacking CaV3.1 T-type calcium channels have altered sleep/wake activity. We found that these mice were also resistant to high-fat diet-induced weight gain, without changes in food intake or sensitivity to high-fat diet-induced disruptions of diurnal rhythm. Administration of a potent and selective antagonist of T-type calcium channels, TTA-A2, to normal-weight animals prior to the inactive phase acutely increased sleep, decreased body core temperature, and prevented high-fat diet-induced weight gain. Administration of TTA-A2 to obese rodents reduced body weight and fat mass while concurrently increasing lean muscle mass. These effects likely result from better alignment of diurnal feeding patterns with daily changes in circadian physiology and potentially an increased metabolic rate during the active phase. Together, these studies reveal what we believe to be a previously unknown role for T-type calcium channels in the regulation of sleep and weight maintenance and suggest the potential for a novel therapeutic approach to treating obesity.
Abstract LB-256: Immunotherapy using genetically modified T lymphocytes to target CLEC14A on the tumor vasculature
Authors: Xiaodong Zhuang, Baksho Kaul, Michael Bentley, Zsuzsanna Nagy, Enrico Giraudo, Gavin Bendle, David Gilham, Roy Bicknell, Steven P. Lee
Journal: Cancer Research (2014)

Abstract Chimeric antigen receptor (CAR) therapy combines the specificity of a monoclonal antibody with the potent cytotoxic and immune regulatory activity of self-replicating T cells. This approach has shown remarkable efficacy in recent clinical trials targeting T cells to hematological cancers. More limited benefit has been reported with solid tumors, possibly because of lack of suitable target antigens, immune evasion mechanisms in the malignant cells and/or lack of T cell infiltration into the tumor tissue. An alternative approach that avoids some of these problems is to use a CAR that targets the tumor vasculature rather than the malignant cells directly. CLEC14A is a glycoprotein recently identified to be selectively overexpressed on the surface of the tumor vasculature in a wide range of human cancers, including ovarian, liver, bladder, prostate, breast and kidney, and is therefore of considerable interest for tumor therapy. Here we explore for the first time the feasibility of targeting the tumor vasculature using CLEC14A-specific CARs. Initially we generated CARs from several CLEC14A-specific monoclonal antibodies and then expressed them in T cells. In vitro T cell functional assays demonstrated that these CARs can trigger potent antigen-specific activation including cytotoxicity in engineered T cells. These CARs recognize both human and mouse forms of CLEC14A, so safety/efficacy studies could be conducted using mouse models. Following infusion of escalating doses of engineered T cells into healthy mice, circulating CAR-T cells persisted for at least the next 5 weeks without signs of toxicity. To explore anti-tumor effects, Lewis lung carcinoma cells were subcutaneously implanted into C57BL6 mice and 4 days later mice received a single dose of CLEC14A-specific CAR-T cells. Our recent data demonstrate statistically significant inhibition of tumor growth in mice treated with CAR-T cells compared with mock-transduced T cells. The engineered cells also appeared to expand/accumulate at the tumor site. These data suggest CLEC14A can be safely and effectively targeted with CAR-T cells, potentially offering a potent and widely applicable cancer therapy. Citation Format: Xiaodong Zhuang, Baksho Kaul, Michael Bentley, Zsuzsanna Nagy, Enrico Giraudo, Gavin Bendle, David Gilham, Roy Bicknell, Steven P. Lee. Immunotherapy using genetically modified T lymphocytes to target CLEC14A on the tumor vasculature. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-256. doi:10.1158/1538-7445.AM2014-LB-256
Rash and acute nephritic syndrome due to candesartan
Authors: A. Morton
Journal: BMJ (2004)

A 73 year old man presented with a two day history of a pruritic rash and oedema affecting both lower legs. He had had hypertension for three years, for which he had been taking candesartan, an angiotensin II receptor antagonist, for the past two years. He was not taking any other medications or preparations. He had no infective, gastrointestinal, or respiratory symptoms and no arthralgias.

Examination showed non-palpable, non-tender purpura affecting both legs, with pitting oedema, and urticarial lesions on the left knee and anterior chest. Testing of urine was positive for protein and blood. Urine microscopy showed > 100 …