tbuckley/cabot-search huggingface dataset:
Response to Comment on: Riddle et al. Contributions of Basal and Postprandial Hyperglycemia Over a Wide Range of A1C Levels Before and After Treatment Intensification in Type 2 Diabetes. Diabetes Care 2011;34:2508–2514
Authors: Matthew Riddle, Guillermo Umpierrez, Andres DiGenio, Rong Zhou, Julio Rosenstock
Journal: Diabetes Care (2011)

We thank Monnier (1) for his interest in and comments on our article (2). We believe his original work on the relationships between fasting and postprandial hyperglycemia has opened discussion on various important questions, both physiological and clinical (3). In our present analysis, we aimed to extend this work by addressing two of the clinical questions in a larger population than has previously been studied (2). These were 1 ) In a common clinical setting, when oral therapy is no longer successful in keeping A1C below 7%, which form of hyperglycemia is quantitatively most prominent? 2 ) How does intensification of treatment affect hyperglycemic patterns? Our results show that in this …
OC-091 Ondansetron slows transit and improves stool consistency in patients with diarrhoea predominant irritable bowel syndrome
Authors: K Garsed, M Hastings, L Marciani, C Lam, G Singh, M Lingaya, P Whorwell, R Banwait, R Spiller
Journal: Gut (2012)

<h3>Introduction</h3> 5-Hydroxytryptamine three receptor antagonists (5HT3RA) are effective in diarrhoea predominant irritable bowel syndrome (IBS-D), with a number needed to treat (NNT) for Alosetron of 7.<sup>1</sup> Due to safety concerns (constipation [25%] and ischaemic colitis [0.1%]) Alosetron is not licensed in the UK. Ondansetron (OND) is a 5HT3 RA, widely and safely used for nausea, with constipation as a side effect. <h3>Methods</h3> We recruited 125 patients meeting the Rome III criteria from primary and secondary care to a two centre randomised, double-blind, placebo-controlled, crossover trial. Screening comprised of blood tests, rectal biopsy and a 1-week baseline Bristol stool form diary before randomisation to placebo (PLA) or OND for 5 weeks. Efficacy was optimised by dose titration during weeks 1–3 starting at 4 mg daily, increasing (max 8 mg three time a day) or decreasing as required. A 2-week washout preceded 5 weeks of the opposite therapy to that received in treatment 1. Symptom diaries including stool form, frequency, pain, bloating and urgency were completed daily. Transit using the Metcalf method was measured after each treatment period.<sup>2</sup> The primary endpoint was the difference in average stool form between baseline and the last 2 weeks of each treatment. Stool consistency “responders” were defined as experiencing &gt;50% reduction in the days/week with stool form 6 or 7. Analysis is presented by intention to treat. <h3>Results</h3> 80 women and 28 men completed the study (mean age 40.8, range 18–72, and 41.5, range 25–60). The mode dose of OND was &lt;4 mg a day. Stool form improved significantly in the OND arm, mean change 1.4 (95% CI 1.2 to 1.6), vs 0.5 (95% CI 0.3 to 0.7) compared to PLA, p=&lt;0.0001. Stool frequency improved on OND, mean 0.86 (95% CI 0.8 to 1.4), vs 0.44 (95% CI 0.4 to 0.89) on PLA, p=&lt;0.01, as did urgency score 0.6 (95% CI 0.8 to 0.4) vs 0.3 (95% CI 0.5 to 0.2) p=&lt;0.001. There were no significant improvements in pain or bloating. 74% of patients preferred OND while 26% preferred PLA or had no preference, χ<sup>2</sup> p=&lt;0.0001. 70% were “stool consistency responders” while taking OND compared with 33% taking PLA giving a NNT of 2.7. Whole gut transit slowed significantly while taking OND, 25 (13.5–47.5) h compared to 16 (7–29) h with PLA p=&lt;0.001. 9% receiving OND complained of constipation compared to 2% on PLA, all but one responded to dose reduction alone. 2% withdrew because of constipation. There was no case of ischaemic colitis. <h3>Conclusion</h3> Using dose titration Ondansetron acts to slow whole gut transit and is highly effective in IBS-D with a low incidence of constipation. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <b>Cremonini F</b>. <i>Neurogastroenterol Motil</i> 2003. 2. <b>Metcalf A</b>. <i>Gastroenterology</i> 1987.
Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response
Authors: Peter J. Snyder, Robert D. Utiger
Journal: Journal of Clinical Investigation (1973)

Repetitive administration of thyrotropin-releasing hormone (TRH) to human subjects was used to produce small elevations of endogenous serum triiodothyronine (T3) and thyroxine (T4) levels and thereby to determine the effect of these small elevations on the serum thyrotropin (TSH) response to subsequent doses of TRH. Each subject received 13 consecutive doses of 25 μg TRH at 4-h intervals. Serum T3, T4, and TSH levels were measured before the 1st, 7th, and 13th doses ("basal levels") and for the 4 h after each of these doses.
Renal Osteodystrophy
Authors: Beldon A. Idelson
Journal: JAMA (1974)

A patient undergoing maintenance hemodialysis for more than four years had diffuse bone pain and was found to have multiple, lytic bone lesions on x-ray film. Absence of subperiosteal bone resorption led to a presumptive diagnosis of metastatic neoplasm. The bone biopsy specimen showed a brown tumor. Parathyroid exploration showed four diffusely hyperplastic glands, consistent with secondary hyperparathyroidism. To our knowledge, brown tumors without subperiosteal bone resorption have not been reported in patients with secondary hyperparathyroidism. (<i>JAMA</i>230:870-872, 1974)
CTLA-4 checkpoint blockade in breast cancer, a case in point report
Authors: Chiara Dellepiane, Michela Lia, Mario Roberto Sertoli
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts A patient concomitantly affected by breast cancer and melanoma is presented in order to contribute to the ongoing debate on breast cancer immunotherapy [[1][1], [2][2]]. In 1996 the patient was operated on for left early breast cancer and treated with adjuvant radiotherapy and 5
Successful Repair of Sinus of Valsalva-Left Atrial Fistula
Authors: JEROME HAROLD KAY, ROBERT M. ANDERSON, REUBEN R. LEWIS, MARTIN REINBERG
Journal: Circulation (1959)

An unusual dissecting sinus of Valsalvaleft atrial fistula with successful repair is reported. This lesion was repaired by open heart surgery with the utilization of a heart-lung machine.
Eating Fish and Risk of Type 2 Diabetes: A Population-Based, Prospective Follow-Up Study
Authors: Barbara J. Boucher, Nasima Mannan
Journal: Diabetes Care (2010)

Van Woudenbergh et al. (1) report that consumption of lean but not of fatty fish was associated prospectively with a significant increase in risk of new-onset type 2 diabetes, not accounted for by differences in eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) consumption. They further report that this risk was abolished by adjustment for intakes of selenium, cholesterol, and vitamin …
Rates of vertebral bone loss before and after liver transplantation in women with primary biliary cirrhosis
Authors: Richard Eastell, Rolland E. Dickson, Stephen F. Hodgson, Russell H. Wiesner, Michael K. Porayko, Heinz W. Wahner, Sandra L. Cedel, Lawrence B. Riggs, Ruud A. F. Krom
Journal: Hepatology (1991)

Atraumatic fractures caused by osteoporosis may be a serious complication of primary biliary cirrhosis. Mean (+/- S.D.) bone mineral density in the lumbar spine in 210 ambulatory women with primary biliary cirrhosis was 1.02 +/- 0.19 gm/cm2, 7% lower than that in 139 age-matched normal women (after adjustment for age and body weight) (p less than 0.001). Bone mineral density in the lumbar spine was inversely related to a risk score index of liver disease severity (r = -0.29, p less than 0.001). The mean rate of bone loss in 105 of these 210 women was 2%/yr +/- 4%/yr, twice as great as in the 139 normal women (p less than 0.02). In 20 women with primary biliary cirrhosis followed up after orthotopic liver transplantation, bone mineral density in the lumbar spine decreased at 3 mo (p less than 0.01), and this decrease may have resulted in atraumatic fractures in 13 of them. Bone mineral density in the lumbar spine then increased (p less than 0.01) so that by 12 mo the median bone mineral density in the lumbar spine was similar to that before transplantation and by 24 mo it was 5% above it. Therefore we conclude that the progressive bone loss observed in primary biliary cirrhosis (which is further accentuated immediately after transplantation) may be halted, and the bone mass may be restored toward normal within 2 to 3 yr after orthotopic liver transplantation.
Physicians' Accuracy for Diagnosing Sore Throats-Reply
Authors: Randall D. Cebul
Journal: JAMA (1986)

<h3>In Reply.—</h3> We agree with Dr Forsyth that single throat cultures cannot diagnose streptococcal pharyngitis as well as multiple cultures combined with antistreptolysin-O titers. However, in most clinical settings, single throat swabs are performed, and only their results are available in time to affect decision making. Our study was designed, not to assess the general accuracy of "clinical diagnosis," but specifically to assess the accuracy of physicians' probability estimates for a familiar test result used by them to make clinical decisions. We believe that the methods used for obtaining cultures in our study were representative of those used in practice. The physicians swabbed the throat in the appropriate manner, and placed their swabs in a standard culturette (American Scientific Products) containing 0.5 mL of modified Stuart's bacterial transport medium. Cultures generally reached the laboratory in two hours. They were plated immediately and incubated aerobically. All isolates were serogrouped by the
SHORTENING AN ELONGATED UVULA FOR THE CURE OF COUGH
Authors: J. Dundas-Grant
Journal: BMJ (1932)

A female, aged 68, with pernicious anaemia.The anaemia was of two years' duration; one year before she had been in hospital in a crisis; and she had also been in a-mental hospital.She was readmitted to Dunedin Hospital with heart failure.On December 26th, 1929, the red cells were 1.5 millions per c.mrn., with a typical blood picture; the pulse rate varied from 100 to 160 per minute.She had the usual treatment
Ecological Effects of Selective Decontamination on Resistant Gram-negative Bacterial Colonization
Authors: Evelien A. N. Oostdijk, Anne Marie G. A. de Smet, Hetty E. M. Blok, Emily S. Thieme Groen, Gerard J. van Asselt, Robin F. J. Benus, Sandra A. T. Bernards, Ine H. M. E. Frénay, Arjan R. Jansz, Bartelt M. de Jongh, Jan A. Kaan, Maurine A. Leverstein-van Hall, Ellen M. Mascini, Wouter Pauw, Patrick D. J. Sturm, Steven F. T. Thijsen, Jan A. J. W. Kluytmans, Marc J. M. Bonten
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) eradicate gram-negative bacteria (GNB) from the intestinal and respiratory tract in intensive care unit (ICU) patients, but their effect on antibiotic resistance remains controversial.We quantified the effects of SDD and SOD on bacterial ecology in 13 ICUs that participated in a study, in which SDD, SOD, or standard care was used during consecutive periods of 6 months (de Smet AM, Kluytmans JA, Cooper BS, Mascini EM, Benus RF, van der Werf TS, van der Hoeven JG, Pickkers P, Bogaers-Hofman D, van der Meer NJ, et al. N Engl J Med 2009;360:20-31).Point prevalence surveys of rectal and respiratory samples were performed once monthly in all ICU patients (receiving or not receiving SOD/SDD). Effects of SDD on rectal, and of SDD/SOD on respiratory tract, carriage of GNB were determined by comparing results from consecutive point prevalence surveys during intervention (6 mo for SDD and 12 mo for SDD/SOD) with consecutive point prevalence data in the pre- and postintervention periods.During SDD, average proportions of patients with intestinal colonization with GNB resistant to either ceftazidime, tobramycin, or ciprofloxacin were 5, 7, and 7%, and increased to 15, 13, and 13% postintervention (P < 0.05). During SDD/SOD resistance levels in the respiratory tract were not more than 6% for all three antibiotics but increased gradually (for ceftazidime; P < 0.05 for trend) during intervention and to levels of 10% or more for all three antibiotics postintervention (P < 0.05).SOD and SDD have marked effects on the bacterial ecology in an ICU, with rising ceftazidime resistance prevalence rates in the respiratory tract during intervention and a considerable rebound effect of ceftazidime resistance in the intestinal tract after discontinuation of SDD.
CAN STRESS SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING PROVIDE EFFECTIVE CARDIAC RISK STRATIFICATION IN OCTOGENARIANS WITH NO KNOWN CORONARY ARTERY DISEASE?
Authors: Sanjeev U. Nair, Shishir Mathur, Abhijit Ghatak, Vivian Texeira, Mahjabeen Rashid, Fawad Kazi, Alan Ahlberg, Anuj Shah, Roger Mennett, Deborah Katten, Gary Heller
Journal: Journal of the American College of Cardiology (2010)
The human 230-kD bullous pemphigoid antigen gene (BPAG1). Exon-intron organization and identification of regulatory tissue specific elements in the promoter region.
Authors: K Tamai, D Sawamura, H C Do, Y Tamai, K Li, J Uitto
Journal: Journal of Clinical Investigation (1993)

The 230-kD bullous pemphigoid antigen (BPAG1), a hemidesmosomal protein, is encoded by a gene at the human chromosomal locus 6p11-12. We have elucidated the exon-intron organization of the entire human BPAG1 gene, including approximately 2.6 kb of 5'-flanking DNA. Seven overlapping genomic clones, spanning approximately 20 kb, contained the entire approximately 9 kb coding sequence of BPAG1 and consisted of 22 separate exons, which varied from 78 to 2,810 bp in size. The 5' flanking region of DNA, upstream from the ATG initiation codon for translation, was found to contain several putative transcriptional response elements. Most interestingly, two motifs potentially conferring keratinocyte specific expression to the gene were detected. The presence of such elements was suggested by approximately 20-fold higher expression of a promoter/chloramphenicol acetyl transferase (CAT) construct in normal human epidermal keratinocytes that express the endogenous gene, as compared to several non-expressing cell types. Transient transfections with 5'-deletion clones of the promoter/reporter gene (CAT) constructs identified a region containing a putative tissue specific element, KRE2, which also conferred tissue specificity to the expression of the truncated promoter downstream from this element, however, a mutated derivative of KRE2 was not functional. Detailed knowledge of the structure and regulation of the BPAG1 gene will aid in further elucidation of diseases affecting the cutaneous basement membrane zone.
Modification of Hormonal Responses to Arginine by -Adrenergic Blockade
Authors: J. M. H. Buckler, A. M. Bold, M. Taberner, D. R. London
Journal: BMJ (1969)

α-Adrenergic blockade with phentolamine significantly enhances the insulin response to arginine. In women phentolamine may inhibit the growth hormone response to arginine. It is suggested that adrenergic mechanisms may act as modulators in hormonal responses to infused amino-acid.
Isolated guinea pig gastric chief cells express tumour necrosis factor receptors coupled with the sphingomyelin pathway.
Authors: S Fiorucci, L Santucci, G Migliorati, C Riccardi, A Amorosi, A Mancini, R Roberti, A Morelli
Journal: Gut (1996)

The tumour necrosis factor alpha (TNF), has been implicated in the pathogenesis of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy and Helicobacter pylori induced gastritis. Both conditions are characterised by high plasma pepsinogen concentrations, which are thought to reflect an increased rate of enzyme release by the pepsinogen secreting (chief) cells. The mechanisms responsible for this cell dysfunction are unknown. This study investigates whether chief cells express TNF receptors and, if so, whether their activation results in cell death. Immunohistochemical studies conducted with monoclonal antibodies (mAbs) directed against two TNF receptor associated proteins of 55 kDa (TNF-R1) and 75 kDa (TNF-R2) showed that TNF binding sites were expressed in approximately 100% gastric chief cells. Western blot analysis of whole chief cell lysates probed with the TNF-R1 and TNF-R2 mAbs gave two distinct bands of 55 and 75 kDa in the immunoprecipitate. Incubating chief cells with TNF caused concentration and time dependent cell death, which was prevented by pretreating the cells with anti-TNF receptor mAbs. Exposing the cells to TNF reduced sphingomyelin content by 25%. Sphingomyelinase (10(-6) to 10(-2) IU/ml) mimicked the effect of TNF in that it provoked a concentration and time dependent reduction in chief cell viability and increased pepsinogen release. In conclusion, gastric chief cells express two TNF receptors partially linked to the sphingomyelin pathway. TNF induced chief cell dysfunction might be responsible for the high plasma pepsinogen concentrations seen in patients with NSAID gastropathy or H pylori induced gastritis.
Comparison of Sudden and Nonsudden Coronary Deaths in the United States
Authors: Luis G. Escobedo, Matthew M. Zack
Journal: Circulation (1996)

The present study was designed to compare risk factor prevalences in coronary heart disease deaths in persons dying within 1 hour of onset of cardiovascular symptoms (sudden coronary death), those dying without such sudden symptoms (nonsudden coronary death), and those with unknown duration of symptoms before death (other coronary death).Data from the 1986 National Mortality Followback Survey and the US Bureau of the Census were examined to assess death rates for sudden, nonsudden, and other coronary deaths. Multivariate logistic regression methods were used to calculate the odds ratio (OR), compared with nonsudden and other coronary deaths, for sudden coronary death associated with socioeconomic status variables, the person's location at death, and coronary heart disease risk factors. Mortality rates for all coronary deaths increased with age, were higher for men than women, and increased with decreasing years of schooling. The rate of sudden coronary death was highest for Hispanics. In 1986, an estimated 251,000 sudden coronary deaths (95% CI = 238,000 to 263,000) occurred in the United States. Sudden coronary deaths were less likely than nonsudden coronary deaths to occur at home (OR = 0.5, 95% CI = 0.4 to 0.6), but individuals who died of sudden coronary death were more likely to have been current cigarette smokers (OR = 1.3, 95% CI = 1.0 to 1.8). No other modifiable risk factors for coronary heart disease distinguished sudden coronary deaths from nonsudden coronary deaths.Contrary to the commonly held view, coronary deaths in the home are more likely to be nonsudden than sudden. Cigarette smoking more likely results in sudden than nonsudden coronary death, perhaps because of nicotine-induced ventricular arrhythmias.
Inhibition of demand pacemakers by skeletal muscle potentials
Authors: D. A. Winter
Journal: JAMA (1973)

Inhibition of demand pacemakers by interference arising from myopotentials has not received due recognition as a significant clinical problem. We have encountered four cases in which cerebral ischemic episodes resulted from pacemaker inhibition associated with isometric contraction of the subadjacent pectoralis major. It can be shown that even myoelectric signals detected on the skin surface are capable of inhibiting implantable ventricular-inhibited units. In a sample of our patients, 24% were shown to be vulnerable to pectoral muscle contraction by routine electrocardiographic testing. The problem may be very difficult to eliminate since significant and even maximal myoelectric energy levels may occur at frequencies within the QRS spectrum.
Cholangiodrainage in Roux-en-Y-settings: implantation of large-caliber stents via single balloon enteroscopy
Authors: D. Albers, U. Peitz
Journal: Endoscopy (2010)

Biliary tract endoscopic interventions using a push and pull enteroscope in patients with Roux-en-Y-reconstruction [1] [2] are limited by the width of the working channel of this type of endoscope, which allows insertion of stents up to a maximum diameter of 7 Fr.
Attenuation of vasopressin-mediated coronary constriction and myocardial depression in the hypoxic heart.
Authors: W A Boyle, L D Segel
Journal: Circulation Research (1990)

To investigate the ability of arginine vasopressin (AVP) to compete with metabolic vasodilatory factors in the coronary circulation, we examined the coronary vascular and myocardial effects of AVP in isolated working rat hearts during normoxic and hypoxic perfusion. In normoxic hearts, AVP treatment (777 +/- 67 pg/ml) reduced coronary flow by 38.4 +/- 2.6%. Myocardial function was also significantly decreased by AVP whereas efficiency significantly increased. In contrast, the same dose of AVP administered to hypoxic hearts resulted in substantially smaller effects on coronary flow (-11.5 +/- 2.8%), myocardial function, and efficiency. In hearts treated first with AVP and then with hypoxia, the greater degree of coronary vasodilation compared with that observed in hearts treated with hypoxia alone also indicated an antagonizing effect of hypoxia on AVP-mediated coronary constriction. It was also noted that the hypoxia treatment alone resulted in reductions of O2 supply and consumption identical to those produced by AVP treatment during normoxia. However, hypoxia was associated with a significantly greater effect on myocardial function and, in contrast to the effect of AVP, a marked reduction in efficiency. The rate of lactate release was greater during hypoxia alone (2.07 +/- 0.08 mumol/min) than with AVP treatment during normoxia (0.76 +/- 0.05 mumol/min). These results indicate that the effect of AVP on the coronary vessels, as well as its effect on the myocardium, is significantly attenuated during hypoxia. In addition, AVP-constricted vessels appear to retain considerable vasodilatory reserve despite evidence of ischemic conditions. Thus, although the effects of AVP resemble ischemia, the increased efficiency and the relatively small effect of AVP on contractile function, as well as the preserved vasodilatory reserve, suggest otherwise. A physiological explanation for these observations is proposed wherein the constricting effects of AVP modulate the effects of autoregulatory factors such that blood flow requirements are minimized while allowing preservation of adequate blood flow for vital tissue function.
TCT-596 Pantera Lux Drug Coated Balloon: Twelve-Month Results On The Diabetics Subgroup Of The International DELUX Registry
Authors: Christoph Naber, Andrejs Erglis, Béla Merkely, Gert Richardt, Kristof Graf, Bernhard Witzenbichler, Ton Slagboom, Ran Kornowski, Bruno Huret, Stefan Hoffmann, Ralph Toelg
Journal: Journal of the American College of Cardiology (2012)
DETERMINATION OF HqMOGLOBIN V. PRECISION OF COLORIMETRIC METHODS
Authors: E.J. King, M. Gilchrist, I.D.P. Wootton, R. Donaldson, R.B. Sisson, R.G. Macfarlane, H.M. Jope, J.R.P. O'Brien, J.M. Peterson, D.H. Strangeways
Journal: The Lancet (1948)
Statistical evaluation of the diagnostic accuracy of methods used to determine the progression of visual field defects in glaucoma
Authors: Chihiro Mayama, Makoto Araie, Yasuyuki Suzuki, Kyoko Ishida, Tetsuya Yamamoto, Yoshiaki Kitazawa, Motohiro Shirakashi, Haruki Abe, Hidetoshi Tsukamoto, Hiromu K. Mishima, Kenichi Yoshimura, Yasuo Ohashi
Journal: Ophthalmology (2004)