tbuckley/cabot-search huggingface dataset:
Our Medical Marriage
Authors: Richard M. Berlin
Journal: Annals of Internal Medicine (1999)

Ad Libitum2 November 1999Our Medical MarriageRichard M. Berlin, MDRichard M. Berlin, MDRichmond, MA 01254 (Berlin)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-9-199911020-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail for SusanneWe kneeled on the bookstore floortwo students scanning the bodiesof new books, checking outeach other's Principlesof Internal Medicine.Scores of textbooks laterwe're a pair of pagers and missed dinners,companions in sleep-deprived nights.We suffered the long delaybefore our only child while we ranto slashed wrists and ODs,sprinted from half-read journalto school play to board meeting.In conversation long as summer lightwe talked patients and drugs,recited the crushed prayers of the dying,learned how we both took medicineas a life-long lover.... Author, Article, and Disclosure InformationAffiliations: Richmond, MA 01254 (Berlin)Corresponding Author: Richard M. Berlin, MD, 856 Lenox Road, Richmond, MA 01254. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 2 November 1999Volume 131, Issue 9Page: 711KeywordsDrugsKnees ePublished: 15 August 2000 Issue Published: 2 November 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Immediate adverse reactions to immunotherapy in allergy
Authors: R. Tamir, I. Levy, S. Duer, A. I. Pick
Journal: Allergy (1992)

We report our experience of adverse reactions to immunotherapy (IT) in patients with insect venom allergy and inhalant respiratory allergy. Adverse reactions included large local reactions, generalized cutaneous reactions or systemic reactions. Among 87 patients treated for venom allergy, 43% had adverse reactions during the course of IT, averaging 2.5 reactions per patient and per course of IT. Nine had systemic reactions, of which 7 required adrenaline administration. Among 52 patients treated with inhalant allergen extracts, 40% had adverse reactions averaging 3 reactions per patient per course of treatment. Ten patients had systemic reactions but only 2 required adrenaline administration. There was no difference between the rate of adverse reactions in the venom and the inhalant treatment groups. IT has an inherent risk which has to be weighed against its benefits.
Treatment of Esophageal and Gastric Tumors
Authors: H. Inoue, M. Tani, K. Nagai, T. Kawano, K. Takeshita, M. Endo, T. Iwai
Journal: Endoscopy (1999)

Endoscopic mucosal resection (EMR) has gained increasing popularity in the treatment of esophageal and gastric mucosal cancers in Japan, for complete local resection of the cancer-bearing mucosa. In Western countries, the concept of mucosal cancer and the necessity of treating it are gradually but steadily coming to be accepted. As a treatment for inoperable cases of advanced cancer, on the other hand, intubation with self-expanding metal stents has been widely accepted as a less invasive form of palliation for malignant obstruction of the upper gastrointestinal tract. Tumor ingrowth into the stent can be mechanically avoided by adding a membrane coating to it. In the last two years, applications for therapeutic endoscopy in the treatment of esophageal and gastric tumors have continued to widen.
Vaccination Against Measles in the Canadian Arctic
Authors: John Furesz
Journal: JAMA (1966)

Measles virus vaccine, live, attenuated (Schwarz strain), was administered in June 1965 to 84 Eskimo and 21 white children, 7 months to 6 years of age, living in a village of the Canadian Eastern Arctic. Specific antibodies to measles virus were detected in 100% of 42 serum specimens from the Eskimo children and 15 (94%) of 16 serum specimens from the white children. Except for high fever, severe clinical reactions were not observed during the vaccination program. Rectal temperatures over 103 F (39.4 C) were noted in 12 (33.3%) of 36 Eskimo children and in 3 (18.8%) of 16 white children 6 to 11 days following vaccination. Mild rash developed in 11 (30.6%) of 36 Eskimo and in 6 (37.5%) of 16 white children. These data have demonstrated the safety and efficacy of use of the Schwarz vaccine among Eskimo children.
Subsidiary pacemaker function in complete heart block after His-bundle ablation.
Authors: H Schmidinger, P Probst, B Schneider, H Weber, J Kaliman
Journal: Circulation (1988)

To investigate the electrophysiological properties of ventricular impulse formation after His-bundle ablation in 11 patients, incremental ventricular overdrive stimulation studies were performed. The studies, which were spread over a follow-up period of up to 601 days, were carried out invasively with temporary leads as well as noninvasively with the implanted pacemakers and chest wall inhibition. The overdrive pacing rate was increased in steps of 10 beats/min, and the pacing duration was 2 minutes at each level. Ten out of 11 patients had a reliable ventricular escape rhythm; in the remaining patient, consistently no subsidiary pacemaker function was observed up to 10 seconds. In 83% of the studies, incremental ventricular overdrive stimulation caused progressive suppression of ventricular impulse formation with exponential increase in ventricular recovery time and progressive postrecovery subsidiary pacemaker depression. In the remaining 17%, ventricular recovery time showed a heterogeneous response to overdrive stimulation--as possible cause alterations in the sympathetic tone and limitations attributable to the method used are discussed. The results of this study demonstrate a rate-dependent overdrive suppression of subsidiary ventricular pacemaker tissue. This can be of clinical importance in patients with complete heart block and rate-adaptive pacemakers because sudden pacemaker failure or temporary pacemaker inhibition at high stimulation rates may cause Stokes-Adams attacks not reproducible at lower pacing rates.
Magnification Endoscopy with Acetic Acid for Barrett’s Esophagus
Authors: J.-F. Rey, H. Inoue, M. Guelrud
Journal: Endoscopy (2005)

Barrett's esophagus is present in approximately 6 %-12 % of patients undergoing endoscopy for symptomatic gastroesophageal reflux disease. It is currently defined as the presence of columnar epithelium of any length in the distal esophagus, if biopsies in these segments reveal specialized intestinal metaplasia with goblet cells when a combined hematoxylin and eosin/Alcian blue stain of pH 2.5 is applied. Segments less than 3 cm in length and greater than 3 cm are called short-segment and long-segment Barrett's esophagus, respectively. Barrett's esophagus is the only clearly recognized risk factor for adenocarcinoma of the esophagus and this risk is associated topographically with the areas of specialized intestinal metaplasia. Adenocarcinoma of the esophagus is detected with increasing frequency and its incidence continues to rise. The estimated annual cancer risk for a given patient with Barrett's esophagus is approximately 0.5 %. The 5-year survival rate for this malignancy remains dismal, because survival is stage-dependent and currently most cancers are at advanced stages when detected. Strategies for an improved survival rate among patients with adenocarcinoma of the esophagus focus on improving the diagnosis of Barrett's esophagus, on better identification of dysplasia, and on detection of cancer at earlier and potentially curable stages.
DNA prime/canarypox boost—based immunotherapy of chronic hepatitis B virus infection in a chimpanzee
Authors: P Pancholi
Journal: Hepatology (2001)

There are about 200 million chronic hepatitis B virus (HBV) carriers at high risk of development of cirrhosis and hepatocellular carcinoma. Termination of the carrier state may avert these risks. We have investigated immunotherapy for chronic HBV infection in a chimpanzee HBV carrier using recombinant DNA-based immunization followed by a recombinant canarypox booster. One week after the booster, HBV DNA declined greater than 400-fold and remained undetectable by the quantitative polymerase chain reaction (PCR) assay for 186 weeks. Plasma levels of hepatitis B surface antigen (HBsAg) declined for only a short time. The decline in HBV DNA correlated with a boost in gamma interferon production without a corresponding boost in cytotoxic T lymphocyte levels, and decline in the transcriptional template or covalently closed circular DNA level. Confirmation of these findings requires further studies in chimpanzees and/or in humans.
The Burned Man
Authors: D.A. Feinfeld
Journal: Annals of Internal Medicine (1997)

Ad Libitum15 July 1997The Burned ManD.A. Feinfeld, MDD.A. Feinfeld, MDNassau County Medical Center East Meadow, NY 11554Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-2-199707150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail through ... Author, Article, and Disclosure InformationAffiliations: Nassau County Medical Center East Meadow, NY 11554Corresponding Author: D.A. Feinfeld, MD, Department of Medicine, Nassau County Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1997Volume 127, Issue 2Page: 161KeywordsBloodBurnsDrugsPainStainingThorax ePublished: 15 August 2000 Issue Published: 15 July 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Mechanism of tau transfer: insights from cell culture and animal models
Authors: Jessica Wu, Dara Dickstein, Karen Duff
Journal: Molecular Neurodegeneration (2013)

Objective Tau inclusions composed of tau fibrils are one of the key hallmarks of Alzheimer’s disease and other tauopathies. Studies from transgenic animal models and human AD pathological cases suggest that tau inclusions spread from the transentorhinal cortex to mono and transynaptically connected regions of the hippocampus and neocortical regions. This study examines cell-to-cell propagation of pathological tau in cell culture and in vivo animal models.
Deafness Complicating Antibiotic Therapy of Hepatic Encephalopathy
Authors: DENNIS P. BERK
Journal: Annals of Internal Medicine (1970)

Five cases of ototoxicity associated with the oral administration of neomycin are reported. The absence of renal failure but the presence of low serum antibiotic levels in these cases suggests that with prolonged exposure even minimal absorption can be toxic. Additional observations suggest that the related drug paromomycin may be similarly dangerous.
Problems in the diagnosis of intermittent explosive disorder
Authors: S Monopolis, J R Lion
Journal: American Journal of Psychiatry (1983)

The authors studied the accuracy with which intermittent explosive disorder was diagnosed in a university hospital setting. An index of diagnostic features abstracted from the description of intermittent explosive disorder in DSM-III was used for chart review. Diagnosis of the disorder was made in 20 out of 830 admissions (2.4%). In 14 cases (1.7%) it was a primary one; in another five (.6%) it was secondary; and in one case (.1%) it was tertiary. The authors discuss the varied rigorousness of the diagnosis and the importance of using an index of diagnostic features to enhance diagnostic accuracy.
Chemoprophylaxis Against Neisseria Meningitidis
Authors: Larry K. Pickering
Journal: JAMA (1976)

THE DIAGNOSIS of<i>Neisseria meningitidis</i>meningitis usually requires 48 to 72 hours for isolation and identification of the organism and serotyping to be performed. Determination of antimicrobial susceptibility takes an additional 24 to 48 hours. Moreover, many hospital laboratories are not equipped to perform proper sensitivity testing, resulting in further delay. Thus, these factors retard the prompt institution of specific antimicrobial chemoprophylaxis of household contacts. The choice of antibiotic depends on the serogrouping and antimicrobial sensitivity of the organism isolated from the index case. Following is a report of three patients with<i>N meningitidis</i>meningitis, two of whom were friends in whom the disease developed within the same week due to different serogroups. Countercurrent immunoelectrophoresis (CIE) provides a rapid and reliable method of diagnosing meningococcal meningitidis, allowing prompt and appropriate therapy for the index case and immediate antimicrobial chemoprophylaxis for household contacts. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 10-year-old girl
Impaired cardiopulmonary baroreflex control of renal nerves in renal hypertension.
Authors: M D Thames, L N Johnson
Journal: Circulation Research (1985)

We recently reported that arterial baroreflex control of renal nerve traffic is impaired in renal hypertensive rabbits. The purpose of this study was to determine if vagal cardiopulmonary baroreflex control of renal nerve traffic is also impaired. Experiments were performed in 10 hypertensive (mean arterial pressure +/- SE in conscious state, 110 +/- 3 mm Hg) and 10 normotensive (79 +/- 1 mm Hg) chloralose-anesthetized rabbits. Responses to graded blood volume expansion (+5, +10, +15 ml/kg) with dextran in saline were recorded with all baroreflexes intact, after sinoaortic baroreceptor denervation, and after vagotomy. With arterial and cardiopulmonary baroreflexes intact, volume expansion resulted in decreases in renal nerve traffic of -12 +/- 2%/mm Hg increase in left atrial pressure in normotensive rabbits, but of only -5 +/- 2%/mm Hg in the hypertensive rabbits (P less than 0.05). This difference is particularly striking in view of the larger maximum increases in arterial (25 +/- 7 vs. 12 +/- 3 mm Hg) and left atrial pressure (9 +/- 1 vs. 6 +/- 1 mm Hg) during volume expansion in hypertensive vs. normotensive rabbits. After sinoaortic baroreceptor denervation, the responses of normotensive rabbits were preserved (-11 +/- 3%/mm Hg), while those of hypertensive rabbits were impaired further (-2 +/- 1%/mm Hg). Vagotomy abolished responses of renal nerves to volume expansion in both groups. These data demonstrate striking impairment of vagal cardiopulmonary baroreflex control of renal nerve traffic in renal hypertension. Even though arterial baroreflexes have been shown to be abnormal in renal hypertension, they still may partially compensate for markedly impaired cardiopulmonary baroreflex control of the renal nerves.
Do We Carry Adequate Malpractice Coverage?
Authors: Arthur A. Kirchner
Journal: JAMA (1961)

TO BE SUED for malpractice and have a verdict returned against him is most unpleasant for a physician. But it can be doubly distressing if the physician carries no professional liability insurance or the limits of his liability are insufficient to cover the amount of the jury's award. Interviews with such physicians, their professional colleagues, their patients, their insurance counselors, and their attorneys reveals that all too frequently physicians fail to carry either any or sufficient professional liability insurance.  Protection of one's estate, the ability to indemnify injured patients, and to equitably share with one's colleagues the burdens of an unfortunate medical accident, as well as finance an adequate defense of one's professional reputation, are all compelling reasons why a physician should carry reasonably adequate professional liability insurance. The risks are high. Medical practice has become more complicated and hazardous. Jury awards in all types of personal injury cases are
NK3-specific natural killer cells are selectively inhibited by Bw4-positive HLA alleles with isoleucine 80.
Authors: M Cella, A Longo, G B Ferrara, J L Strominger, M Colonna
Journal: The Journal of Experimental Medicine (1994)

Natural killer (NK) cell clones have been previously described which are inhibited by HLA-C alleles with Asn77-Lys80 (NK1-specific cells) or by HLA-C alleles with Ser77-Asn80 (NK2-specific cells). In the present work, the generation of NK cells with HLA-B-related specificities was attempted by stimulation of a Bw4 homozygous responder by a Bw6 homozygous donor. Two NK clones were found, which were inhibited by HLA-Bw4 (but not by HLA-Bw6) allotypes and by some HLA-A allotypes that share the Bw4 public epitope. Inhibition of NK cell-mediated lysis strongly correlated with the presence of an Ile residue at position 80 of the protective allele. These NK cell clones define a new specificity termed NK3.
Preoperative risk evaluation and stratification of long-term survival after valve replacement for aortic stenosis. Reasons for earlier operative intervention.
Authors: O Lund
Journal: Circulation (1990)

Predictability of prognosis was analyzed in 630 patients who were alive 30 days after valve replacement (1965-1986) for aortic stenosis. Follow-up totaled 4,072 patient-years. During the operative periods of 1965-1971 (n = 62), 1972-1976 (n = 164), 1977-1981 (n = 158), and 1982-1986 (n = 246), decreases in cardiothoracic index (0.56 +/- 0.06, 0.53 +/- 0.06, 0.52 +/- 0.06, and 0.51 +/- 0.06; p less than 0.0001), in the prevalence of functional classes III and IV (87%, 76%, 68%, and 62%; p less than 0.0001), and of left ventricular (50%, 39%, 36%, and 30%; p less than 0.05) were accompanied by improved survival (5 year/10 year +/- SE: 73 +/- 6%/53 +/- 6%, 82 +/- 3%/65 +/- 4%, 89 +/- 3%/79 +/- 4%, and 87 +/- 3%/-; p = 0.002) despite increasing age (56 +/- 9, 57 +/- 11, 59 +/- 10, and 61 +/- 11 years; p less than 0.01). A Cox regression analysis identified peak-to-peak systolic gradient (p = 0.0001; inversely related to death rate), cardiothoracic index (p = 0.0003), left ventricular failure (p = 0.0005), prosthetic orifice diameter of 15 mm or less (p = 0.001), age (p = 0.003), ventricular ectopic beats (p = 0.004), male gender (p = 0.03), and antianginal/antiarrhythmic treatment (p = 0.03) as independent risk factors. A prognostic index calculated from the final Cox model stratified the patients into eight risk groups, having observed +/- SE/predicted/expected (matched background population) 10-year survival rates of 90 +/- 7% (n = 29)/94%/91%, 84 +/- 6% (n = 61)/89%/87%, 86 +/- 3% (n = 105)/83%/81%, 75 +/- 4% (n = 165)/75%/77%, 62 +/- 6% (n = 128)/63%/74%, 51 +/- 8% (n = 84)/47%/71%, 29 +/- 9% (n = 40)/31%/67%, and 16 +/- 9% (n = 18)/14%/54% (p less than 0.000001/-/-). Excess mortality relative to the background populations prevailed predominantly in risk groups 5-8 and was mainly caused by congestive heart failure. Thus, improved long-term survival during the 22-year operative period was related to improved preoperative patient status. Earlier operation (= low prognostic index) inferred a survival rate comparable to that of a matched background population. The prognostic index was probably predominantly related to preoperative myocardial damage that caused late predictable death from congestive heart failure.
Relationship between systemic and coronary endothelial function in women with chest pain: pilot phase data from the NHLBI women's ischemia syndrome evaluation (WISE)
Authors: R.A. Kerensky, L. Lin, A. Boyette, J.F. Lewis, S.P. McGorray, B.L. Sharaf, C.N.Bairey Merz, C.J. Pepine
Journal: Journal of the American College of Cardiology (1998)
Thrombin receptor activation elicits rapid protein tyrosine phosphorylation and stimulation of the raf-1/MAP kinase pathway preceding delayed mitogenesis in cultured rat aortic smooth muscle cells: evidence for an obligate autocrine mechanism promoting cell proliferation induced by G-protein-coupled receptor agonist.
Authors: C J Molloy, J E Pawlowski, D S Taylor, C E Turner, H Weber, M Peluso
Journal: Journal of Clinical Investigation (1996)

Treatment of quiescent rat aortic smooth muscle cells with either alpha-thrombin or a thrombin receptor-derived agonist peptide (SFLLRNP) resulted in pronounced increases in [3H]thymidine incorporation that were concentration dependent and reached a maximum of approximately 15-fold above serum-starved controls. However, in contrast to FBS, PDGF-BB, or basic fibroblast growth factor (bFGF), that initiated DNA synthesis promptly after 16-19 h, thymidine incorporation in response to thrombin was delayed by an additional 3-6 h. Delayed mitogenesis correlated with the appearance of a potent mitogenic activity in conditioned media samples obtained from thrombin-stimulated rat aortic smooth muscle cells, as assayed using Swiss 3T3 fibroblasts. This activity was not inhibited by neutralizing antibodies directed against PDGF or bFGF. Furthermore, in the Swiss 3T3 cells, simple addition of either alpha-thrombin or SFLLRNP failed to elicit a significant mitogenic response. In signal transduction studies, both thrombin and SFLLRNP treatment led to rapid tyrosine phosphorylation of proteins with apparent molecular masses of 42, 44, 75, 120, and 190 kD, respectively, as assessed by antiphosphotyrosine immunoblotting. The overall pattern of protein tyrosine phosphorylation was distinct from that observed after PDGF-BB addition. Activation of Raf-1 and the mitogen-activated protein (MAP) kinases p44mapk and p42mapk was also observed. However, the time course and duration of Raf-1/MAP kinase activation after thrombin stimulation were similar to those elicited by PDGF-BB. Taken together, our results indicate that thrombin-stimulated vascular smooth muscle proliferation is delayed and requires the de novo expression of one or more autocrine mitogens. In addition, the rapid induction of discrete intracellular signaling mechanisms by thrombin, including the Raf-1/MAP kinase pathway, appears to be insufficient alone to promote vascular smooth muscle cell mitogenesis.
Exaggerated Blood Pressure Responses During Mental Stress Are Associated With Enhanced Carotid Atherosclerosis in Middle-Aged Finnish Men
Authors: Thomas W. Kamarck, Susan A. Everson, George A. Kaplan, Stephen B. Manuck, J. Richard Jennings, Riitta Salonen, Jukka T. Salonen
Journal: Circulation (1997)

Background Exaggerated cardiovascular reactivity to mental stress is hypothesized to increase atherosclerotic risk. We examined this hypothesis using cross-sectional data from the Kuopio Ischemic Heart Disease study, a population-based epidemiological sample. Methods and Results 901 Eastern Finnish men from four age cohorts (age, 42 to 60 years) were administered a standardized testing battery to assess cardiovascular reactivity to mental stress. Ultrasound measures of intima-medial thickness (IMT) and plaque height from the common carotid arteries were used as noninvasive markers of atherosclerosis. Diastolic blood pressure (DBP) responses to mental stress were significantly associated with mean IMT ( b =.021, P =.006), maximum IMT ( b =.026, P =.013), and mean plaque height ( b =.017, P =.041). Significant associations were also shown between stress-related systolic blood pressure (SBP) reactivity and mean IMT ( b =.0151, P =.042). When examined separately by age, associations with IMT were significant only in the youngest half of the sample (age, 46 and 52 years, n=433; for mean IMT, DBP b =.033, P =.0002, SBP b =.0266, P =.003; for maximum IMT, DBP b =.039, P =.002, SBP b =.032, P =.011). Results remained significant in the younger subjects after adjustment for smoking, lipid profiles, fasting glucose, and resting blood pressure ( b =.024, P =.011); results also remained significant in a subgroup of unmedicated younger subjects without symptomatic cardiovascular disease (n=135; for SBP reactivity, b =.031, P =.036; for DBP, b =.037, P =.007). Conclusions The tendency to show exaggerated pressor responses to mental stress is a significant independent correlate of atherosclerosis in this population sample of Finnish men. The effect does not appear to be accounted for by the confounding influence of other risk factors or preexisting clinical disease.