tbuckley/cabot-search huggingface dataset:
Hormonal Contraception in Women With IDDM: Influence on glycometabolic control and lipoprotein metabolism
Authors: Kresten R Petersen, Sven O Skouby, Pernille Vedel, Anne B Haaber
Journal: Diabetes Care (1995)

OBJECTIVE Safe and effective contraceptive methods are essential for women with insulin-dependent diabetes mellitus (IDDM), but opinions on the use of hormonal oral contraceptives by these women are conflicting. We evaluated the effects on glycometabolic control and lipoprotein metabolism in women with IDDM treated with an oral contraceptive not previously studied in a diabetic population. RESEARCH DESIGN AND METHODS A total of 22 women with IDDM received a monophasic combination of ethinyl estradiol and gestodene for 1 year; 20 women of comparable diabetic status using nonhormonal contraception were selected as control subjects. Evaluation was performed before and after 1, 3, 6, and 12 months of hormonal intake using nonparametric statistical methods. RESULTS Except for a higher median age of the control group, the baseline values for all clinical and metabolic variables were similar in the two groups, and in neither of the groups were changes in blood pressure, body mass index, or glycemic control observed. In the oral contraceptive group, decreased serum levels of low-density lipoprotein (LDL) cholesterol and increased levels of triglycerides and lipoprotein A were noted, whereas total cholesterol and high-density lipoprotein cholesterol levels were unchanged. In the control group, a decrease of LDL cholesterol was observed. No effect of tobacco smoking on glycometabolic control or lipoprotein metabolism could be demonstrated during hormonal intake. CONCLUSIONS No evidence of impaired glycometabolic control or adverse changes in serum levels of lipoproteins known to be associated with atherosclerosis was observed in women with well-controlled IDDM during 1 year of oral contraception with ethinyl estradiol and gestodene.
THE USE OF HEMODYNAMIC SUPPORT IN OCTOGENERIAN PATIENTS DURING HIGH RISK PERCUTANEOUS CORONARY INTERVENTIONS
Authors: Ghassan Fraij, Joseph Massaro, Shukri David, Neal Kleiman, Ali Denktas, Simon Dixon, Erik Ohman, Jeffrey Moses, William O'Neill, Ashish Pershad
Journal: Journal of the American College of Cardiology (2014)
Epinephrine Auto-injector Use In Children At Risk Of Food-induced Anaphylaxis: Is It Used Appropriately?
Authors: K. Mukaida, T. Kusunoki, N. Mito, A. Hayashi, I. Hieijima, F. Nozaki, R. Kawakita, K. Saito, T. Kumada, T. Miyajima, T. Fujii
Journal: Journal of Allergy and Clinical Immunology (2012)
Prevention of hepatic ischemia–reperfusion injury by pre-administration of catalase-expressing adenovirus vectors
Authors: Masahiro Ushitora, Fuminori Sakurai, Tomoko Yamaguchi, Shin-ichiro Nakamura, Masuo Kondoh, Kiyohito Yagi, Kenji Kawabata, Hiroyuki Mizuguchi
Journal: Journal of Controlled Release (2009)
Residual amblyopia in recruits to the British Army.
Authors: B Hopkisson, J R Clarke, B J Oelman
Journal: BMJ (1982)

effect; the mechanism of this is unknown but is associated with prolongation of the QT interval.3There is little doubt that in the two cases reported here amiodarone exerted an antiarrhythmic effect within a few hours of the first oral dose.Possibly previous treatment with other antiarrhythmic agents had in some way sensitised the myocardium to the effects of amio- darone.The prolongation of the QT interval suggests that in our patients oral amiodarone produced an acute pharmacological effect similar to that seen after intravenous administration.Our observations cannot be explained on the basis of current knowledge of the pharmacokinetics of oral amiodarone and highlight the need for further investigation of its mode of action.
The C Terminus of Cardiac Troponin I Stabilizes the Ca <sup>2+</sup> -Activated State of Tropomyosin on Actin Filaments
Authors: Agnieszka Galińska, Victoria Hatch, Roger Craig, Anne M. Murphy, Jennifer E. Van Eyk, C. -L. Albert Wang, William Lehman, D. Brian Foster
Journal: Circulation Research (2009)

Ca(2+) control of troponin-tropomyosin position on actin regulates cardiac muscle contraction. The inhibitory subunit of troponin, cardiac troponin (cTn)I is primarily responsible for maintaining a tropomyosin conformation that prevents crossbridge cycling. Despite extensive characterization of cTnI, the precise role of its C-terminal domain (residues 193 to 210) is unclear. Mutations within this region are associated with restrictive cardiomyopathy, and C-terminal deletion of cTnI, in some species, has been associated with myocardial stunning.We sought to investigate the effect of a cTnI deletion-removal of 17 amino acids from the C terminus- on the structure of troponin-regulated tropomyosin bound to actin.A truncated form of human cTnI (cTnI(1-192)) was expressed and reconstituted with troponin C and troponin T to form a mutant troponin. Using electron microscopy and 3D image reconstruction, we show that the mutant troponin perturbs the positional equilibrium dynamics of tropomyosin in the presence of Ca(2+). Specifically, it biases tropomyosin position toward an "enhanced C-state" that exposes more of the myosin-binding site on actin than found with wild-type troponin.In addition to its well-established role of promoting the so-called "blocked-state" or "B-state," cTnI participates in proper stabilization of tropomyosin in the "Ca(2+)-activated state" or "C-state." The last 17 amino acids perform this stabilizing role. The data are consistent with a "fly-casting" model in which the mobile C terminus of cTnI ensures proper conformational switching of troponin-tropomyosin. Loss of actin-sensing function within this domain, by pathological proteolysis or cardiomyopathic mutation, may be sufficient to perturb tropomyosin conformation.
Increased glycoxidation and lipoperoxidation in the collagen of the myocardium in hemodialysis patients
Authors: J Meng
Journal: Cardiovascular Research (2000)

Objective: The purpose of this study was to examine the glycoxidation and lipoperoxidation products in the collagen of the myocardium in hemodialysis (HD) patients and age-matched control subjects. Methods: Cardiac samples from 15 autopsied subjects (HD, n=6; control, n=9) were sequentially extracted with 0.9% NaCl and collagenase to obtain two fractions [soluble fraction (SF) and collagenase soluble fraction (CSF)]. The glycoxidation and lipoperoxidation products of these two fractions were measured by pentosidine-linked fluorescence (λex, 335; λem, 385) and malondialdehyde (MDA)-linked fluorescence (λex, 390; λem, 460), respectively. Results: Both pentosidine- and MDA-linked fluorescence were found to have significantly increased more in the collagenase soluble fraction (CSF) extracted form the anterior and posterior wall in HD patients than in the controls (P<0.05, control, n=9 vs. HD, n=6). Interestingly, the level of the lipid peroxides strongly correlated with that of the glycoxidation product in CSF (both P<0.0001 for the anterior and posterior wall). In contrast, in SF, which did not contain matrix collagen, neither significant difference nor correlation in the levels of pentosidine- and MDA-linked fluorescence was observed in these two groups. Conclusion: the present study provides the first biochemical evidence for an increase in glycoxidation and a close link between glycoxidation and lipoperoxidation in the collagen of the myocardium in hemodialysis patients. These findings suggest that these two spontaneous chemical reactions in the collagen matrix of myocardium may synergistically contribute to cardiac damage in hemodialysis patients.
Role of the Therapist in Biofeedback Training
Authors: Paula Bram Amar
Journal: Psychotherapy and Psychosomatics (1978)

The therapist in biofeedback training plays the role of a teacher or coach. This role, derived from learning theory and practiced in the classroom and playing field, imposes special constraints upon the psychotherapeutic situation. The therapist must be capable of physiological manipulation in self before attempting to teach this skill to another. The issue of transfer of training and maintenance of therapeutic gain are also discussed.
Doctors in management
Authors: J. Stephenson
Journal: BMJ (2009)

We present a rare case of association of anterior rectal duplication and posterior urethral valve (PUV). A term neonate with no antenatal concerns was admitted with urosepsis and acute renal injury at 18 days of age. History revealed a poor urinary stream and dribbling. After resuscitation and stabilisation, renal tract ultrasound and micturating cysto-urethrogram were performed. Cystourethroscopy showed PUV and a mass indenting the bladder posteriorly. MRI confirmed the presence of a cystic lesion anterior to the rectum suspicious of rectal duplication. Laparoscopic-assisted excision of the anterior rectal duplication cyst was then performed. The infant recovered uneventfully. Creatinine normalised postoperatively and has been stable at follow-up.
Augmented agonist-induced Ca(2+)-sensitization of coronary artery contraction in genetically hypertensive rats. Evidence for altered signal transduction in the coronary smooth muscle cells.
Authors: S Satoh, R Kreutz, C Wilm, D Ganten, G Pfitzer
Journal: Journal of Clinical Investigation (1994)

The Ca2+ responsiveness of vascular smooth muscle myofilaments is not unique: it is increased during neuro-humoral activation and decreased during beta-adrenergic stimulation. In this study we tested whether an augmented Ca2+ responsiveness of smooth muscle myofilaments may contribute to the increased coronary tone observed in hypertension using beta-escin-permeabilized coronary arteries from 3-mo-old stroke-prone spontaneously hypertensive rats (SHRSP) and their age matched normotensive reference strain (WKY rats). In intact coronary arteries, the response to 5-hydroxytryptamine (5-HT) but not to KCl was larger in SHRSP than in WKY rats. In beta-escin permeabilized coronary arteries in which the receptor effector coupling is still intact, 5-HT enhanced force at constant submaximal (Ca2+) (pCa 6.38) to a greater extent in SHRSP. The Ca2+ sensitizing effect of 5-HT was mimicked by GTP gamma S (0.01-10 microM); again this effect was larger in SHRSP. In the absence of 5-HT or GTP gamma S the Ca2+ force relation was similar in both groups. Forskolin induced relaxation at constant submaximal (Ca2+). This desensitizing effect was smaller in SHRSP than in WKY rats. In conclusion, this study shows that intracellular signalling pathways involved in modulating the Ca2+ responsiveness of coronary smooth muscle myofilaments are altered in the genetically hypertensive animals favoring a hypercontractile state in the coronary circulation.
Medical Informatics and the Need for General Internists
Authors: J. Claude Bennett
Journal: Annals of Internal Medicine (1993)

Letters1 May 1993Medical Informatics and the Need for General InternistsJ. Claude Bennett, MDJ. Claude Bennett, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-9-199305010-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Gozum's thoughtful, provocative response to the FCIM position paper [1]. The Council agrees with Dr. Gozum about the importance of medical informatics and accordingly cited the large, ever-changing body of knowledge that intimidates students and residents into choosing careers in which they can limit the information base they must master. It also highlighted the need for more opportunities during medical school and residency training to gain experience in information appraisala term the Council used to emphasize the importance of developing skills in both medical informatics and the critical appraisal of clinical-scientific literature. Finally, as part ...REFERENCE1. Federated Council for Internal Medicine. General internal medicine and general internists: recognizing a national need. Ann Intern Med. 1992; 117:778-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1993Volume 118, Issue 9Page: 750-751KeywordsMedical educationResidencySub-specialty care ePublished: 15 August 2000 Issue Published: 1 May 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Challenges in Systematic Reviews of Educational Intervention Studies
Authors: Darcy Reed, Eboni G. Price, Donna M. Windish, Scott M. Wright, Aysegul Gozu, Edbert B. Hsu, Mary Catherine Beach, David Kern, Eric B. Bass
Journal: Annals of Internal Medicine (2005)

Educators have recognized the need to apply evidence-based approaches to medical training. To do so, medical educators must have access to reliable evidence on the impact of educational interventions. This paper describes 5 methodologic challenges to performing systematic reviews of educational interventions for health care professionals: finding reports of medical education interventions, assessing quality of st udy designs, assessing the scope of interventions, assessing the evaluation of interventions, and synthesizing the results of educational interventions. We offer suggestions for addressing these challenges and make recommendations for reporting, reviewing, and appraising interventions in medical education.
The Effect of Dose and Timing of Dose on the Association between Airborne Particles and Survival
Authors: Joel Schwartz, Brent Coull, Francine Laden, Louise Ryan
Journal: Environmental Health Perspectives (2007)

Understanding the shape of the concentration-response curve for particles is important for public health, and lack of such understanding was recently cited by U.S. Environmental Protection Agency (EPA) as a reason for not tightening the standards. Similarly, the delay between changes in exposure and changes in health is also important in public health decision making. We addressed these issues using an extended follow-up of the Harvard Six Cities Study.Cox proportional hazards models were fit controlling for smoking, body mass index, and other covariates. Two approaches were used. First, we used penalized splines, which fit a flexible functional form to the concentration response to examine its shape, and chose the degrees of freedom for the curve based on Akaike's information criterion. Because the uncertainties around the resultant curve do not reflect the uncertainty in model choice, we also used model averaging as an alternative approach, where multiple models are fit explicitly and averaged, weighted by their probability of being correct given the data. We examined the lag relationship by model averaging across a range of unconstrained distributed lag models.We found that the concentration-response curve is linear, clearly continuing below the current U.S. standard of 15 microg/m3, and that the effects of changes in exposure on mortality are seen within two years.Reduction in particle concentrations below U.S. EPA standards would increase life expectancy.
Genome-Wide Linkage and Follow-Up Association Study of Postpartum Mood Symptoms
Authors: Pamela Belmonte Mahon, Jennifer L. Payne, Dean F. MacKinnon, Francis M. Mondimore, Fernando S. Goes, Barbara Schweizer, Dubravka Jancic, William H. Coryell, Peter A. Holmans, Jianxin Shi, James A. Knowles, William A. Scheftner, Myrna M. Weissman, Douglas F. Levinson, J. Raymond DePaulo, Peter P. Zandi, James B. Potash
Journal: American Journal of Psychiatry (2009)

Objective: Family studies have suggested that postpartum mood symptoms might have a partly genetic etiology. The authors used a genome-wide linkage analysis to search for chromosomal regions that harbor genetic variants conferring susceptibility for such symptoms. The authors then fine-mapped their best linkage regions, assessing single nucleotide polymorphisms (SNPs) for genetic association with postpartum symptoms. Method: Subjects were ascertained from two studies: the NIMH Genetics Initiative Bipolar Disorder project and the Genetics of Recurrent Early-Onset Depression. Subjects included women with a history of pregnancy, any mood disorder, and information about postpartum symptoms. In the linkage study, 1,210 women met criteria (23% with postpartum symptoms), and 417 microsatellite markers were analyzed in multipoint allele sharing analyses. For the association study, 759 women met criteria (25% with postpartum symptoms), and 16,916 SNPs in the regions of the best linkage peaks were assessed for association with postpartum symptoms. Results: The maximum linkage peak for postpartum symptoms occurred on chromosome 1q21.3-q32.1, with a chromosome-wide significant likelihood ratio Z score (Z LR ) of 2.93 (permutation p=0.02). This was a significant increase over the baseline Z LR of 0.32 observed at this locus among all women with a mood disorder (permutation p=0.004). Suggestive linkage was also found on 9p24.3-p22.3 (Z LR =2.91). In the fine-mapping study, the strongest implicated gene was HMCN1 (nominal p=0.00017), containing four estrogen receptor binding sites, although this was not region-wide significant. Conclusions: This is the first study to examine the genetic etiology of postpartum mood symptoms using genome-wide data. The results suggest that genetic variations on chromosomes 1q21.3-q32.1 and 9p24.3-p22.3 may increase susceptibility to postpartum mood symptoms.
Struma Ovarii Coexisting With Mucinous Cystadenoma Detected by Radioactive Iodine
Authors: Daisuke Utsunomiya, Shinya Shiraishi, Koichi Kawanaka, Flora Lwakatare, Seiji Tomiguchi, Rumi Kido, Hidetaka Katabuchi, Hitoshi Okamura, Yasuyuki Yamashita
Journal: Clinical Nuclear Medicine (2003)

The authors describe a case of struma ovarii coexisting with mucinous cystadenoma. Ultrasonography and magnetic resonance imaging showed a multilocular cystic mass with a solid component. The ovarian tumor demonstrated uptake of I-123 sodium iodide, allowing a preoperative diagnosis of struma ovarii. In women with an unexplained increase in thyroid function and low I-123 uptake in the cervical thyroid gland, scintigraphy of the pelvis should be considered.
Updated Hodgkin's Disease: A. Introduction
Authors: Philip Rubin
Journal: JAMA (1972)

A number of major strides have been made during the past decade toward the cure of Hodgkin's disease. They include the following: (1) development of a meaningful classification (Introductory Fig); (2) a greater effort to determine the true extent of the disease by means of sophisticated radiography; (3) the use of laparotomy; (4) biopsy evaluation of inaccessible abdominal sites; (5) the development of very refined megavoltage radiation therapy techniques; and (6) an effective, cyclic, multidrug, chemotherapy schedule. As a result, an air of optimism has supplanted the pessimism that pervaded the literature and clinical practice in the past. These aggressive diagnostic and therapeutic approaches have overcome the initial obstacles to cure. A new medical radicalism has been spawned by the combination of all types of contemporary technology; success has resulted from multidisciplinary teamwork leading into interdisciplinary decision making. The concern now is that promising investigational procedures and new ideas presently
OC-049 Rectal Neuroendocrine Tumours: Management And Survival In 60 Patients
Authors: K Naik, R Rossi, M Caplin, C Toumpanakis
Journal: Gut (2014)

<h3>Introduction</h3> Rectal neuroendocrine tumours (rNETs) are increasing in incidence, with more found incidentally on routine colonoscopy. Our aim is to retrospectively analyse a cohort of rNETs to characterise diagnostic features and clinical behaviour. <h3>Methods</h3> Patients (pts) with confirmed diagnosis of rNET were identified from a database. <h3>Results</h3> 60 pts evaluated, median age 55 years (range 23–78). Most common presentation was rectal bleeding n = 29 (48%). 29/60 pts had tumour &lt;1 cm, 7/60 pts 1–2 cm, 22/60 &gt;2 cm, 2/60 size was unknown. Of patients with tumour size &lt;1 cm, 3/29 did not require endoscopic follow-up (pT1a) and of the other 26, none had evidence of recurrence on endoscopic follow-up (follow-up range 6 to 88 m). 24/60 pts had metastases at presentation, 5/60 developed metastases during follow-up (of these 29 pts 86% liver, 40% bone, 10% lung). Of 29 pts with metastases, 24/29 had somatostatin receptor imaging with 62% avid uptake. Chromogranin A available in 23/29 pts: not elevated in 83%. Of 29 pts with metastases, 19/29 had chemotherapy, 10/29 somatostatin analogues (SST), 15/29 surgery and 10/29 peptide-receptor-radionuclide-therapy (PRRT). Chemotherapy: 1/19 pts partial response, 2/19 stable disease (SD), 12/19 progressive disease (PD) (median time to progression 4 months (m)); 4/19 no data. PRRT: 4/10 had SD (follow-up range 24 to 53 m), 4/10 PD (median time to progression 4 m, range 2–9), 2/10 no data. SST: 2 sustained SD (range 12–27 m), 7/10 PD, (median time to progression 3m, range 2–5); 1/10 no data. During median follow-up of 20 m (range 3–170 m), 100% of pts with primary tumour &lt;1 cm, 86% with tumour size 1–2 cm, and 25% with size &gt;2 cm are currently alive. Tumour size &gt;2 cm have poorer outcome than the other 2 groups (p &lt; 0.001). <h3>Conclusion</h3> Tumours &gt;2 cm are associated with poor prognosis. Chromogranin A is mostly normal even in advanced disease. Prospective studies are needed to determine progression free survival data for systemic therapy. <h3>Disclosure of Interest</h3> None Declared.
Lessons from the withdrawal of rofecoxib: France has policy for overall assessment of public health impact of new drugs
Authors: Lucien Abenhaim
Journal: BMJ (2004)

EDITOR—In their editorial commenting on the withdrawal of rofecoxib, Dieppe et al advocate a series of measures before a drug can be licensed.1 Several experiences at the directorate general of the Health of France relating to this issue have led to the formulation of a new policy.

Whenever a drug is likely to be used on a large scale, pharmaceutical companies must present a pre-reimbursement assessment and organise a postmarketing study of the public health impact of the drug. This impact assessment goes far beyond single end points, as is the case in trials and classic …
Late Regression of the Dilated Site After Coronary Angioplasty
Authors: John A. Ormiston, Fiona M. Stewart, Antony H. G. Roche, Bruce J. Webber, Ralph M. L. Whitlock, Mark W. I. Webster
Journal: Circulation (1997)

Background Limited data are available on the changes that occur at the dilated site late after coronary angioplasty. The aim of this study was to evaluate with quantitative angiography the natural history of changes that occur in the dilated segment between “early” (≈6 months) and “late” (≈5 years) follow-up after angioplasty. Methods and Results Of 127 consecutive patients (174 lesions) with successful angioplasty, 125 underwent early angiography. Three patients subsequently died, and 24 underwent revascularization surgery or repeated angioplasty, giving a study-eligible population of 98 patients. Quantitative angiographic analysis was performed before and immediately after angioplasty and at early and late follow-up in the study population of 84 patients (115 lesions), which was 86% of study-eligible patients. Mean lesion diameter stenosis decreased from 36.3±14.2% at early to 29.6±13.5% at late follow-up ( P &lt;.0001). No lesion developed late restenosis by the 50% diameter loss criterion. Late regression was related to stenosis severity at early angiography ( r =−.58, P &lt;.001). Subgroups at early angiography of 40% to 49% stenosis and ≥50% stenosis showed significant regression at late angiography. Conclusions Lesion regression at the dilated site is common late after angioplasty. The more severe a stenosis is at early angiography, the more likely the chance that there will be late regression. A strategy of watchful waiting may be appropriate for patients with restenotic lesions of borderline severity.