tbuckley/cabot-search huggingface dataset:
Pseudomalabsorption of Levothyroxine
Authors: Kenneth B. Ain, Samuel Refetoff, Henry G. Fein, Bruce D. Weintraub
Journal: JAMA (1991)

--The issue of patient compliance with pharmacological therapy vs malabsorption of medication was explored in the context of persistent hypothyroidism despite the administration of large doses of levothyroxine sodium.--Retrospective case series.--Referred care in two large tertiary care centers.--Four patients, seen within two decades, with clinical and biochemical hypothyroidism while receiving levothyroxine, were evaluated for selective malabsorption of this hormone.--Studies included serial measurements of thyroid hormone levels after a loading dose of levothyroxine or liothyronine sodium or evaluation with a double-labeled thyroxine tracer technique. Results were compared with studies of levothyroxine malabsorption in the medical literature.--All patients were ultimately found to have normal (82% to 100%) absorption of oral levothyroxine. There was no evidence that malabsorption of levothyroxine can occur as an isolated abnormality.--Some patients exhibit a factitious disorder suggesting malabsorption of levothyroxine. When treating hypothyroidism, psychiatric issues may result in noncompliance with levothyroxine therapy.
Removal of Rings from Swollen Fingers
Authors: E. Garraway
Journal: BMJ (1859)

same course, and, as far as individual experience goes, bear testimony to its efficiency.It is not so objectionable to the little patient's friends as a blister, and is at the same time more manageable; and, from the extent of surface to which it is applied, decidedly more powerfully revulsive.REMOVAL OF RINGS FROM SWOLLEN FINGERS.By, E. GARitRAWAY, Esq., Faversliam.THE following methocd of removing a ring from a swollen finger, I have reason to believe, is not so generally known as it deserves.Wlhence I derived the idea is out of my remem- brance; but the claim of its origin certainly does not rest with me.A patient, in wlhom I lhave just had recourse to it, wvas suf-
Malignant transformation of immortalized human bronchial epithelial cells by asbestos fibers.
Authors: T K Hei, L J Wu, C Q Piao
Journal: Environmental Health Perspectives (1997)

Although asbestos is a well-established lung carcinogen, there currently is no suitable human cell model in which to examine the underlying cellular and molecular changes associated with fiber-mediated bronchial carcinogenesis. Using a recently established transformation model based on a human papillomavirus-immortalized human bronchial epithelial cell line, we successfully transformed these BEP2D cells after a single, 7-day treatment with a 20-microgram/ml (4 micrograms per cm2 area) dose of Union Internationale Contre le Cancer (UICC) Rhodesian chrysotile fibers. Asbestos treatment resulted in a surviving fraction of 0.18 compared to control cells. Transformed cells developed through a series of sequential steps, including altered growth kinetics, resistance to serum-induced terminal differentiation, and anchorage-independent growth, before becoming tumorigenic to form progressively growing tumors in nude mice. Seven tumorigenic cell lines were isolated and determined to be of human epithelial origin based on immunofluorescent staining of keratin and isozyme analysis. Analysis of tumor DNA revealed no mutations at either codon 12 or 13 in any the ras oncogenes. An independent role for K-ras mutation in fiber carcinogenesis, therefore, cannot be confirmed. This model provides a unique opportunity to study the cellular and molecular changes at the various stages in fiber-mediated neoplastic transformation of human bronchial epithelial cells.
Effects of resistance training and detraining on muscle strength and blood lipid profiles in postmenopausal women
Authors: K J Elliott, C Sale, N T Cable
Journal: British Journal of Sports Medicine (2002)

To study the effects of eight weeks of supervised, low intensity resistance training (80% of 10 repetition maximum (10RM)) and eight weeks of detraining on muscle strength and blood lipid profiles in healthy, sedentary postmenopausal women.Fifteen postmenopausal women, aged 49-62 years, took part in the study. Subjects were assigned to either a control (n = 7) or training (n = 8) group. The training regimen consisted of three sets of eight repetitions of leg press, bench press, knee extension, knee flexion, and lat pull-down, three days a week at 80% of 10RM. Dynamic leg strength, 10RM, and blood lipid profiles (total cholesterol (TC), low and high density lipoprotein cholesterol (LDL-C, HDL-C), triglycerides, and very low density lipoprotein cholesterol (VLDL-C)) were measured at baseline, after eight weeks of training, and after a further eight weeks of detraining.Eight weeks of resistance training produced significant increases in knee extension (F(1,13) = 12.60; p<0.01), bench press (F(1,13) = 13.79; p<0.01), leg press (F(1,13) = 15.65; p<0.01), and lat pull-down (F(1,13) = 16.60; p<0.005) 10RM strength tests. Although 10RM strength decreased after eight weeks of detraining, the results remained significantly elevated from baseline measures. Eight weeks of training did not result in any significant alterations in blood lipid profiles, body composition, or dynamic isokinetic leg strength. There were no significant differences in any of the variables investigated over the 16 week period in the control group.These data suggest that a short, low intensity resistance training programme produces substantial improvements in muscle strength. Training of this intensity and duration was not sufficient to produce significant alterations in blood lipid concentrations.
The role of massage in the management of the athlete: a review.
Authors: M J Callaghan
Journal: British Journal of Sports Medicine (1993)

Massage has been a therapeutic modality in all cultures since early civilization and has had a long tradition of use in the sporting context. However, there has been a paucity of scientific evidence of the physiological, psychological and therapeutic effects of commonly used massage techniques. This paper reviews the early and more recent studies on the effects of massage and also the more recent literature on its use on the sports person. Little agreement was found in English publications of the efficacy of massage and there were contradictory findings as to the optimum technique and length of time of application. It is clear that the role of massage - a time-consuming technique for a physiotherapist to perform - needs to be evaluated further in order to resolve some contentious issues arising about this mode of treatment and to justify its use.
Evaluating healthcare policies: the case of clinical audit
Authors: J. Lord, P. Littlejohns
Journal: BMJ (1997)

Clinicians are under increasing pressure to show that their services are effective and efficient. Some have recently suggested that policymakers should be subject to the same discipline.1 Before the introduction of radical changes in the NHS in 1991 the government's decision not to pilot the proposals or evaluate them was widely criticised. One component of the reforms was a national programme to promote clinical audit by doctors, later extended to nurses and therapy professionals. This was generally welcomed, though dissenting voices questioned the underlying political motivations2 and pointed to a lack of evidence on the value of clinical audit.3 4 5

Since then there have been repeated calls for the evaluation of audit,6 and the public accounts committee has expressed concern at the failure to assess the overall cost effectiveness of the programme.7 In fact, the NHS Executive has commissioned several evaluations of audit,8 9 as well as monitoring progress through local and regional annual reports. However, it has not been possible to use scientifically rigorous methods to quantify the overall costs or benefits of national or local programmes of audit.10 This paper describes the various approaches that have been tried (see box) and outlines the merits and disadvantages of each approach.

### Box 1: Methods used to evaluate clinical audit and examples

Experimental studies of specific audit projects 

Before-after studies of specific audit projects 

Quantitative observational studies of audit programmes 

Qualitative studies of audit programmes …
Euthanasia across the North Sea
Authors: H. Rigter, E. Borst-Eilers, H J J Leenen
Journal: BMJ (1988)

The United Kingdom and The Netherlands are separated by a narrow stretch of sea but in terms of an understanding of euthanasia they seem to be light years apart. An attempt to bridge the information gap seems in order. The position paper on euthanasia published by the Royal Dutch Medical Association contains 16 typed pages.<sup>1</sup> In contrast, the report on euthanasia issued by a working party of the British Medical Association is 80 pages in small print.<sup>2</sup>
Waist-to-Hip Ratio, but Not Body Mass Index, Is Associated With an Increased Risk of Barrett's Esophagus in White Men
Authors: Jennifer R. Kramer, Lori A. Fischbach, Peter Richardson, Abeer Alsarraj, Stephanie Fitzgerald, Yasser Shaib, Neena S. Abraham, Maria Velez, Rhonda Cole, Bhupinderjit Anand, Gordana Verstovsek, Massimo Rugge, Paola Parente, David Y. Graham, Hashem B. El–Serag
Journal: Clinical Gastroenterology and Hepatology (2012)
Power spectrum analysis of heart rate variability in human cardiac transplant recipients.
Authors: J P Zbilut, C E Lawless
Journal: Circulation (1989)

The study by Sands et all reported promising results with the mathematical technique of power spectrum analysis of heart rate variability to detect graft rejection.We were surprised, however, to learn that they did not find spectral peaks in transplant recipients.In a similar study,2 we detected peaks at the so-called Mayer wave frequency (0.1 Hz) as well as at the frequency of respiratory sinus arrhythmia (RSA).Furthermore, we found that the RSA peak had better repeatability at two weeks (r=0.81)than the Mayer wave frequency and was significantly lower during rejection periods (p=0.039).We suspect that part of the difference in our findings may be attributable to the different techniques used.Specifically, Sands et al used a smoothing technique that, in effect, created a low-pass filter.Although this is acceptable, this often results in large, low-frequency spectral peaks that may "swamp" or interfere with small, higher-frequency peaks such as the RSA.3To avoid this problem, we high-pass filtered the data at approx- imately 0.04 Hz to remove the low-frequency drift or aperiodic trend.This technique may also introduce spurious peaks near the corner frequency of the filter.However, we believe it highly unlikely that this filtering procedure affected the RSA peaks because the RSA frequencies were sufficiently higher.Further- more, one of our subjects demonstrated clear, unequivocal Cheyne-Stokes respirations that modulated the heart rate and were clearly evident on the tachogram.4,5We agree with Sands et al that this technique is of potential benefit to transplant recipients and that larger, more-controlled studies are warranted.
Maternal Immunity and Prevention of Congenital Cytomegalovirus Infection
Authors: Karen B. Fowler, Sergio Stagno, Robert F. Pass
Journal: JAMA (2003)

Context Vaccine development to prevent congenital cytomegalovirus (CMV) infection has been impeded by the uncertainty over whether maternal immunity protects the fetus. Objective To determine whether the presence of maternal antibodies to CMV significantly reduces the risk of congenital CMV infection in future pregnancies. Design, Setting, and Participants Cohort study of 3461 multiparous women from a population with a high rate of congenital CMV infection who delivered newborns screened for congenital CMV infection between 1993 and 1998, and whose cord serum specimen from a previous delivery could be retrieved and tested for antibody to CMV. Main Outcome Measure Congenital CMV infection according to maternal immune status, age, race, parity, and socioeconomic status. Results Of 604 newborns born to initially seronegative mothers, congenital CMV infection occurred in 18 (3.0%). In contrast, of 2857 newborns born to immune mothers, congenital CMV infection occurred in 29 (1.0%) Two factors, preconception maternal immunity (adjusted risk ratio, 0.31; 95% confidence interval, 0.17-0.58) and maternal age of 25 years or older (adjusted risk ratio, 0.19; 95% confidence interval, 0.07-0.49), were highly protective against congenital CMV infection. No other factors were associated with a reduction in the risk of congenital CMV infection. Conclusion Naturally acquired immunity results in a 69% reduction in the risk of congenital CMV infection in future pregnancies.
Neuropathological Study of the Dorsal Raphe Nuclei in Late-Life Depression and Alzheimer’s Disease With and Without Depression
Authors: Michelle Hendricksen, Alan J. Thomas, I. Nicol Ferrier, Paul Ince, John T. O’Brien
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: Few studies have examined pathological changes in serotonergic neurons in depression, particularly in elderly patients and in elderly patients in which depression occurs in dementia. The authors hypothesized that greater neurofibrillary pathology and fewer serotonergic neurons would be found in the dorsal raphe nuclei in depressed elderly subjects, compared with nondepressed elderly subjects, and in Alzheimer's disease patients with depression, compared to Alzheimer's disease patients without depression. METHOD: In a postmortem study, immunocytochemistry and two-dimensional image analysis were used to measure neuronal density and neuritic pathology in serotonergic neurons in the dorsal raphe nuclei of elderly subjects with primary major depression (N=14), elderly Alzheimer's disease patients with (N=8) and without (N=7) comorbid depression, and nondepressed elderly comparison subjects (N=10). RESULTS: No differences in neuritic pathology or neuronal density were found between the subjects with primary major depression and the nondepressed comparison subjects. The Alzheimer's disease subjects showed markedly fewer serotonergic neurons and associated higher levels of neuritic pathology, compared with the subjects with primary depression and the nondepressed comparison subjects, but the Alzheimer's disease subjects with comorbid major depression did not differ from the Alzheimer's disease subjects without depression on these measures. CONCLUSIONS: The study found no evidence of a loss of serotonergic neurons or of neuritic pathology in the dorsal raphe nuclei in older people with depression, with or without comorbid Alzheimer's disease. These findings suggest that if serotonergic dysfunction occurs in older depressed subjects, it is not due to neuronal loss in the brainstem. Pathophysiological changes may lie elsewhere, such as in the frontal-subcortical circuits.
Epidemiology of Invasive Pneumococcal Infections in Children in Finland
Authors: Juhani Eskola
Journal: JAMA (1992)

To study the epidemiologic characteristics of invasive infections in children caused by Streptococcus pneumoniae to provide background data for vaccination programs.A nationwide laboratory-based prospective surveillance of all invasive pneumococcal infections in children during 1985 through 1989.A network of all microbiologic laboratories and pediatric wards in Finland.Children aged 0 to 15 years who were admitted to a hospital with S pneumoniae isolated from blood, cerebrospinal fluid, or deep aspirate sample.Four hundred fifty-two invasive pneumococcal infections were diagnosed in 1985 through 1989. The annual incidence rate was 8.9 per 100,000 children less than 16 years of age (24.2 per 100,000 among children less than 5 years of age and 45.3 per 100,000 among those less than 2 years of age). The most common clinical entities were bacteremia without focus (310 cases), pneumonia (66 cases), and meningitis (51 cases), with other focal infections seen in 25 cases. The pneumococcal groups/types 14, 6, 19, 7, 18, and 23 comprised 78% of all invasive infections.Streptococcus pneumoniae is a common cause of invasive infections in children in Finland. A pneumococcal conjugate vaccine containing the six most common groups/types could prevent up to 70% of invasive pneumococcal infections of children in Finland if fully protective in infancy.
???Sub???-Super Scan???Manifestation of Bone Marrow Metastases?
Authors: DONALD A. PODOLOFF, E EDMUND KIM
Journal: Clinical Nuclear Medicine (1989)

A case is presented in which bone imaging over a period of 1 year indicated continued and increased radionuclide uptake. In association with CT and magnetic resonance imaging studies it was determined that the continued increased activity was related to developing bone marrow metastases.
The PMPO Syndrome (Postmenopausal Palpable Ovary Syndrome)
Authors: H. R. K. Barber, E. A. Graber
Journal: CA A Cancer Journal for Clinicians (1972)

If we are to save more women and diminish the mortality rate from ovarian cancer, we must become more liberal in our indications for operation. We suggest that the palpation of what appears to be a normal-sized ovary for a patient three to five years postmenopausal is indicative of an ovarian tumor and should be investigated promptly. These patients should not be followed and re-evaluated but rather subjected to proof as to the presence or absence of an ovarian tumor. To wait until one feels a solid tumor mass of up to 5 cm. and expect a cure is an exercise in fancy and futility. John Gardner said, “We are all faced with wonderful opportunities brilliantly disguised as insoluble problems.” Ovarian cancer is not insoluble. Perhaps, by adding a small segment at a time, the total picture will emerge to the benefit of our patients. Remember the PMPO Syndrome!
An aid to reducing unnecessary investigations
Authors: N Paterson
Journal: BMJ (1981)

ence of one of us (SLS) in over 500 suprapubic catheterisations for postoperative bladder drainage bowel perforation has occurred on only one occasion, and was satisfactorily managed as we described.We take Miss Senapti's point that the use of a catheter with an adjustable flange may lead to urinary extravasation if the catheter is not inserted well into the bladder.Indeed, we see this as one of the advantages of the Bonanno catheter, which is our preferred instrument, since its flanges are fixed some 17j cm from the proximal side hole.
Plasma Insulin during Remission in Juvenile Diabetes Mellitus
Authors: K. Johansen, H. Orskov
Journal: BMJ (1969)

Three juvenile diabetics in partial remission were studied before and after the recurrence of overt diabetes. The remissions were partial because glucose tolerance never returned to normal. However, it improved sufficiently to cause the discontinuance of insulin therapy for at least four months.The insulin output in response to double glucose tolerance tests was increased during remission. The degree of remission seemed to be related to the magnitude of the insulin response to glucose. In two of the patients the increase was low and the response very slight. The third patient, however, had a delayed hyper-response and his carbohydrate tolerance during the remission was much more improved than those of the other patients.
TCT-60 Comparison Of Manual Aspiration With Rheolytic Thrombectomy In Acute Myocardial Infarction: The Final 6-Month Results Of The SMART Primary PCI Trial
Authors: Guido Parodi, Renato Valenti, Angela Migliorini, Nazario Carrabba, Akiko Maehara, Ruben Vergara, Benedetta Bellandi, Gary Mintz, David Antoniucci
Journal: Journal of the American College of Cardiology (2012)
P1-206: Optimization of small cell lung cancer (SCLC) treatment by heparin plus chemoradiotherapy: report of an exhaustive retrospective study of 239 patients in a single specialized center
Authors: Bernard E. Lebeau, Mariette Baud, Tarik Mokhtari, Ioanna Papanikolaou, Christos Chouaid
Journal: Journal of Thoracic Oncology (2007)
Monitoring altitude acclimatization--a case study of an elite woman athlete.
Authors: M A Nimmo
Journal: British Journal of Sports Medicine (1995)

A simple study monitoring altitude acclimatization, which is not intrusive to the athlete's training, is described. Particular attention is drawn to the change in production of lactate in response to steady state exercise, before and after altitude. The results suggest that a more thorough assessment of aerobic ability at altitude is required than that described in the British Association of Sports and Exercise Science (BASES) guidelines. It is also relevant to note that elevations in haemoglobin, promoted by altitude, can mask iron abnormalities. It is therefore recommended to assay for iron in addition to haemoglobin.
A low-sodium diet corrects the defect in beta-adrenergic response in older subjects.
Authors: R D Feldman
Journal: Circulation (1992)

BACKGROUND One of the prominent cardiovascular abnormalities in the elderly is reduced beta-adrenoceptor responsiveness. Because dietary sodium restriction corrects the defect in vascular and lymphocyte beta-adrenoceptor responsiveness in hypertensive subjects, we postulated an analogous effect in the elderly. Thus, vascular and lymphocyte beta-adrenergic responsiveness were studied in 10 older normotensive subjects (age, 56 +/- 2 years) on either a 400- or 10-meq/day sodium diet. METHODS AND RESULTS In older subjects fed a high-sodium diet, maximal isoproterenol-mediated vasodilation was depressed compared with a group of normotensive younger subjects studied previously. When they were fed a low-sodium diet, however, maximal isoproterenol-mediated vasodilation in the elderly was increased significantly. Lymphocyte adenylyl cyclase sensitivity to isoproterenol was comparably increased. Blood pressure was significantly reduced on a low-sodium diet, and mean arterial pressure was significantly inversely correlated with the extent of isoproterenol-mediated vasodilation. CONCLUSIONS These studies indicate that a low-sodium diet corrects the defect in both vascular and lymphocyte beta-adrenergic responsiveness with aging. This suggests an important role for dietary modification in the adrenergic regulation of vascular tone in the elderly.
Sodium retention and hepatic function after two-thirds hepatectomy in the rat
Authors: Toshiyuki Ohno, Ramzi Sabra, Robert A. Branch
Journal: Hepatology (1991)

Recently it was suggested that the onset of sodium retention in experimental cirrhosis in rats is related to a critical threshold of hepatic function, as assessed by the aminopyrine breath test. The aim of this study was to evaluate whether sodium retention occurred after two-thirds hepatectomy in rats and to investigate the relationship between sodium retention and changes in hepatic function associated with liver regeneration in this model. Sodium balance, creatinine clearance, serum sodium and the aminopyrine rate constant of elimination were evaluated daily for 4 days after surgery in partially hepatectomized (n = 6) and sham-operated rats (n = 6). All rats in the partial hepatectomy group exhibited sodium retention (sodium balance greater than 0.7 mmol/day) 24 hr after surgery. This was associated with a 62% reduction of the aminopyrine rate constant of elimination. Spontaneous natriuresis which occurred between 2 and 4 days after surgery, was associated with an increase in the aminopyrine rate constant of elimination (from 0.73 +/- 0.02 x 10(-2) min-1 on the last day of sodium retention to 0.95 +/- 0.04 x 10(-2) min-1 on the first day of natriuresis [p less than 0.05]). In contrast, no change in creatinine clearance occurred over the same period. A negative curvilinear association was found between sodium balance and the aminopyrine rate constant of elimination in all animals (r = -0.72, p less than 0.001). These observations indicate that natriuresis is related to the recovery of liver function, not to changes in creatinine clearance. In conclusion, the concept of a critical threshold of liver function below which sodium retention occurs has been substantiated in this model of hepatic dysfunction.