tbuckley/cabot-search huggingface dataset:
The role of pulmonary surfactant in obstructive airways disease
Authors: J Hohlfeld, H Fabel, H Hamm
Journal: European Respiratory Journal (1997)

Pulmonary surfactant research has an increasing impact on treatment considerations in adult respiratory disorders, above all acute respiratory distress syndrome (ARDS). Obstructive airways diseases have only been sporadically addressed in this respect. In the last decade, direct and circumstantial evidence for surfactant as a contributing factor in the regulation of airway calibre has emerged. Morphologically, a bronchiolar surfactant layer has been demonstrated, whereby the airways are mostly supplied by alveolar surfactant components via the mucociliary escalator. Functionally, prevention of airway film collapse and collapse of the airway walls are important surfactant properties in maintaining airway stability. In addition to its surface activity, airway surfactant improves bronchial clearance and regulates airway liquid balance, thus indirectly modulating airway wall thickness and airway diameter. Surfactant has furthermore been shown to modulate the function of respiratory inflammatory cells. Its immunomodulatory activity includes suppression of cytokine secretion and transcription factor activation. This may be of importance in the inflammatory network of asthma. Thus, dysfunction of surfactant in obstructive lung disease might be one of the mechanisms leading to increased airway resistance, which is commonly thought to be due to narrowing of airways under humoral and nervous control. In animal models of asthma, surfactant dysfunction was demonstrated, which was possibly due to protein inhibition. Furthermore, surfactant therapy seems to be capable of preventing allergen-induced bronchoconstriction. Human studies on surfactant impairment in obstructive airways diseases are still scarce but the data available are consistent with animal studies. Antiobstructive pharmacotherapy, mainly with corticosteroids, might influence and improve airway surfactant balance, but the exact mechanisms and the overall effect of pharmacotherapy on surfactant function in obstructive airways disease has to be further elucidated. Our knowledge about the role of pulmonary surfactant in obstructive airways disease is still limited, but there is convincing evidence that pulmonary surfactant plays a role in keeping the airways open.
“Did you see it? Where did it go?”
Authors: David E Price, Robert M Redfern
Journal: BMJ (2007)

Objective To assess the effect of altitude on match results and physiological performance of a large and diverse population of professional athletes.Design Statistical analysis of international football (soccer) scores and results.Data resources FIFA extensive database of 1460 football matches in 10 countries spanning over 100 years.Results Altitude had a significant (P<0.001)negative impact on physiological performance as revealed through the overall underperformance of low altitude teams when playing against high altitude teams in South America.High altitude teams score more and concede fewer goals with increasing altitude difference.Each additional 1000 m of altitude difference increases the goal difference by about half of a goal.The probability of the home team winning for two teams from the same altitude is 0.537, whereas this rises to 0.825 for a home team with an altitude difference of 3695 m (such as Bolivia v Brazil) and falls to 0.213 when the altitude difference is -3695 m (such as Brazil v Bolivia).Conclusions Altitude provides a significant advantage for high altitude teams when playing international football games at both low and high altitudes.Lowland teams are unable to acclimatise to high altitude, reducing physiological performance.As physiological performance does not protect against the effect of altitude, better predictors of individual susceptibility to altitude illness would facilitate team selection.
Alexithymia in Young Adulthood: A Risk Factor for Pathological Gambling
Authors: James D.A. Parker, Laura M. Wood, Barbara J. Bond, Peggy Shaughnessy
Journal: Psychotherapy and Psychosomatics (2004)

&lt;i&gt;Background:&lt;/i&gt; Pathological gambling is more prevalent among postsecondary students than among the general adult population. While the prevalence of pathological gambling in this group has risen over the past decade, factors underlying the development of problem gambling among university students remain largely unexplored. One early study found alexithymia to be associated with pathological gambling. The aim of the present study was to further examine the relationship between alexithymia and gambling among postsecondary students. &lt;i&gt;Methods:&lt;/i&gt; The relationship between alexithymia and pathological gambling was examined in 562 postsecondary students who completed the South Oaks Gambling Screen (SOGS) and the 20-item Toronto Alexithymia Scale (TAS-20). &lt;i&gt;Results:&lt;/i&gt; Approximately 12% of the sample was classified as alexithymic according to the TAS-20. These individuals were found to have significantly more gambling problems, as measured by the SOGS, than nonalexithymic individuals. Approximately 9% of the sample was classified as pathological gamblers according to the SOGS. These individuals were found to have significantly higher levels of alexithymia, as measured by the TAS-20, than nonproblem gamblers. &lt;i&gt;Conclusions:&lt;/i&gt; Alexithymia is associated with pathological gambling and may be a risk factor among postsecondary students for developing severe gambling problems.
Responses by general practitioners in Avon to proposals for general practice in the white paper Working for Patients.
Authors: M. Whitfield, N. Wood, F. Wright
Journal: BMJ (1989)

OBJECTIVE--To determine the views of Avon9s general practitioners about the general practice proposals within the government9s white paper Working for Patients. DESIGN--Postal questionnaire survey. SETTING--A county in south west England. SUBJECTS--All general practitioner principals (n = 537) under contract with Avon Family Practitioner Committee. MEASUREMENTS AND MAIN RESULTS--492 doctors (92%) responded to the survey. More than three quarters of the respondents were opposed to the government9s proposals on budgets for specific surgical procedures, prescribing, and diagnostic tests; and between 63% and 93% felt negative about advantages that might accrue from the proposals. Over three quarters of general practitioners were in favour of family practitioner committees monitoring work load, prescribing, and referrals. General practitioners in large, potentially budget holding practices held similar views to doctors in smaller practices. CONCLUSIONS--Avon9s general practitioners substantially reject most of the government9s proposals about general practice in the white paper Working for Patients.
The Groningen Protocol — Euthanasia in Severely Ill Newborns
Authors: Eduard Verhagen, Pieter J.J. Sauer
Journal: New England Journal of Medicine (2005)

Drs. Eduard Verhagen and Pieter Sauer state that of the 200,000 children born in the Netherlands every year, about 1000 die during the first year of life. For 600 of these infants, death is preceded by a medical decision regarding the end of life. The question now is whether deliberate life-ending procedures are acceptable for newborns and infants, despite the fact that these patients cannot express their own will.
FULL VISION BIFOCAL OPERATING SPECTACLES
Authors: Myron Metzenbaum
Journal: JAMA (1926)

Many forms of glasses have been devised to enable persons to see at a distance with one part of the lens and at a close range with the other part. The bifocal is usually placed in the lower segment, although sometimes it is in the upper segment or in the center. These various arrangements of lenses afford either long or short distant vision through only a part of the lens, and it is impossible to view the whole field in all directions. The spectacles recently devised consist of two pairs of lenses in two separately hinged frames. The first pair gives full vision for distance. When the second pair is lowered against the first pair, it supplies the additional lenses necessary for full near vision. For certain work, the full vision is desirable or even necessary. For the ear, nose and throat specialist whose offices are usually made up of
Congenital Absence of Both Kidneys
Authors: P. E. Sylvester, D. R. Hughes
Journal: BMJ (1954)

VOMITING SICKNESS OF JAMAICA ME (Michel), 0.7 unit.(3) Blood urea, 45 mg. per 100 ml.(4) Serum calcium, 11 mg.per 100 ml. (5)Carbon dioxide combining power, 40 volumes per 100 ml.( 6) E.C.G., normal.(7) Blood sugar, 19 mg. per 100 ml.(8) Liver biopsy (immediate): almost complete absence of liver glycogen
Fancy drugs for worried folks
Authors: G. Dunea
Journal: BMJ (1999)

When Mrs Boronowski, aged 67, went to Dr Jingle for her nervous indigestion and multiple allergies, she left his office with a bunch of prescriptions. She was given omeprazole ($4 (£2.50) a tablet), even though belladonna or a bottle of amphojel would have done as well. To calm her shattered nerves she received buspirone ($1.30 a tablet), because diazepam is too common to be effective. For her allergies Dr Jingle prescribed loratidine ($2.20 a tablet), because …
Hyperplasia of vascular smooth muscle in experimental hypertension in the rabbit.
Authors: R D Bevan, E van Marthens, J A Bevan
Journal: Circulation Research (1976)

Evidence for smooth muscle cell hyperplasia was sought in elastic and muscular vessels of rabbits 2 weeks after hypertension had been induced by partial constriction of the abdominal aorta above both kidneys. In those arteries taken from the circulation proximal to the constriction, specifically the common carotid artery and the aorta, vessel length, wall thickness, weight, and deoxyribonucleic acid content were increased in proportion to the rise in arterial pressure. There was no change in the extracellular space of muscular arteries as measured by [14C]inulin. [3H]Thymidine uptake measured in a gastric artery increased in proportion to the rise in arterial pressure. As demonstrated by light microscope autoradiography, [3H]thymidine was incorporated into cells in all layers of the artery wall but predominantly into the smooth muscle cells. There was no change in the size of arteries below the ligature where the arterial pressure was within normal limits. The data demonstrated that the increase in vessel wall dimensions in this animal model of hypertension is due in part, during the acute phase, to an increase in the number of cells, particularly vascular smooth muscle cells.
Multifunctional core-shell polymeric nanoparticles for transdermal DNA delivery and epidermal Langerhans cells tracking
Authors: Po-Wei Lee, Sheng-Hsiang Hsu, Jin-Sheng Tsai, Fu-Rong Chen, Pei-Jai Huang, Cherng-Jyh Ke, Zi-Xian Liao, Chun-Wen Hsiao, Hao-Jan Lin, Hsing-Wen Sung
Journal: Biomaterials (2010)
THE VALUE OF MODERN BLOOD CHEMISTRY TO THE CLINICIAN
Authors: ALEXANDER O. GETTLER
Journal: JAMA (1918)

The investigation of the chemistry of the blood during the past decade has brought us somewhat nearer to the elucidation of certain clinical problems. We know considerable of the etiology of diseases and still more of their end-results, their pathology. But as to the chemistry of their development and progress, little is known. Particularly is this true of the so-called endogenous, or, perhaps more correctly, the metabolic diseases. It is in the latter group that the most satisfactory chemical results have been obtained. Certain metabolic alterations, notably the elimination of the catabolic products, are definitely determinable by laboratory methods; and no matter how divergent may be the views on points such as technic, interpretation of results, and consideration of normal or of physiologic factors varying the normal, the findings are valuable as indicating the nature of the disturbances in the process of the abnormal production or of the elimination of
Discovery of nitric oxide and cyclic GMP in cell signaling and their role in drug development
Authors: Ferid Murad
Journal: Molecular Neurodegeneration (2012)

The role of nitric oxide in cellular signaling in the past three decades has become one of the most rapidly growing areas in biology.Nitric oxide is a gas and a free radical with an unshared electron that can regulate an evergrowing list of biological processes.Nitric oxide is formed from L-arginine by a family of enzymes called nitric oxide synthases.These enzymes have a complex requirement for a number of cofactors and regulators including NADPH, tetrahydrobioterin, flavins, calmodulin and heme.The enzymes are present in most cells and tissues.In many instances, nitric oxide mediates its biological effects by activating the soluble isoform of guanylyl cyclase and increasing cyclic GMP synthesis from GTP. Cyclic GMP, in turn, can activate cyclic GMP-dependent protein kinase (PKG) and can cause smooth muscles and blood vessels to relax, decrease platelet aggregation, alter neuron function, etc.These effects can decrease blood pressure, increase blood flow to tissues, alter memory and behavior, decrease blood clotting, etc.The list of effects of nitric oxide that are independent of cyclic GMP formation is also growing at a rapid rate.For example, nitric oxide can interact with transition metals such as iron, thiol groups, other free radicals, oxygen, superoxide anion, unsaturated fatty acids, and other molecules.Some of these reactions result in the oxidation of nitric oxide to nitrite and nitrate to terminate the effect, while other reactions can lead to altered protein structure function and/or catalytic capacity.These effects probably regulate bacterial infections, inflammation of tissues, tumor growth, and other disorders.These diverse effects of nitric oxide that are cyclic GMP dependent or independent can alter and regulate numerous important physiological events in cell regulation and function.Nitric oxide can function as an intracellular messenger, an antacoid, a paracrine substance, a neurotransmitter, or as a hormone
Safety of Pacemaker Implantation in Nonagenarians
Authors: Anant Mandawat, Jeptha P. Curtis, Aditya Mandawat, Valentine Y. Njike, Rachel Lampert
Journal: Circulation (2013)

Data are scarce on outcomes of pacemaker implantation in nonagenarians (age≥90 years).We identified patients >70 years of age (n=115 683) who underwent initial pacemaker implantation in the 2004 to 2008 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. Outcomes included in-hospital mortality, complications, length of stay, and charges. Unadjusted outcomes were compared using χ(2) and Mantel-Haenszel tests. Multivariate hierarchical logistic models and stepwise linear regression models adjusted for case-mix variation and clustering. Eleven percent (12 917) were >90 years of age. Relative to patients aged 70 to 79 years, patients >90 years of age were more likely to have moderate/severe comorbidity (Charlson score >1; 43.2% versus 40.1%) and less likely to be admitted electively (17.5% versus 29.9%), all P<0.001. The unadjusted mortality and complication rates in patients aged 70 to 79 years were 0.60% (confidence interval [CI], 0.53-0.67%) and 5.61% (CI, 5.40-5.82%), respectively, and in patients aged >90 years were 1.87% (CI, 1.63-2.11%) and 6.31% (CI, 5.89-6.72%). Length of stay and charges in patients aged 70 to 79 years were 3.22 days (CI, 3.20-3.24 days) and $38 871 (CI, $38 700-$39 043), and in patients aged >90 years, 4.27 days (CI, 4.25-4.30 days) and $41 373 (CI, $41 190-$41 556). Multivariable analysis revealed severe comorbidity (odds ratio, 5.00; 95% CI, 4.05-6.17) was a greater predictor of mortality than increasing age (odds ratio, 2.81 per decade; CI, 2.35-3.35), all P<0.001. Similarly, severe comorbidity (Charlson score >5) was more strongly associated with complications, length of stay, and charges than age.Although increasing age predicts worsening outcomes in the elderly, the absolute rates are modest, even in nonagenarians, and comorbidity is a stronger predictor.
Autofluorescence endoscopy in surveillance of Barrett’s esophagus: a multicenter randomized trial on diagnostic efficacy
Authors: J. Borovicka, J. Fischer, J. Neuweiler, P. Netzer, J. Gschossmann, T. Ehmann, P. Bauerfeind, G. Dorta, U. Zürcher, J. Binek, C. Meyenberger
Journal: Endoscopy (2006)

Background and study aims: The reference surveillance method in patients with Barrett's esophagus is careful endoscopic observation, with targeted as well as random four-quadrant biopsies. Autofluorescence endoscopy (AFE) may make it easier to locate neoplasia. The aim of this study was to elucidate the diagnostic accuracy of surveillance with AFE-guided plus four-quadrant biopsies in comparison with the conventional approach. Patients and methods: A total of 187 of 200 consecutive Barrett's esophagus patients who were initially enrolled (73 % male, mean age 67 years, mean Barrett's segment length 4.6 cm), who underwent endoscopy for Barrett's esophagus in four study centers, were randomly assigned to undergo either AFE-targeted biopsy followed by four-quadrant biopsies or conventional endoscopic surveillance, also including four-quadrant biopsies (study phase 1). After exclusion of patients with early cancer or high-grade dysplasia, who underwent endoscopic or surgical treatment, as well as those who declined to participate in phase 2 of the study, 130 patients remained. These patients were examined again with the alternative method after a mean of 10 weeks, using the same methods described. The main study parameter was the detection of early cancer/adenocarcinoma or high-grade dysplasia (HGD), comparing both approaches in study phase 1; the secondary study aim in phase 2 was to assess the additional value of the AFE-guided approach after conventional surveillance, and vice versa. Test accuracy measures were derived from study phase 1. Results: In study phase 1, the AFE and conventional approaches yielded adenocarcinoma/HGD rates of 12 % and 5.3 %, respectively, on a per-patient basis. With AFE, four previously unrecognized adenocarcinoma/HGD lesions were identified (4.3 % of the patients); with the conventional approach, one new lesion (1.1 %) was identified. Of the 19 adenocarcinoma/HGD lesions detected during AFE endoscopy in study phase 1, eight were visualized, while 11 were only detected using untargeted four-quadrant biopsies (sensitivity 42 %). Of the 766 biopsies classified at histology as being nonneoplastic, 58 appeared suspicious (specificity 92 %, positive predictive value 12 %, negative predictive value 98.5 %). In study phase 2, AFE detected two further lesions in addition to the initial alternative approach in 3.2 % of cases, in comparison with one lesion with conventional endoscopy (1.7 %). Conclusions: In this referral Barrett's esophagus population with a higher prevalence of neoplastic lesions, the AFE-guided approach improved the diagnostic yield for neoplasia in comparison with the conventional approach using four-quadrant biopsies. However, AFE alone was not suitable for replacing the standard four-quadrant biopsy protocol.
Caffeine and Cardiac Arrhythmias
Authors: Martin G. Myers
Journal: Annals of Internal Medicine (1991)

Purpose: To review the evidence supporting the belief that caffeine causes cardiac arrhythmias. Data Sources: Studies published since 1982 identified through computerized searches of MEDLINE, TOXLINE, and Chemical Abstracts and a review of bibliographies of relevant articles on the subject of caffeine and cardiac arrhythmias. Study Selection: All clinical studies examining caffeine as a cause of cardiac arrhythmias and a selection of basic science experiments to illustrate caffeine's effects in vitro. Data Extraction: Study quality was assessed and all available clinical data pertaining to caffeine as a cause of arrhythmias were summarized. Results of Data Analysis: In one electrophysiologic study, caffeine was associated with an increased susceptibility to provoked cardiac arrhythmias. In five placebo-controlled trials, caffeine in doses up to 500 mg daily (equivalent to 5 to 6 cups of coffee) did not increase the frequency or severity of ventricular arrhythmias. One large epidemiologic study reported an increase in the frequency of ventricular extrasystoles in persons consuming 9 or more cups of coffee daily. Conclusion: Moderate ingestion of caffeine does not increase the frequency or severity of cardiac arrhythmias in normal persons, patients with ischemic heart disease, or those with pre-existing serious ventricular ectopy.
Treatment of Hepatic Failure and Coma
Authors: Henry Brown
Journal: JAMA (1967)

The liver is the site where most of the important metabolic functions are carried out. Hepatic failure, therefore, involves almost every known synthesis and function. Clinically, it is characterized by jaundice, ascites, progressive emaciation, flap of hands, and physical weakness leading to ataxia and mental confusion. This is followed by stupor, deep coma, and finally death.  The rapidly expanding research into hepatic physiology has provided a basis for much of the modern treatment of hepatic failure. Biochemically, with involvement of most synthetic pathways, there is a deficit in protein synthesis characterized by anemia, reduced serum albumin, and reduced plasma clotting factors. The latter includes reduced fibrinogen and low prothrombin levels aggravated by poor vitamin K absorption. Serum globulins are first increased, then decreased. There is usually an increase in serum bilirubin from either obstruction of the biliary tree or inability to metabolize bilirubin breakdown products. Prolonged hyperglycemia is commonly observed
Use of basiliximab as a cyclosporin-sparing agent in palmoplantar pustular psoriasis with myalgia as an adverse effect
Authors: H.K. Bell, R.A.G. Parslew
Journal: British Journal of Dermatology (2002)

British Journal of DermatologyVolume 147, Issue 3 p. 606-607 Use of basiliximab as a cyclosporin-sparing agent in palmoplantar pustular psoriasis with myalgia as an adverse effect H.K. Bell, H.K. Bell Department of Dermatology, Link 10 C, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, U.K.Search for more papers by this authorR.A.G. Parslew, R.A.G. Parslew Department of Dermatology, Link 10 C, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, U.K.Search for more papers by this author H.K. Bell, H.K. Bell Department of Dermatology, Link 10 C, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, U.K.Search for more papers by this authorR.A.G. Parslew, R.A.G. Parslew Department of Dermatology, Link 10 C, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, U.K.Search for more papers by this author First published: 04 October 2002 https://doi.org/10.1046/j.1365-2133.2002.48452.xCitations: 12 Correspondence: Dr Hazel Bell. E-mail: fam.shaw@virgin.net Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume147, Issue3September 2002Pages 606-607 RelatedInformation
Laudanum in Lakeland
Authors: P. Mortimer
Journal: BMJ (2001)

Among the Christmas reading in our family last year was A Passionate Sisterhood by Kathleen Jones. This carefully researched book begins with the young lives of the two sets of sisters—the Frickers and the Hutchinsons—that Coleridge, Wordsworth, and Southey married into, and with Wordsworth's own sister, Dorothy. Then, in its later chapters, Coleridge's daughter Sara and Wordsworth's daughter Dora, together with Southey's daughters, take centre stage.

More may often be learnt about the medicine of earlier times from lay people than from what their doctors wrote about it. The lay sources are …