tbuckley/cabot-search huggingface dataset:
Mechanism of 'inappropriate' sinus tachycardia. Role of sympathovagal balance.
Authors: C A Morillo, G J Klein, R K Thakur, H Li, M Zardini, R Yee
Journal: Circulation (1994)

BACKGROUND "Inappropriate" sinus tachycardia (IST) is an uncommon and poorly defined atrial tachycardia characterized by inappropriate tachycardia and exaggerated acceleration of heart rate with "normal" P wave. The mechanism of this tachycardia is unknown. The purpose of the present study was to determine the role of autonomic balance in the genesis of IST. METHODS AND RESULTS Six female patients aged 23 to 38 years with IST and 10 age- and sex-matched control subjects were assessed with the following autonomic function tests: (1) sympathovagal balance to the sinus node assessed by calculating the LF/HF (low frequency/high frequency) ratio using power spectral analysis both in the supine position and after 10 minutes of head-up tilt to 60 degrees, (2) cardiovagal reflex assessed by cold face test (CFT), (3) beta-adrenergic sensitivity as determined by calculating isoproterenol dose-response curves and isoproterenol chronotropic dose 25 (CD25), and (4) intrinsic heart rate (IHR) assessed after autonomic blockade with atropine 0.04 mg/kg and propranolol 0.2 mg/kg administered as an intravenous bolus. No significant differences in the LF/HF ratio both in the supine position (2.8 +/- 0.3 versus 2.6 +/- 0.4) and during upright tilt (8.7 +/- 1.3 versus 8.5 +/- 0.5) were observed between control subjects and IST patients. Cardiovagal response to CFT was markedly depressed in all patients (6.3% IST patients versus 24.2% control subjects, P &lt; .001). beta-Adrenergic hypersensitivity to isoproterenol was noted in all patients (mean CD25, 0.29 +/- 0.10 microgram IST patients versus 1.27 +/- 0.4 microgram control subjects; P &lt; .001), and high IHR was noted in all cases. The patients were treated with high doses of beta-blockers with adequate short-term control. Radiofrequency catheter ablation of the sinus node area was performed in one drug-refractory patient. CONCLUSIONS These findings suggest that the mechanism leading to IST is related to a primary sinus node abnormality characterized by a high IHR, depressed efferent cardiovagal reflex, and beta-adrenergic hypersensitivity.
Gastric Antigens in Health and Disease. Behaviour in Early Development, Senescence, Metaplasia, and Cancer
Authors: W. G. R. M. de Boer, A. Forsyth, R. C. Nairn
Journal: BMJ (1969)

Immunofluorescence studies of the behaviour of gastric antigens in health and disease have shown that during foetal development both gastric and intestinal antigens are present in the gastric superficial mucous epithelium. The intestinal component disappears soon after birth; it re-emerges in senescence and in metaplasia and neoplasia, while the gastric antigen, which normally persists in adult life, is depleted in these circumstances. The loss of adult and the re-emergence of foetal antigen in both metaplasia and neoplasia suggest a possible fundamental relationship between these conditions; the phenotypic variation may reflect cytogenetic liability, which has malignant transformation as a final irreversible step.
EXFOLIATIVE DERMATITIS AND DEATH DUE TO PHENOBARBITAL
Authors: Daniel L. Sexton
Journal: JAMA (1941)

The toxic effects of phenobarbital, for the most part, are limited to a cutaneous eruption which subsides soon after the withdrawal of the drug. In an occasional case a severe constitutional reaction occurs in which exfoliative dermatitis is one of the manifestations. The first case of exfoliative dermatitis reported due to phenobarbital was that by Hamilton, Geiger and Roth<sup>1</sup>in 1926. Although there was an exfoliation of all epidermal layers, recovery occurred after a prolonged illness. Eleven cases of severe cutaneous eruption were reviewed by Poole,<sup>2</sup>another by Haubrich<sup>3</sup>and two by Lancaster,<sup>4</sup>in one of which there were marked urticarial wheals and the patient died five days after the rash appeared. This patient was being treated for a fracture and had received 85 grains (5.5 Gm.) of phenobarbital. Autopsy reports on the subject are few. Bronchopneumonia has been reported in a majority of the cases,
Statins for the treatment of asthma: a discovery well, dry hole or just snake oil
Authors: B. K Rubin
Journal: Thorax (2008)

Until the 1906 Food and Drug Act in the USA, it was common for travelling salesman to move from town to town selling miraculous cures in the form of patent medicines. With the wide spread promotion of Clark Stanley’s Snake Oil Liniment, the term “snake oil” became a widely accepted derogatory phrase for ineffective patent medications sold with claims for curing an extraordinarily variety of illnesses.1

Statins are inhibitors of the 3-hydroxy-3-methylglutaryl coenzymes A (HMG-CoA) reductase. These are among the most widely prescribed medications in the world today. Statins are dramatically effective, treating hyperlipidaemia and preventing cardiovascular disease, particularly in high risk populations.2 Statins have also been shown in the laboratory to have impressive immunomodulatory effects.3 These drugs suppress T helper (Th)1 cell development and promote Th2 polarisation from CD4 cells in vitro.4 Statins act as direct inhibitors of major histocompatibility antigen (MHC) class 2 expression and interferon γ (IFNγ) and thus inhibit T cell activation.5

In animal models, statins can ameliorate Th1 inflammatory disorders such as collagen induced arthritis and are being considered as a promising therapy …
Thalassaemia in Cyprus
Authors: Th. Ashiotis, Z. Zachariadis, K. Sofroniadou, D. Loukopoulos, G. Stamatoyannopoulos
Journal: BMJ (1973)

Frequencies of the thalassaemias in Cyprus were examined by a survey of hospital inpatients and haematological investigations of adult and newborn population samples. The data indicate that 15% of the Greek and Turkish Cypriots are carriers of beta-thalassaemia genes, while 10% of the population carry alpha-thalassaemia genes. These are the highest frequencies of thalassaemia genes found today in any Caucasian population.
Clinically and Statistically Significant Differences-Reply
Authors: Emmett B. Keeler
Journal: JAMA (1986)

In Reply.—  We agree with Dr Fuchs that a 1.9 mm Hg reduction in diastolic blood pressure might not mean much for a particular patient, but an average drop of that size in a population of patients with hypertension could have large benefits. Such a drop normally comes from large reductions in some people averaged with many others who have no effects of the intervention. More important, except for the Multiple Risk Factor Intervention Trial, recent clinical trials show clear lifesaving benefits to control of even mild hypertension.  Our study was much too small to show any significant effects of control on mortality, but two other large randomized trials definitively show that cardiovascular mortality falls when hypertension is controlled. 1,2 These trials are supported by many longitudinal studies that show cardiovascular disease is associated with hypertension. 3 Other trials have had samples that were too small to show statistically significant
Systemic oxygen transport in patients with congenital heart disease.
Authors: W Berman, S C Wood, S M Yabek, T Dillon, R R Fripp, R Burstein
Journal: Circulation (1987)

The physiology of oxygen delivery was studied in 118 stable patients from 3 months to 20 years old with congenital heart disease. During cardiac catheterization, oxygen consumption (VO2), arterial and venous blood gases and oxygen saturations (range 41% to 98%), hemoglobin concentration, diphosphoglycerate (2,3-DPG), and P50 levels were measured, and then cardiac output, systemic oxygen transport (SOT), arterial and venous oxygen contents, and the VO2/SOT ratio (fractional O2 extraction) were calculated. P50 averaged 31 mm Hg, compared with 27 mm Hg in 10 control children (p less than .01). The composite O2-hemoglobin dissociation curve in vivo was broad: Po2 varied from 37 to 65 mm Hg at 80% saturation. P50, 2,3-DPG, hemoglobin concentrations, and O2 saturation varied widely and inconsistently with Po2 and arterial and venous O2 content, but resulted in clustering of the arterial oxygen content near 165 +/- 23 (SD) ml/liter over a wide range of Po2 and hemoglobin concentrations. SOT varied in direct relation with flow (r = .82, p less than .001), but not with oxygen content, Po2, or P50. VO2 varied widely at normal or high levels of SOT, but decreased linearly at SOT levels below 400 ml/min/m2. Oxygen extraction varied inversely with venous O2 content, rising to about 50% and plateauing below venous contents of 100 ml/liter. O2 extraction did not correlate with Po2, arterial O2 content, or P50. These data suggest that: O2 saturation cannot be predicted or calculated accurately from measured Po2, but must be measured directly, 2,3-DPG, hemoglobin concentration, and P50 fluctuate to stabilize arterial oxygen content, SOT is determined primarily by cardiac output in subjects who are adapted chronically, O2 extraction rises, due to a fall in venous O2 content, to maintain VO2 as transport falls, below a critical level of SOT, O2 extraction ceases to rise and VO2 falls with further reduction in transport.
Hyperparathyroidism and Medullary Sponge Kidney
Authors: David H. Gremillion
Journal: JAMA (1977)

PATIENTS with medullary sponge kidney frequently have nephrocalcinosis, nephrolithiasis, and hypercalciuria. The cause of the augmented calcium excretion is unknown. Because of these frequent associations, there has been no impelling reason to seek other causes to explain these manifestations. Recent case reports<sup>1,2</sup>emphasize the presumably chance occurrence of hyperparathyroidism with medullary sponge kidney. The true incidence of this association is unknown. Morris<sup>3</sup>has recently suggested that hyperparathyroidism is capable of inducing a renal lesion urographically indistinguishable from medullary sponge kidney. This implies that the morbidity from medullary sponge kidney might be diminished if hyperparathyroidism could be detected and surgically treated. This report describes the fourth reported case with coexisting hyperparathyroidism and medullary sponge kidney and complements previous observations of this unusual association. <h3>Report of a Case</h3> A 38-year-old woman had passed stones or gravel at monthly intervals for about 18 years. She was found to have unexplained hypercalciuria
LTP and reinforcement: Possible role of the monoaminergic systems
Authors: Mikhail N. Zhadin
Journal: Behavioral and Brain Sciences (2000)

The absence of a clear influence of the responses modified by new connections created by LTP on the development of these connections casts doubt on an essential role of LTP in learning and memory formation without any association with reinforcement. The evidence for the involvement of the monoaminergic systems in synaptic potentiation in the cerebral cortex during learning is adduced, and their role in reinforcement system function is discussed.
Fluticasone Furoate Nasal Spray Demonstrates Consistent and 24-hour Efficacy for Nasal and Ocular Symptoms of Seasonal Allergic Rhinitis (SAR) in Prospectively Designed Clinical Trials.
Authors: R.A. Nathan, T. Toler, A. Ellsworth, E. Philpot
Journal: Journal of Allergy and Clinical Immunology (2009)
Early Insulinization to Prevent Diabetes Progression
Authors: Itamar Raz, Ofri Mosenzon
Journal: Diabetes Care (2013)

This article reviews data collected from clinical studies regarding the place of early insulin treatment in preservation of β-cell function in type 2 diabetic patients. It emphasizes the stepwise progression of the data, starting with small uncontrolled studies and progressing to larger-scale controlled studies. It summarizes current knowledge in the field, emphasizing the additional information gained from the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial (1).

### Effect of glucotoxicity and lipotoxicity on β-cells

Glucotoxicity and lipotoxicity have long been recognized as having a deleterious effect on both β-cell function and insulin action (2–4). Glucolipotoxicity refers to the combined deleterious effects of elevated glucose and free fatty acids on β-cell mass and function (5). Significant progress has been made in recent years toward a better understanding of the cellular and molecular basis of glucolipotoxicity (5–7). Insulin protects the β-cell by inducing rapid reversal of glucolipotoxicity and β-cell rest (8,9). The rapid reversal of glucolipotoxicity by insulin therapy is one of the justifications for early insulin treatment (2–10).

### Treat to target or treat to failure?

The importance of avoiding prolonged hyperglycemia in patients with short diabetes duration in order to minimize its negative effect on late microvascular and macrovascular complications has been established (11). Hence, present guidelines (12–16) recommend early initiation of life style changes with or without metformin and subsequent addition of 2nd- and 3rd-line therapy when previous treatments fail to achieve or maintain the goal. The goals in the treatment of hyperglycemia in newly diagnosed type 2 diabetes are to achieve near-normal glucose control as early as possible in order to preserve β-cell function and maintain long-term normoglycemia.

The capacity of antidiabetes medication to maintain prolonged glycemic control (glucose durability) is of great importance. In the ADOPT study, rosiglitazone (17) demonstrated the best “glucose durability” compared with sulfonylurea (SU) and metformin. …
Risk of Colorectal and Other Cancers in Patients With Serrated Polyposis
Authors: Daniel L. Edelstein, Marcia Cruz-Correa, Marievelisse Soto-Salgado, Jennifer E. Axilbund, Linda M. Hylind, Katharine Romans, Cherie Blair, Elizabeth Wiley, Anne C. Tersmette, Johan A. Offerhaus, Francis M. Giardiello
Journal: Clinical Gastroenterology and Hepatology (2015)
The effect of progressive endurance-strength training and electrical stimulation on muscle strength and surface electromyography parameters in volleyball players with infraspinatus syndrome
Authors: N Shavandi, R S Hoseini
Journal: British Journal of Sports Medicine (2011)

Background Infraspinatus syndrome is a condition of painless weakness and atrophy of the infraspinatus muscle that results from suprascapular neuropathy. Objectives Survey the effects of a short term progressive endurance-strength training program and electrical stimulation on elite volleyball players with infraspinatus syndrome. Design Randomized clinical trial with control group. Setting and participants National team players. Participants 12 volleyball players with Infraspinatus syndrome were randomly divided to two groups: progressive endurance-strength training (six persons) and electrical stimulation (six persons). 20 healthy players were also used as a control group. Intervention Therapeutic exercises and electrical stimulation were performed for 8 weeks in both intervention groups. Main outcomes Surface electromyography of infraspinatus and tress minor muscles and maximal isometric strength of external rotator muscles before and after interventions. Results 32 players were studied in three groups: progressive endurance-strength (6 persons, age), electrical stimulation (six persons) and a control group (20 persons, age 25/1±4/2, height 187/7±3/9, weight 75/6±7/1, sport history 9±3/8 and national team history 3/9±2/3). After 8 weeks, maximal isometric strength of the external rotators in both experimental groups was increased significantly, but there were no significant changes observed in IEMG and RMSEMG. Conclusions Progressive endurance-strength training and electrical stimulation can result in an increase of maximal isometric strength of the shoulder external rotator muscles. But both therapeutic methods have no effect on electromyograghic parameters in infraspinatus and tress minor muscles. It seems that we can't use surface electromyography for detecting the effect of these protocols on above the muscles.
Delayed Accumulation (Flip Flop) of Tc-99m DTPA in a Leiomyosarcoma
Authors: JAMES D. SLAVIN, JOAN M. MACK, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1988)

An 85-year-old woman with leiomyosarcoma occupying the abdominopelvic area had a renal dynamic study with Tc-99m DTPA. The tumor area initially showed almost no content of the radiopharmaceutical. At 24 hours, there was retention of activity in the leiomyosarcoma as compared with surrounding tissues (flip flop). It was noted that, based on literature reports, tumors of mesodermal origin (leiomyoma, spindle cell sarcoma, neurofibroma) may have the ability to concentrate Tc-99m DTPA.
Scabies. Subungual areas harbor mites
Authors: J. A. Witkowski
Journal: JAMA (1984)

ANECDOTAL reports have been circulating that the usefulness of lindane in the treatment of scabies has been waning. A patient with scabies was said to have mites resistant to lindane when in fact only crotamiton had been used. Resistance of<i>Sarcoptes scabiei</i>to this agent is known to exist,<sup>1</sup>although in vivo or in vitro resistance to lindane has not been reported. We recently saw a patient with scabies whose condition was thought initially to be resistant to lindane until the mites were discovered in the subungual spaces. <h3>Report of a Case</h3> A 72-year-old woman was hospitalized for rheumatoid arthritis, diabetes mellitus, dehydration, iron-deficiency anemia, reflux esophagitis, and severe pruritus. She was being treated with acetominophen, cimetidine, desipramine hydrochloride, diphenhydramine hydrochloride, ferrous sulfate, propoxyphene napsylate, and a diabetic diet. The pruritus had been present for six months; although she was conscious of it throughout the day, it was most
Case 15-1962
Authors: David Littmann
Journal: New England Journal of Medicine (1962)

Presentation of CaseA fifty-two-year-old woman entered the hospital because of chest pain.She experienced an episode of pain in the right anteroinferior portion of the chest one week before admission. The pain was exacerbated by coughing, but not by respiration. Intermittent diarrhea occurred, and a mild, nonproductive cough and dyspnea developed. Physical examination three days before entry was negative. The diarrhea persisted, and generalized weakness and anorexia occurred, but she continued to work. Two days before admission the chest pain recurred as a chronic ache or feeling of pressure, with no radiation to the arms, but with involvement of . . .
Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C
Authors: George J. Schwartz, Michael F. Schneider, Paula S. Maier, Marva Moxey-Mims, Vikas R. Dharnidharka, Bradley A. Warady, Susan L. Furth, Alvaro Muñoz
Journal: Kidney International (2012)
Function of the Male Sex Organs in Heroin and Methadone Users
Authors: Theodore J. Cicero, Roy D. Bell, Walter G. Wiest, James H. Allison, Kenneth Polakoski, Eli Robins
Journal: New England Journal of Medicine (1975)

The function of the secondary sex organs was found to be markedly impaired in 29 participants in a methadone maintenance program. The ejaculate volume and seminal vesicular and prostatic secretions were reduced by over 50 per cent in methadone clients, as compared to 16 heroin addicts and 43 narcotic-free controls. Serum testosterone levels were also approximately 43 per cent lower in methadone clients than in controls or heroin users. Although the sperm count of methadone clients was more than twice the control levels, reflecting a lack of sperm dilution by secondary-sex-organ secretions, the sperm motility of these subjects was markedly lower than normal. On all measures of secondary-sex-organ and testicular function, heroin addicts appeared to fall between the methadone and control subjects, but, with the exception of sperm motility, the deviation from control values did not reach statistical significance. (N Engl J Med 292:882–887, 1975)
Specific Activation of the Cysteine Protease CPP32 during the Negative Selection of T Cells in the Thymus
Authors: Antoine Alam, Michel Y. Braun, Franca Hartgers, Sylvie Lesage, Luchino Cohen, Patrice Hugo, François Denis, Rafick-Pierre Sékaly
Journal: The Journal of Experimental Medicine (1997)

Cysteine proteases of the CED-3 and ICE family have been recently proposed as the ultimate executioners in several mammalian cell death pathways. Among them, the cysteine protease CPP32 has been shown to participate in programmed cell death (PCD), or apoptosis, affecting lymphoid cells in vitro. In the thymus, negative selection is a mechanism through which developing thymocytes expressing a TcR with high affinity for self peptide–MHC complexes are eliminated by PCD. In order to investigate the role of CPP32 in thymic apoptosis, isolated thymocytes were submitted to cell surface CD3 crosslinking by immobilized anti-CD3 mAb or to dexamethasone treatment. Although apoptosis occurred in the absence or after crosslinking with anti-CD3 mAb, specific activation of CPP32, as assessed by the extent of proteolytic cleavage of the p32 zymogen, was only detected in thymocytes cultured in the presence of the immobilized antibody or dexamethasone. This activation was a very early event during apoptosis as it occurred before the exposure of phosphatidyl serine to the upper side of the cell membrane. This was observed both in anti–CD3- and dexamethasone-induced apoptosis. Moreover, using mice transgenic for pigeon cytochrome C (PCC)-specific TcR, we were able to show that, after injection of PCC, the activation of CPP32 and cleavage of its substrate occurred in thymocytes obtained from mice expressing a permissive MHC haplotype for PCC presentation (H-2k). Moreover, PCC induced apoptosis was blocked by the caspase inhibitor zVAD. While spontaneous apoptosis was not accompanied by detectable levels of CPP32 processing, it was characterized by the proteolysis of poly(ADP-ribose) polymerase (PARP) and was blocked by the cysteine protease inhibitor, zVAD-CH2F. Taken together, these results support the concept that CPP32 is among the earliest effectors of the pathway leading to negative selection of autoreactive thymocytes. Our results also suggest the involvement of a distinct CPP32-like cysteine protease in spontaneous apoptosis of thymocytes.