tbuckley/cabot-search huggingface dataset:
Health checks in general practice
Authors: P. D Toon
Journal: BMJ (1995)

was maintained primarily by the pharmacological effects of nicotine.An advisory panel to the Food and Drug Administration subsequently concluded that nicotine was addictive and that all cigarettes available in the United States can provide addicting levels ofnicotine.Recent biomedical research on the nature and mechanisms of nicotine addiction supports the consideration of regulatory reform.For example, nicotine has certain effects and mechanisms in common with cocaine, including the involve- ment of dopaminergic transmitters.Research is unravelling the specific mechanisms by which nicotine influences behaviour.5Exposure to nicotine produces lasting changes in the body's structure, which include increased expression and reduced turnover of nicotine receptors in the brain; these seem to be important in the development of tolerance and dependence.'68Nicotine also has potentially beneficial effects on performance, which are reportedly sought by many tobacco users and could facilitate the development and maintenance of addiction.9 10 Possible strategies to be overseen by the Food and Drug Administration could include new systems of evaluating cigarettes' dosing characteristic's,3 restrictions on the amount of nicotine in tobacco products," and new restrictions on advertising and marketing.'Prohibition is unlikely.The Food and Drug Administration is clearly committed to examining the range of options available and developing solutions with the long term potential of substantially reducing tobacco use and death and disease caused by tobacco.4The clock may be slowed by any number of events, but to turn it back will be difficult given the extensive findings that commercial tobacco products are systems that deliver an addictive drug and confer a high risk of disability and death.
Rex Ernest Coupland
Authors: S. Monkhouse
Journal: BMJ (2009)

Anyone who puts Rex’s name into a search engine will be rewarded with sites concerning his adrenal and neuroendocrine research, sites concerning his place in the history of research using magnetic resonance imaging, and sites about anatomy teaching and its place in medical training. Who’s Who lists many other accomplishments and achievements, including service to many national and professional bodies. All this gives some indication of his broadness of vision, his enormous knowledge, and his prophetic qualities. From it you can deduce his dedication, his love of his work, and the prodigious energy that made him one of the youngest professors in the UK when he was appointed to Dundee, that led him to be an ambassador worldwide for his enthusiasms, and that led him to medical politics and the General Medical Council.

Rex was born in 1924 and raised in Mirfield. From the grammar school, he went to Leeds Medical School, where he displayed prowess scholarly and physical, receiving academic plaudits and playing tennis for the university. Rex had a clinical career in mind, and it was accidental that he fell into anatomy, but fortunate that he landed on his feet in the department of Professor Durward, who seeded the world with several eminent anatomists. After his time in Leeds and …
System-wide molecular evidence for phenotypic buffering in Arabidopsis
Authors: Jingyuan Fu, Joost J B Keurentjes, Harro Bouwmeester, Twan America, Francel W A Verstappen, Jane L Ward, Michael H Beale, Ric C H de Vos, Martijn Dijkstra, Richard A Scheltema, Frank Johannes, Maarten Koornneef, Dick Vreugdenhil, Rainer Breitling, Ritsert C Jansen
Journal: Nature Genetics (2009)
Doctor who cut rugby player's lip is free to practise after warning
Authors: C. Dyer
Journal: BMJ (2010)

The doctor at the centre of the “Bloodgate” rugby scandal is free to resume her career after a General Medical Council panel ruled that, despite her dishonesty, her fitness to practise was not impaired.

Wendy Chapman, 49, cut the lip of player Tom Williams with a stitch cutter to make it appear that he had a match injury and gave false evidence to a committee inquiring into the incident.

But the panel held that an “altered state of mind” caused by severe depression made her act out of character and gave her a formal warning, …
Daunorubicin-Induced Apoptosis in Rat Cardiac Myocytes Is Inhibited by Dexrazoxane
Authors: Douglas B. Sawyer, Ryuji Fukazawa, Margaret A. Arstall, Ralph A. Kelly
Journal: Circulation Research (1999)

-The clinical efficacy of anthracycline antineoplastic agents is limited by a high incidence of severe and usually irreversible cardiac toxicity, the cause of which remains controversial. In primary cultures of neonatal and adult rat ventricular myocytes, we found that daunorubicin, at concentrations </=1 micromol/L, induced myocyte programmed cell death within 24 hours, as defined by several complementary techniques. In contrast, daunorubicin concentrations >/=10 micromol/L induced necrotic cell death within 24 hours, with no changes characteristic of apoptosis. To determine whether reactive oxygen species play a role in daunorubicin-mediated apoptosis, we monitored the generation of hydrogen peroxide with dichlorofluorescein (DCF). However, daunorubicin (1 micromol/L) did not increase DCF fluorescence, nor were the antioxidants N-acetylcysteine or the combination of alpha-tocopherol and ascorbic acid able to prevent apoptosis. In contrast, dexrazoxane (10 micromol/L), known clinically to limit anthracycline cardiac toxicity, prevented daunorubicin-induced myocyte apoptosis, but not necrosis induced by higher anthracycline concentrations (>/=10 micromol/L). The antiapoptotic action of dexrazoxane was mimicked by the superoxide-dismutase mimetic porphyrin manganese(II/III)tetrakis(1-methyl-4-peridyl)porphyrin (50 micromol/L). The recognition that anthracycline-induced cardiac myocyte apoptosis, perhaps mediated by superoxide anion generation, occurs at concentrations well below those that result in myocyte necrosis, may aid in the design of new therapeutic strategies to limit the toxicity of these drugs.
Population-Based Incidence of IDDM in the State of São Paulo, Brazil
Authors: Sandra RG Ferreira, Laercio J Franco, Marco A Vivolo, Carlos A Negrato, Antonio CP Simoes, Carlos R Ventureli
Journal: Diabetes Care (1993)

OBJECTIVE To study the incidence of IDDM among children, infants to 14 yr of age, in the state of São Paulo, Brazil, 1987–1991. RESEARCH DESIGN AND METHODS A prospective population-based register was established, using physician reports of newly diagnosed IDDM patients &amp;lt; 15 yr of age as the primary source of case identification and school surveys as the main secondary source. Data were collected according to the methods recommended by the Diabetes Epidemiology Research International group. RESULTS Case ascertainment was estimated at 95.0, 92.8, and 98.8% complete for each of the three cities studied. The average annual IDDM incidence was 7.6/100,000 inhabitants (95% confidence interval, 5.6–9.7). We found a higher incidence rate in girls than boys. CONCLUSIONS The incidence of childhood IDDM in a tropical region in South America (São Paulo, Brazil) is in the middle incidence range observed in developed countries throughout the world. Increased incidence of IDDM in girls compared with boys will be tested by the ongoing Brazilian incidence study being developed in 18 other centers across the country.
Salivary Levels and Digitalis Toxicity
Authors: James E. Doherty
Journal: JAMA (1973)

<h3>To the Editor.—</h3> I have read with interest the EDITORIAL by Dr. Samuel Vaisrub, "Salivary Electrolytes and Digitalis Toxicity," which appeared inThe Journal(225:519, 1973). I do not agree that there is impressive evidence that salivary electrolytes will reveal digitalis toxicity when not shown by an electrocardiogram or serum levels. On the contrary, the lack of correlation between serum levels and salivary electrolytes shown in all of the references mentioned<sup>1-3</sup>tends to make me disregard salivary electrolyte determinations as a meaningful evaluation in the assessment of digitalis toxicity. Virtually all of those<sup>4-6</sup>who have studied the correlation of digitalis serum levels with toxicity, except Fogelman et al,<sup>7</sup>find a high degree of statistical correlation. The major shortcoming of serum level determinations obtained by radioimmunoassay is the overlap between patients "normally" digitalized, as well as underdigitalized, and those with toxicity. In brief, the radioimmunoassay for digitalis in
Multislice MRI in Assessment of Myocardial Perfusion in Patients With Single-Vessel Proximal Left Anterior Descending Coronary Artery Disease Before and After Revascularization
Authors: Kirsi Lauerma, Kari S. Virtanen, Leena M. Sipilä, Pauli Hekali, Hannu J. Aronen
Journal: Circulation (1997)

Our purpose was to use multislice MRI for detection of reversible myocardial ischemia and assessment of the effect of revascularization on tissue perfusion in patients with coronary artery disease.Eleven patients with single-vessel proximal left anterior descending coronary artery disease were studied with MRI and thallium scintigraphy before and 3 months after revascularization. All patients had a reversible perfusion defect by scintigraphy before treatment. With a 1.5-T MR imager, IR-prepared turboflash images were acquired in three left ventricular short-axis planes during 0.05 mmol/kg Gd-DTPA bolus at rest and with dipyridamole-induced stress. Before treatment, stress increased enhancement slope in normal (6.4+/-4.4 to 7.4+/-5.0 s(-1), P<.04) and decreased it in underperfused (5.4+/-3.7 to 2.6+/-1.4 s(-1), P<.02) regions, resulting in a contrast-to-noise ratio of 6.87+/-3.09 in underperfused myocardium. Revascularization normalized enhancement patterns of the formerly underperfused myocardium and decreased defect size both in scintigraphy (66+/-53 degrees to 8+/-12 degrees, P<.001) and MRI sections (49+/-41 degrees to 9+/-8 degrees, P<.001). Agreement of 85% in detection and correlation of 0.86 (SEE, 21 degrees, P<.001) in sizing perfusion defects was found between MRI and scintigraphy.Multislice contrast-enhanced MRI can be used to detect myocardial perfusion defects in patients with coronary artery disease and in assessment of the effect of treatment on myocardial perfusion.
Sustained compression and healing of chronic venous ulcers.
Authors: A. D. Chant
Journal: BMJ (1989)

Referrals to hospital by general practitioners SIR,-We have recently completed an extensive study into non-attendance for psychiatric ap- pointments, and several points emerge from a comparison of the findings of Dr Kieran JMcGlade and others' with ours.Their 20% level of overall non-attendance for initial appointments in all specialties is far higher than that we encountered for the Grampian region of Scotland.Our figure of 8% is more in keeping with that of Grace and Armstrong.2More striking is the discrepancy between their figures and ours for psychiatric non- attendance.In contrast to their 40% rate we found that only 234 out of 2771 (8 4%) first appointments were not kept.This difference may of course reflect the small number of patients in the Belfast study.Furthermore, it is interesting to note that, at least in Grampian, appointment default is no more common in psychiatry than in other specialties.There are, however, two points on which the
Defective Urinary Acidification in Wilson's Disease
Authors: MILFORD FULOP
Journal: Annals of Internal Medicine (1968)

Four of 12 patients with treated Wilson's disease had subnormal urinary acidifying capacity, and one of them had bilateral medullary nephrocalcinosis characteristic of distal renal tubular acidosis. Hyperchloremic acidosis was not present in three of these patients and was minimal in a fourth. None of them had urinary symptoms, osteomalacia, or hypokalemia. One, who had the Fanconi syndrome before treatment with D-penicillamine, manifested marked improvement in his proximal renal tubular abnormalities after which his urinary acidification defect first appeared. It appears that this abnormality may be an inherent feature of Wilson's disease.
Impaired sweating function in adult atopic dermatitis: results of the quantitative sudomotor axon reflex test
Authors: K. Eishi, J-B. Lee, S-J. Bae, M. Takenaka, I. Katayama
Journal: British Journal of Dermatology (2002)

Impaired sweating is thought to be a cause of barrier dysfunction in atopic dermatitis (AD).To examine the sweating function in AD in a quantitative manner.We investigated the sweating response of lesional and non-lesional skin of adult patients with AD by a quantitative sudomotor axon reflex test in which the axon reflex is stimulated by acetylcholine iontophoresis. Sweat volume on the volar aspect of the forearm was measured in 18 adult patients with AD and in 40 non-atopic controls; five patients with Sjögren's syndrome were also studied as disease comparators. We also evaluated the sweating function in four AD patients after topical corticosteroid therapy. Latency time, direct (DIR) sweat volume and axon reflex-mediated indirect (AXR) sweat volume were the variables studied.The latency time in AD patients was significantly prolonged and AXR sweat volume significantly reduced compared with those in non-atopic control subjects. The latency time and AXR sweat volume of lesional AD skin were significantly more prolonged and reduced, respectively, than those of non-lesional skin. In contrast, the DIR sweat volume of lesional or non-lesional AD skin induced by direct stimulation with acetylcholine was only slightly reduced when compared with that in non-atopic controls. Latency time and sweat volumes of lesional and non-lesional AD skin improved after topical corticosteroid therapy.These results suggest that the impaired sweat response in AD is attributable to an abnormal sudomotor axon reflex, which is reversed by topical corticosteroid administration.
Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States
Authors: B. P Kennedy, I. Kawachi, D. Prothrow-Stith
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To determine the effect of income inequality as measured by the Robin Hood index and the Gini coefficient on all cause and cause specific mortality in the United States. <b>Design</b>: Cross sectional ecological study. <b>Setting</b>: Households in the United States. <b>Main outcome measures</b>: Disease specific mortality, income, household size, poverty, and smoking rates for each state. <b>Results</b>: The Robin Hood index was positively correlated with total mortality adjusted for age (r=0.54; P&lt;0.05). This association remained after adjustment for poverty (P&lt;0.007), where each percentage increase in the index was associated with an increase in the total mortality of 21.68 deaths per 100000. Effects of the index were also found for infant mortality (P=0.013); coronary heart disease (P=0.004); malignant neoplasms (P=0.023); and homicide (P&lt;0.001). Strong associations were also found between the index and causes of death amenable to medical intervention. The Gini coefficient showed very little correlation with any of the causes of death. <b>Conclusion</b>: Variations between states in the inequality of income were associated with increased mortality from several causes. The size of the gap between the wealthy and less well off—as distinct from the absolute standard of living enjoyed by the poor—seems to matter in its own right. The findings suggest that policies that deal with the growing inequities in income distribution may have an important impact on the health of the population. <h3>Key messages</h3> The size of the gap between the wealthy and less well off—as distinct from the absolute standard of living enjoyed by the poor—seems to be related to mortality Policies that deal with the growing inequities in income distribution may have a considerable impact on the health of the population
Anti-inflammatory effects of salmeterol/fluticasone, tiotropium/fluticasone or tiotropium in COPD
Authors: D-W. Perng, C-W. Tao, K-C. Su, C-C. Tsai, L-Y. Liu, Y-C. Lee
Journal: European Respiratory Journal (2009)

The anti-inflammatory effects of salmeterol/fluticasone (SFP), tiotropium/fluticasone (Tio+FP) and tiotropium (Tio) alone were investigated on the inflammatory cells and mediators in sputum induced from chronic obstructive pulmonary disease patients. Subjects were either newly diagnosed or had not taken any medication for 3 months prior to the study. Subjects (n = 99) were randomised (not double blinded) and received either SFP (100/1,000 μg daily), Tio+FP (18/1,000 μg daily) or Tio (18 μg daily) for 12 weeks. Induced sputum and serum C-reactive protein (CRP) were analysed prior to and at the end of treatment. The results showed that treatment with SFP caused a significant reduction in interleukin (IL)-8 and matrix metalloprotease (MMP)-9 in induced sputum, compared with treatment with Tio alone. There were no treatment differences between the SFP and Tio+FP groups in decreasing IL-8 and MMP-9 levels. The reduction in IL-8 showed significant association with the reduction in MMP-9. All treatment groups failed to significantly reduce the numbers of total cells, neutrophils, macrophages and eosinophils in induced sputum; in addition, there were no treatment differences in terms of improvement of forced expiratory volume in one second, forced vital capacity, CRP or quality of life between the three groups. The anti-inflammatory effects of salmeterol/fluticasone probably contribute to the clinical benefits seen in chronic obstructive pulmonary disease patients.
Generation and characterization of urokinase receptor-deficient mice.
Authors: M Dewerchin, A V Nuffelen, G Wallays, A Bouché, L Moons, P Carmeliet, R C Mulligan, D Collen
Journal: Journal of Clinical Investigation (1996)

Mice homozygously deficient for the urokinase-type plasminogen activator (u-PA) receptor (u-PAR-1-) were generated by homologous recombination in D3, embryonic stem cells. The genomic sequences comprising exon 2 through 5 of the u-PAR gene were replaced by the neomycin resistance gene, resulting in inactivation of both u-PAR splice variants. The inactivated u-PAR allele was transmitted via mendelian inheritance, and fertility. Inactivation of u-PAR was confirmed by the absence of binding of rabbit anti-murine u-PAR or of an aminoterminal fragment of murine u-PA (mu-PA.1-48) to u-PAR-1- embryonic fibroblasts and macrophages. u-PAR-1- mice displayed normal lysis of a murine plasma clot injected via the jugular vein. Invasion of macrophages into the peritoneal cavity after thioglycollate stimulation was similar in u-PAR-1- and u-PAR-1- mice. u-PAR-1- peritoneal macrophages had a threefold decreased initial rate of u-PA-mediated plasminogen activation in vitro but degraded extracellular matrix proteins in vitro as efficiently as u-PAR-1- macrophages.
Clinical Cardiovascular Physiology
Authors: Harry B. Greenberg
Journal: JAMA (1976)

Will further study of our reptilian kindred (whose hearts demonstrate a unique anaerobic metabolic capacity) yield a treatment for myocardial infarction? Possibly, suggests one of the contributors to<i>Clinical Cardiovascular Physiology</i>. He cites many approaches to the problem of inadequate myocardial oxygenation, including experimental attempts to increase glycolytic flux, enhance excitation-contraction coupling, and improve coronary blood flow. Unfortunately, methods that can effectively increase the energy output of the ischemic myocardial cell have yet to be developed. However, reducing the work load of the ischemic heart (with propranolol, furosamide, or nitroglycerine and nitroprusside) helps balance energy demand and supply. Although they consider the role of the digitalis glucosides and other treatment, Dr Levine and the 39 contributors to his book mostly present their concepts of normal and abnormal cardiac physiology. They also take up the effects of disordered cardiac function on the kidneys and lungs, often in much detail. Schreiner and
A Long-Acting Phenothiazine as a Possible Agent to Control Deviant Sexual Behavior
Authors: A. A. BARTHOLOMEW
Journal: American Journal of Psychiatry (1968)

Various techniques have been tried in an endeavor to control deviant sexual drive. This paper presents the results obtained using a long-acting phenothiazine given intramuscularly and working on a depot basis, the theoretical advantages being a lesser incidence of gynecomastia than with estrogens, and the necessity for less patient cooperation than with oral medication. The results in both sexually normal and deviant groups suggest that the drug is of value in reducing sexual drive and performance, with no undue side effects observed provided antiparkinsonian drugs are given.
Magnetic Resonance Imaging During Untreated Ventricular Fibrillation Reveals Prompt Right Ventricular Overdistention Without Left Ventricular Volume Loss
Authors: Robert A. Berg, Vincent L. Sorrell, Karl B. Kern, Ronald W. Hilwig, Maria I. Altbach, Melinda M. Hayes, Kathryn A. Bates, Gordon A. Ewy
Journal: Circulation (2005)

Most out-of-hospital ventricular fibrillation (VF) is prolonged (>5 minutes), and defibrillation from prolonged VF typically results in asystole or pulseless electrical activity. Recent visual epicardial observations in an open-chest, open-pericardium model of swine VF indicate that blood flows from the high-pressure arterial system to the lower-pressure venous system during untreated VF, thereby overdistending the right ventricle and apparently decreasing left ventricular size. Therefore, inadequate left ventricular stroke volume after defibrillation from prolonged VF has been postulated as a major contributor to the development of pulseless rhythms.Ventricular dimensions were determined by MRI for 30 minutes of untreated VF in a closed-chest, closed-pericardium model in 6 swine. Within 1 minute of untreated VF, mean right ventricular volume increased by 29% but did not increase thereafter. During the first 5 minutes of untreated VF, mean left ventricular volume increased by 34%. Between 20 and 30 minutes of VF, stone heart occurred as manifested by dramatic thickening of the myocardium and concomitant substantial decreases in left ventricular volume.In this closed-chest swine model of VF, substantial right ventricular volume changes occurred early and did not result in smaller left ventricular volumes. The changes in ventricular volumes before the late development of stone heart do not explain why defibrillation from brief duration VF (<5 minutes) typically results in a pulsatile rhythm with return of spontaneous circulation, whereas defibrillation from prolonged VF (5 to 15 minutes) does not.
1062-49 Clinical outcome following percutaneous coronary intervention in patients with end-stage renal disease
Authors: Mamoru Toyofuku, Yasuhiko Hayashi, Michinori Imazu, Yoshiko Masaoka, Hironori Ueda, Tadamichi Sakuma, Yuji Muraoka, Hidekazu Hirao, Takenori Okada, Shinji Mito, Ken Ishibashi, Kentaro Miura
Journal: Journal of the American College of Cardiology (2004)