tbuckley/cabot-search huggingface dataset:
Progressive Tricuspid Valve Disease in Patients With Congenitally Corrected Transposition of the Great Arteries
Authors: Lourdes R. Prieto, Allan J. Hordof, Michelle Secic, Marlon S. Rosenbaum, Welton M. Gersony
Journal: Circulation (1998)

The outcome of patients with corrected transposition of the great arteries (CTGA) is variably affected by associated intracardiac defects, tricuspid valve competence, and systemic right ventricular (RV) function. The relative importance of these factors in long-term outcome has not been evaluated.Since 1958, 40 patients with CTGA were studied to determine risk factors for poor outcome, including age, open heart surgery, tricuspid insufficiency (TI), cardiac rhythm, pulmonary overcirculation, and RV dysfunction. Follow-up ranged from 7 to 36 years (mean 20 years). Intracardiac repair was performed in 21 patients; 19 were unoperated or had closed heart procedures. For the purposes of this study the designation TI(S) refers to at least moderately severe TI as delineated by echocardiogram and/or angiography. TI(s) was the only independently significant factor for death (P=0.01), and in turn, only the presence of a morphologically abnormal TV predicted TI(s)(P=0.03). Twenty-year survival without TI(S)was 93%, but only 49% with TI(S). Poor long-term postoperative outcome was due to TI(S) in all but 1 patient; 20-year survival rates for operated patients with and without TI(s)were 34% and 90%, respectively (P=0.002). Similarly, 20-year survival rates for unoperated patients with and without TI(s)were 60% and 100%, respectively, whether or not attempts to repair the TI were made (P=0.08).TI(S)represents the major risk factor for CTGA patients; RV dysfunction appears to be almost always secondary to long-standing TI. Decisions related to surgical interventions with or without associated lesions must be strongly influenced by the status of the tricuspid valve.
Anaemia and unexplained abdominal pain: looking for a lead
Authors: D. A. Tsitsikas, M. Emery, S. Pomfret, J. K. Mehta, S. Mufti, A. Rezaeinia, R. J. Amos
Journal: BMJ (2012)

<b>Background:</b> The effectiveness of massage therapy for low-back pain has not been documented. This randomized controlled trial compared comprehensive massage therapy (soft-tissue manipulation, remedial exercise and posture education), 2 components of massage therapy and placebo in the treatment of subacute (between 1 week and 8 months) low-back pain. <b>Methods:</b> Subjects with subacute low-back pain were randomly assigned to 1 of 4 groups: comprehensive massage therapy (<i>n</i> = 25), soft-tissue manipulation only (<i>n</i> = 25), remedial exercise with posture education only (<i>n</i> = 22) or a placebo of sham laser therapy (<i>n</i> = 26). Each subject received 6 treatments within approximately 1 month. Outcome measures obtained at baseline, after treatment and at 1-month follow-up consisted of the Roland Disability Questionnaire (RDQ), the McGill Pain Questionnaire (PPI and PRI), the State Anxiety Index and the Modified Schober test (lumbar range of motion). <b>Results:</b> Of the 107 subjects who passed screening, 98 (92%) completed post-treatment tests and 91 (85%) completed follow-up tests. Statistically significant differences were noted after treatment and at follow-up. The comprehensive massage therapy group had improved function (mean RDQ score 1.54 v. 2.86-6.5, <i>p</i> &lt; 0.001), less intense pain (mean PPI score 0.42 v. 1.18-1.75, <i>p</i> &lt; 0.001) and a decrease in the quality of pain (mean PRI score 2.29 v. 4.55-7.71, <i>p</i> = 0.006) compared with the other 3 groups. Clinical significance was evident for the comprehensive massage therapy group and the soft-tissue manipulation group on the measure of function. At 1-month follow-up 63% of subjects in the comprehensive massage therapy group reported no pain as compared with 27% of the soft-tissue manipulation group, 14% of the remedial exercise group and 0% of the sham laser therapy group. <b>Interpretation:</b> Patients with subacute low-back pain were shown to benefit from massage therapy, as regulated by the College of Massage Therapists of Ontario and delivered by experienced massage therapists.
Psychopharmacologic Treatment Strategies for Depression, Bipolar Disorder, and Schizophrenia
Authors: Ira D. Glick, Trisha Suppes, Charles DeBattista, Rona J. Hu, Stephen Marder
Journal: Annals of Internal Medicine (2001)

Patients with serious psychiatric disorders are frequently treated by primary care physicians, who may have difficulty keeping up with recent advances in psychiatry. This paper presents an updated synopsis for three major psychiatric illnesses: major depression, bipolar disorder, and schizophrenia. Current definitions, updated diagnostic criteria, short- and long-term treatment strategies with algorithms, and special challenges for the clinician are discussed for each of these illnesses. On the basis of each illness's distinct characteristics, five treatment principles are emphasized: 1) Treatment strategies should be long-term and should emphasize adherence, 2) treatment choice should be empirical, 3) combinations of medications may be helpful, 4) a combination of psychosocial and pharmacologic treatments may be more useful than either alone, and 5) the family or “significant others” as well as a consumer organization need to be involved. Some of the new directions in clinical research to refine these strategies and meet these challenges are also described.
Effects of carbonic anhydrase inhibition on ventilation-perfusion matching in the dog lung.
Authors: E R Swenson, H T Robertson, M P Hlastala
Journal: Journal of Clinical Investigation (1993)

Lung carbonic anhydrase (CA) permits rapid pH responses when changes in regional ventilation or perfusion alter airway and alveolar PCO2. These pH changes affect airway and vascular resistances and lung compliance to optimize the balance of regional ventilation (VA) and perfusion (Q) in the lung. To test the hypothesis that these or other CA-dependent mechanisms contribute to VA/Q matching, we administered acetazolamide (25 mg/kg intravenously) to six anesthetized and paralyzed dogs and measured VA/Q relationships before and after CA inhibition by the multiple inert gas elimination technique. Four other groups of dogs were studied to control for possible confounding effects of time under anesthesia and nonselective CA inhibition by acetazolamide: (a) saline placebo as a control for duration of anesthesia, (b) 4% CO2 inhalation to mimic systemic CO2 retention, (c) 1 mg/kg benzolamide (a selective renal CA inhibitor) or 0.5 meq/kg HCl to mimic systemic metabolic acidosis, and (d) 500 mg/kg 4,4'-dinitrostilbene-2,2'-disulfonate (an inhibitor of red cell band 3 protein) to mimic the respiratory acidosis arising from an intracapillary block to rapid mobilization of plasma HCO3- in CO2 exchange. Acetazolamide increased VA/Q mismatch and reduced arterial PO2 measured at equilibrium but these did not occur in the control group. There was no deterioration in VA/Q matching when systemic respiratory acidosis produced either by CO2 inhalation or 4,4'-dinitrostilbene-2,2'-disulfonate or metabolic acidosis (benzolamide or HCl) were imposed to mimic the effects of acetazolamide apart from its inhibition of lung CA. These results support the concept that lung CA subserves VA/Q matching in the normal lung.
NHS takeover of prison health service proposed
Authors: J. Wise
Journal: BMJ (1996)

NHS takeover of prison health service proposedAn urgent need exists for the NHS to take over the provision of medical services in prisons in England and Wales, according to a report published last week by Her Majesty's Chief Inspector of Prisons.Sir David Ramsbotham's report Patient or Prisoner?says that the health care provided by the prison medical service does not match that provided by the NHS."Specific groups are particularly disadvantaged such as the mentally ill," he said."Prison can exacerbate mental health problems, with a long term impact on the individual concerned and the community into which he or she is released."The report calls for proper psychiatric ser- vices for mentally ill people in prison, which would require new units for day care centres and the ability to provide nursing services 24 hours a day.Sir David, a former chairman of an NHS hospital, prepared the report after visiting Holloway prison in London and seeing a number of problems with the prison medical service.He said that he hoped his report would stimulate widespread debate of the issues and that the Home Office and the Department ofHealth would have the will to take this forward within the next two years.Similar proposals have been put forward a number of times before, but Sir David said that he would ensure the debate did not fizzle out this time.The report says that prison healthcare staffhave become isolated, with little training and limited support in the management of their areas.For example, most doctors work- ing in the prison service are not qualified in psychiatry and have received no recognised training in assessing and treating mentally disordered offenders or drug misusers.Very few establishments have trained healthcare managers with a good understanding of how health care should be provided, managed, and linked to the NHS.Specific groups of prisoners such as juveniles and women, especially those who are pregnant, are also not adequately catered for in prison, the report says.Benefits of the NHS taking over prison health care * Continuity of planning between the NHS and prison service * Examination of public health issues linked to the wider issues local to prisons * Common standards between the two services * Continuity of health care between prison and the wider community * Healthcare staff trained to work in prison or the NHS * Common system of audit and evaluation * Common commitment to evidence based practice * Common commitment to setting and improving standards-for example, the patient's charter
Psychiatry and Psychotherapy
Authors: C. A. H. Watts
Journal: BMJ (1966)

For some decades, after the introduction of the head-up tilt test into clinical practice, the clinical presentation of vasovagal syncope (VVS) has been classified as typical (or classical) and atypical (or non-classical). Some clinical features and recent data suggest that even unexplained falls and syncope during sleeping hours may be possible clinical presentations of VVS. In recent studies, tilt testing and carotid sinus massage by means of the ‘method of symptoms’ were performed in one group of patients with unexplained falls and in another group with unexplained syncope (presence of prodromal symptoms)<i>.</i> Overall, tilt testing and carotid sinus massage displayed a high positivity rate in the group of patients with unexplained falls (about 60%), which was similar to that of the unexplained syncope group. These new data seem to indicate that some unexplained falls could be cases of atypical VVS/carotid sinus syncope with retrograde amnesia. Some clinical features suggest that syncope during sleeping hours is a form of VVS with a different clinical presentation: high prevalence of autonomic prodromes, of diurnal episodes of typical VVS and specific phobias, and of positive tilt testing with severe cardioinhibition.
Physician attitudes. Effect on the treatment of chemically dependent patients
Authors: J. N. Chappel
Journal: JAMA (1977)

PHYSICIAN attitudes are recognized as being a crucial factor in determining medical treatment. Studies of diagnostic practice indicate that the pervasive attitude among physicians is that "it is better to suspect illness than not—better safe than sorry." Yet in the case of chemically dependent persons, that traditionally positive attitude is often reversed. Negative attitudes toward chemically dependent persons are often taught indirectly in the medical school. Pejorative statements made by attending physicians and house staff about "junkies" and "winos" are a familiar part of medical education. Fisher and his colleagues<sup>1</sup>have shown that attitudes toward alcoholic patients are more negative in the second year of medical school and continue until they reach a substantially lower level among house staff. The effects of these negative attitudes have been noted at many levels. <h3>Diagnosis</h3> Diagnosis of drug dependence may be delayed or missed. Chafetz<sup>2</sup>and others have noted that many
THE EFFECT OF UNILATERAL NEPHRECTOMY ON THE TOTAL NUMBER OF OPEN GLOMERULI IN THE RABBIT
Authors: Robert A. Moore, Gregory F. Lukianoff
Journal: The Journal of Experimental Medicine (1929)

1. Under the experimental conditions employed, from 44 to 78 per cent of the glomeruli of the normal rabbit kidney contain circulating blood at any one moment. 2. After unilateral nephrectomy the number of glomeruli in the remaining kidney, which contain circulating blood, is increased to 91 to 99 per cent. 3. Compensation for the removal of one kidney is accomplished during the first 10 days at least, by an increase of the number of open glomeruli in the opposite kidney.
956. Imaging of Radiation-Inducible Promoters Using a Naturally Secreted Luciferase from the Marine Copepod Gaussia princeps
Authors: Christian E. Badr, Pierre Zalloua, Xandra O. Breakefield, Bakhos A. Tannous
Journal: Molecular Therapy (2006)

Ionizing Radiation (IR)-inducible promoters used as genetic switches for cancer therapy are promising tool for controlling therapeutic gene expression. Here we describe the use of a naturally secreted luciferase from the marine copepod Gaussia princeps (Gluc) for monitoring the activity and induction levels of different IR- sensitive promoters. The following promoters were tested: wild-type p53-activated fragment 1 (WAF1, 2.4 kb); early growth response factor (Egr-1, 550 bp); four tandem repeats of the transcriptional factor nuclear factor-kB (4NF-kB, 400 bp); and a combination of both Egr-1 and 4NF-kB promoters. These promoters were cloned upstream of the humanized Gluc cDNA in a plasmid containing the eGFP gene under the control of an immediate-early herpes simplex virus type-1 promoter. Vero2-2 (African green monkey kidney cells) were transfected with each of these constructs and irradiated at different doses of g-rays. Activity of these promoters and their response to radiation was monitored overtime by taking an aliquot of the cell-free conditioned medium, adding coelenterazine, the Gluc substrate, and measuring bioluminescence. At-least two- fold induction was detected with each promoter as observed by bioluminescence imaging of Gluc. This system can be used to monitor, in real-time, the activity as well as the effectiveness of radiation-inducible promoters to drive the expression of toxic genes for cancer therapy. Ionizing Radiation (IR)-inducible promoters used as genetic switches for cancer therapy are promising tool for controlling therapeutic gene expression. Here we describe the use of a naturally secreted luciferase from the marine copepod Gaussia princeps (Gluc) for monitoring the activity and induction levels of different IR- sensitive promoters. The following promoters were tested: wild-type p53-activated fragment 1 (WAF1, 2.4 kb); early growth response factor (Egr-1, 550 bp); four tandem repeats of the transcriptional factor nuclear factor-kB (4NF-kB, 400 bp); and a combination of both Egr-1 and 4NF-kB promoters. These promoters were cloned upstream of the humanized Gluc cDNA in a plasmid containing the eGFP gene under the control of an immediate-early herpes simplex virus type-1 promoter. Vero2-2 (African green monkey kidney cells) were transfected with each of these constructs and irradiated at different doses of g-rays. Activity of these promoters and their response to radiation was monitored overtime by taking an aliquot of the cell-free conditioned medium, adding coelenterazine, the Gluc substrate, and measuring bioluminescence. At-least two- fold induction was detected with each promoter as observed by bioluminescence imaging of Gluc. This system can be used to monitor, in real-time, the activity as well as the effectiveness of radiation-inducible promoters to drive the expression of toxic genes for cancer therapy.
Membranoproliferative Glomerulonephritis and Persistent Hypocomplementaemia
Authors: J. S. Cameron, E. F. Glasgow, C. S. Ogg, R. H. R. White
Journal: BMJ (1970)

The clinical, laboratory, and histological findings of 50 patients with membranoproliferative glomerulonephritis are described. Three-quarters of the patients, who were mostly older children and young adults, presented clinically with a mixture of "nephritic" and "nephrotic" symptoms; the remaining quarter had no symptoms and were diagnosed after the discovery of proteinuria and microscopic haematuria.Though this clinical picture may occur in other forms of glomerulonephritis, the patients described here were unified as a group by their glomerular morphological appearance-namely, a combination of mesangial proliferation and capillary wall thickening, mainly due to subendothelial accumulations of mesangial matrix.In 68% serum C3 (beta10-globulin) levels were reduced initially, while a further 16% subsequently showed a fall to abnormally low levels. All patients had substantial proteinuria, usually of moderately impaired selectivity, and all but one had haematuria in addition. Children frequently presented with an illness resembling acute nephritis, whereas adults usually had a nephrotic syndrome from the start.In 31 patients, followed for periods of one to eight and a half years, serial measurements of glomerular filtration rate were made. Sixteen have experienced no deterioration of renal function, though their proteinuria continues unchanged. Fifteen have shown progressive deterioration; six of them are still well, six are on regular dialysis treatment, and three have died. Treatment with corticosteroids, azathioprine, or cyclophosphamide, alone or in combination, did not seem to influence the course of the disease, and another two patients died from complications of steroid therapy. The disease usually runs a chronic course and appears to be progressive.
Biosynthesis of 15-deoxy-Δ12,14-PGJ2 and the ligation of PPARγ
Authors: L. Chastine Bell-Parikh, Tomomi Ide, John A. Lawson, Peter McNamara, Muredach Reilly, Garret A. FitzGerald
Journal: Journal of Clinical Investigation (2003)

15-deoxy-Δ12,14-PGJ2 (15d-PGJ2) has been identified as an endogenous ligand for PPARγ, inducing adipogenesis in vitro. Additional roles for this molecule in the propagation and resolution of inflammation, ligation of NF-κB, and mediation of apoptosis have been proposed. However, quantitative, physiochemical evidence for the formation of 15d-PGJ2 in vivo is lacking. We report that 15d-PGJ2 is detectable using liquid chromatography–mass spectrometry–mass spectrometry at low picomolar concentrations in the medium of 3T3-L1 preadipocytes. However, despite induction of COX-2, production of PGs, including 15d-PGJ2, does not increase during adipocyte differentiation, a process unaltered by COX inhibition. 15d-PGJ2 is detectable as a minor product of COX-2 in human urine. However, its biosynthesis is unaltered during or after COX activation in vivo by LPS. Furthermore, the biosynthesis of 15d-PGJ2 is not augmented in the joint fluid of patients with arthritis, nor is its urinary excretion increased in patients with diabetes or obesity. 15d-PGJ2 is not the endogenous mediator of PPARγ-dependent adipocyte activation and is unaltered in clinical settings in which PPARγ activation has been implicated.
Involvement of reactive oxygen intermediates in cyclooxygenase-2 expression induced by interleukin-1, tumor necrosis factor-alpha, and lipopolysaccharide.
Authors: L Feng, Y Xia, G E Garcia, D Hwang, C B Wilson
Journal: Journal of Clinical Investigation (1995)

Reactive oxygen intermediates (ROIs) play an important role in inflammatory processes as mediators of injury and potentially in signal transduction leading to gene expression. Cyclooxygenase (COX) is a rate-limiting enzyme in prostanoid biosynthesis, and its recently cloned inducible form, COX-2, is induced by proinflammatory cytokines. This study linked ROIs to the signaling pathways that induce COX-2 expression. The hydroxyl radical scavengers DMSO (1%), as well as di- and tetramethylthiourea, inhibited IL-1-, TNF alpha-, and LPS-induced COX-2 expression in rat mesangial cells. The suppression of COX-2 mRNA expression correlated with the COX-2 protein level. In comparison with the prolonged induction of the inducible gene encoding protein-tyrosine phosphatase by hydrogen peroxide, the COX-2 gene was only transiently induced. Protein-tyrosine phosphatase is also induced by heat shock and chemical stress, whereas COX-2 is not. Superoxide was a more potent inducer for COX-2 than hydrogen peroxide. In addition, NADPH stimulated COX-2 expression, and an inhibitor of NADPH oxidase blocked COX-2 expression induced by TNF alpha. COX-2 and KC gene expression costimulated by IL-1 were inhibited differentially by the scavengers. These studies demonstrate that oxidant stress is a specific and important inducer of COX-2 gene expression. This induction may contribute to the deleterious amplification of prostanoids in inflammation and compound the direct effects of ROI production.
Use of Surgical Rehabilitation in Young Delinquents
Authors: D. A. Ogden
Journal: BMJ (1959)

BrJo= _ slowly than with penicillin or organic arsenicals.Serological tests became negative in most cases.Dosage, in one series, was 2 g. initially, followed by 2 g. four hours later, and then 1 g.every four hours, day and night, until 70 g.had been given in 11 days.In another series dosage of 60 mg.per kg.body weight per day for eight days seemed satisfactory.Rodriquez et al. (1952), who used the former scheme of treatment, reported on 101 patients so treated and observed for 12 to 15 months.Treatment seems to have been successful in about 75%.Oxytetracycline by mouth has given results similar to those described with chlortetracycline.Dosage in one small series was 3 g.by mouth followed by 0.5 g. every four hours for 15 days, giving a total of 48 g. (Robinson and Robinson, 1951).Treponemes disappeared in 4 to 48 hours.Observation was possible in four cases and all became sero-negative with later sero-relapse in one case.The same authors (1953) examined the three remaining patients two to four years after treatment.All were well with negative serological tests and tests of the cerebrospinal fluid.Irgang and Alexander (1953) treated 10 cases of early syphilis with oxytetra- cycine by mouth, giving 2 g. a day for 14 days.Treponema pallidum disappeared from surface lesions in 44 to 96 hours.In most cases the surface lesions responded favourably, but in a few instances they were slow to resolve.Serological response was favourable in those patients who remained under observation.One case proved resistant to treatment.Baler (1956) gave oxytetracycline intramuscularly in the treatment of 16 patients suffering from early syphilis.Dosage was 200 mg.twice daily for 10 days, the total being 4 g., except in one case in which it was 100 mg.twice daily for three days, followed by 200 mg.twice daily for seven days (3.4 g.).All lesions healed rapidly and Treponema pallidum disappeared in an average of 40 hours.The
Enterocyte protein processing and synthesis
Authors: David H. Alpers
Journal: Hepatology (1987)

Until recently, structural information regarding large brush border proteins was obtained largely by protein purification and protein chemistry. Molecular biology has added the techniques of cell-free translation and cDNA cloning to provide additional information. In addition, the regulation of protein synthesis was largely deduced by the use of inhibitors of protein or nucleic acid synthesis. The ability to assess mRNA content by cell-free translation or by hybridization with isolated cDNA has expanded these studies. Moreover, polysomal isolation and organ explants can now be used to determine synthetic and secretion rates directly. Future research in these areas will depend upon the isolation of cDNA clones encoding specific enterocyte proteins to simplify structural analysis, as well as the use of intestinal cell lines to simplify measurement of synthetic rates and protein processing.