tbuckley/cabot-search huggingface dataset:
Update in Nephrology
Authors: Norman Muirhead
Journal: Annals of Internal Medicine (2010)

Updates1 June 2010Update in NephrologyNorman Muirhead, MDNorman Muirhead, MDFrom University of Western Ontario, London, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-11-201006010-00243 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Reports on several key trials that are relevant to the practice of nephrology and have implications for a broader group of internists, primary care physicians, and others who care for patients with chronic kidney disease were published in 2009. The following summary highlights the findings and importance of these studies.Chronic Kidney DiseasesNormalization of Hemoglobin Levels in Patients With Chronic Kidney Disease and Type 2 Diabetes Provides No Additional Benefit Over Partial Correction of Anemia Pfeffer MA , ...References1. Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, et al; CHOIR Investigators. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006;355:2085-98. [PMID: 17108343] CrossrefMedlineGoogle Scholar2. Drüeke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al; CREATE Investigators. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006;355:2071-84. [PMID: 17108342] CrossrefMedlineGoogle Scholar3. Wanner C, Krane V, März W, Olschewski M, Mann JF, Ruf G, et al; German Diabetes and Dialysis Study Investigators. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med. 2005;353:238-48. [PMID: 16034009] CrossrefMedlineGoogle Scholar4. Kovesdy CP, Anderson JE, Kalantar-Zadeh K. Association of serum bicarbonate levels with mortality in patients with non-dialysis-dependent CKD. Nephrol Dial Transplant. 2009;24:1232-7. [PMID: 19015169] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Western Ontario, London, Ontario, Canada.Article relevant to primary care general internistsDisclosures:Grants/grants pending: AstraZeneca, Novartis, Amgen. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-0323.Corresponding Author: Norman Muirhead, MD, London Health Sciences Centre University Hospital, 339 Windermere Road, London, Ontario N6A 5A5, Canada; e-mail, norman.[email protected]on.ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAcute kidney injury 1 June 2010Volume 152, Issue 11Page: 721-725KeywordsAnemiaBicarbonatesCreatinineCyclophosphamideLupus nephritisMedical dialysisMicroalbuminuriaProteinuriaRenal failureSodium ePublished: 1 June 2010 Issue Published: 1 June 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
474 THE PREDICTION OF CHRONIC RENAL DYSFUNCTION FOLLOWING LIVER TRANSPLANTATION: A TIME-DEPENDENT ANALYSIS
Authors: M. Giusto, F. Gentili, C. Merkel, V. Giannelli, C. Lucidi, A. Ruffa, S. Ginanni Corradini, G. Mennini, M. Rossi, M. Merli
Journal: Journal of Hepatology (2010)
Sham Surgery: An Ethical Analysis
Authors: Franklin G. Miller
Journal: The American Journal of Bioethics (2003)

Abstract Surgical clinical trials have seldom used a "sham" or placebo surgical procedure as a control, owing to ethical concerns. Recently, several ethical commentators have argued that sham surgery is either inherently or presumptively unethical. In this article I contend that these arguments are mistaken and that there are no sound ethical reasons for an absolute prohibition of sham surgery in clinical trials. Reflecting on three cases of sham surgery, especially on the recently reported results of a sham-controlled trial of arthroscopic surgery for arthritis of the knee, I present an ethical analysis that focuses on the methodological rationale for use of sham surgery, risk-benefit assessment, and informed consent. Keywords: SHAMSURGERYPLACEBOCONTROLSSURGICALRESEARCHRESEARCHETHICS
Topical Clonidine and Diabetic Gastroparesis
Authors: Alan S. Sacerdote
Journal: Annals of Internal Medicine (1990)

Letters and Corrections15 May 1990Topical Clonidine and Diabetic GastroparesisAlan S. Sacerdote, MDAlan S. Sacerdote, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-10-796_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: Since my initial report on the use of topical clonidine to treat diabetic diarrhea (1) (based on experimental work by Chang and associates [2] and a clinical report of their use of oral clonidine for this disorder [3]), I have successfully treated an additional five patients for diabetic diarrhea with topical clonidine. After initial control of diarrhea, two treatment failures resulted, from an allergic reaction to the adhesive of the topical clonidine in one case and from inability to retain the patch on the skin due to excessive perspiration in the other case.One of the three...References1. Sacerdote A. Topical clonidine for diabetic diarrhea. Ann Intern Med. 1986;105:139. LinkGoogle Scholar2. ChangFieldMiller EMR. Enterocyte alpha-2 adrenergic receptors: yohimbine and p-aminoclonidine binding relative to ion transport. Am J Physiol. 1983;244:976-82. Google Scholar3. FedorakFieldChang RME. Treatment of diabetic diarrhea with clonidine. Ann Intern Med. 1985;102:197-9. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByGastroduodenal motilityAcute effect of clonidine on gastric emptying in patients with diabetic gastropathy and controlsDiabetic gastroparesis: A reviewAdrenergic mechanisms in the control of gastrointestinal motility: From basic science to clinical applicationsTreatment of diabetic gastroparesis with oral clonidine 15 May 1990Volume 112, Issue 10Page: 796-796KeywordsAllergy and immunologyDiarrheaGastroparesisSweat Issue Published: 15 May 1990 PDF DownloadLoading ...
What safety measures need to be taken in oral food challengesin children?
Authors: S. Reibel, C. Röhr, M. Ziegert, C. Sommerfeld, U. Wahn, B. Niggemann
Journal: Allergy (2000)

Background: Food allergens are often accused of causing numerous ailments. This is particularly true for the pediatric population, where the incidence of food allergy is four times as high as in adults. As food challenges may provoke life‐threatening reactions, intensive safety measures need to be taken during provocation, and prompt medical intervention may become necessary. Methods: We retrospectively evaluated 349 oral challenges in 204 children with atopic dermatitis, looking for criteria to help the physician decide which patients need medical intervention. Results: A total of 178 (51%) oral food challenges with the four allergens (cow's milk [CM], hen's egg [HE], wheat, and soy) showed a positive clinical reaction. Of these, 120 (67%) needed medical intervention. In 42 (35%) cases, intervention was parenteral, and oral medication was given in 78 (65%) cases. There was a strong positive correlation (90%) between the level of specific IgE and the need for medical intervention (≥17.50 kU/l for CM, wheat, and soy; ≥3.50 kU/l for HE). Patient history of food allergy was an indicator of the need for medical intervention ( P =0.01). A positive patient history and a high level of specific IgE were significantly ( P =0.003) associated with parenteral medication in HE. Conclusions: Patient history of food allergy is a reliable indicator of the need for medical intervention in the cases of CM, wheat, and soy regardless of the level of specific IgE. With HE, a positive patient history plus a high level of specific IgE significantly indicates the need for parenteral medication. On the basis of our results, we recommend establishing intravenous access in children with a level of specific IgE of ≥17.50 kU/l (CAP class 4) to CM and wheat, or with specific IgE of ≥3.50 kU/l (CAP class 3) to HE.
Reply: Depression, Smoking, and Health Status
Authors: Kenneth E. Covinsky
Journal: Annals of Internal Medicine (1997)

Letters15 December 1997Reply: Depression, Smoking, and Health StatusKenneth E. Covinsky, MD, MPH and C. Seth Landefeld, MDKenneth E. Covinsky, MD, MPHCase Western Reserve University School of Medicine; Cleveland, OH 44106-4961Search for more papers by this author and C. Seth Landefeld, MDCase Western Reserve University School of Medicine; Cleveland, OH 44106-4961Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-12-199712150-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Jay raises the question of whether smoking status confounds the relation we observed between symptoms of depression and poor health status outcomes in acutely ill hospitalized older persons. This is an important question, given evidence that the rates of cigarette smoking may be higher in persons with depression [1, 2]. However, we believe it unlikely that smoking status explains the adverse health outcomes we observed in depressed patients. Previous studies have found that smokers have a 30% to 50% greater risk for clinically significant symptoms of depression [1, 2]. Because we found that patients with many symptoms ...References1. Glassman AH, Helzer JE, Covey LS, Cottler LB, Stetner F, Tippo JE. Smoking, smoking cessation, and major depression. JAMA. 1990; 264:1546-9. Google Scholar2. Anda RF, Williamson DF, Escobedo LG, Mast EE, Giovino GA, Remington PL. Depression and the dynamics of smoking: a national perspective. JAMA. 1990; 264:1541-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Case Western Reserve University School of Medicine; Cleveland, OH 44106-4961 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1997Volume 127, Issue 12Page: 1131-1132KeywordsDepressionForecasting Issue Published: 15 December 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A Literature Review of the Cost-Effectiveness of Nuclear Medicine
Authors: T. Jefferson
Journal: BMJ (1995)

Jan Carter King's Fund Centre, pounds sterling16.95, pp 112 ISBN 1 85717 082 2

With the growth in imaging techniques and concern about resource limits, an overview of studies on nuclear medicine is highly topical. Jan Carter reports the results of a project aimed at describing what is known about the economics of nuclear medicine procedures, assessing their probability of cost effectiveness, and defining further topics for research.

The book starts with a general section providing an introduction and methods, and a useful background to the study with a short history of nuclear medicine together with a four page introduction to economic concepts in imaging. …
Chemotherapy After Portal Vein Embolization to Protect Against Tumor Growth During Liver Hypertrophy Before Hepatectomy
Authors: Catha Fischer, Laleh G Melstrom, Dean Arnaoutakis, William Jarnagin, Karen Brown, Michael D'Angelica, Anne Covey, Ronald DeMatteo, Peter Allen, T Peter Kingham, Scott Tuorto, Nancy Kemeny, Yuman Fong
Journal: JAMA Surgery (2013)

<h3>Importance</h3> Portal vein embolization improves the safety of liver resection by increasing the size of residual liver, but the embolization may increase tumor growth during the waiting period before definitive hepatectomy. <h3>Objective</h3> To determine whether the administration of chemotherapy mitigates tumor growth after portal vein embolization (PVE) performed before major hepatectomy for metastatic colorectal cancer. <h3>Design, Setting, and Participants</h3> Review of prospectively collected data at Memorial-Sloan Kettering Cancer Center was conducted. The database included patients subjected to PVE before major hepatectomy for metastatic colorectal cancer. <h3>Main Outcomes and Measures</h3> Lesions in both the embolized and nonembolized lobes of the liver before and 1 month after PVE were measured and Response Evaluation Criteria in Solid Tumors were applied to assess disease status. Assessment of survival was based on receipt of post-PVE chemotherapy and then stratified by subsequent resectability. <h3>Results</h3> Two hundred eight tumors were measured in 64 patients; 53 tumors were in patients undergoing post-PVE chemotherapy. Approximately one-third of the lesions progressed after PVE when no chemotherapy was administered. This did not differ significantly according to whether tumors were ipsilateral or contralateral to the PVE. When chemotherapy was administered, there was a significantly lower rate of progression (18.9%,<i>P</i> = .03). In long-term follow-up, treatment with post-PVE chemotherapy was also independently associated with improved survival (<i>P</i> &lt; .006). <h3>Conclusions and Relevance</h3> Chemotherapy does not retard growth of the liver after PVE and may prevent cancer progression. Thus, the combination of PVE and chemotherapy may enhance both oncologic and operative safety.
Increased risk of abnormal proximal renal tubular function with HIV infection and antiretroviral therapy
Authors: Frédéric-Antoine Dauchy, Sylvie Lawson-Ayayi, Renaud de La Faille, Fabrice Bonnet, Claire Rigothier, Nadia Mehsen, Ghada Miremont-Salamé, Charles Cazanave, Carine Greib, Francois Dabis, Michel Dupon
Journal: Kidney International (2011)
The Spectrum of Coronary Heart Disease in a Community of 30,000
Authors: RALPH E. SPIEKERMAN, JOHN T. BRANDENBURG, RICHARD W. P. ACHOR, JESSE E. EDWARDS
Journal: Circulation (1962)

The high rate of necropsy in deaths among permanent residents of Rochester, Minnesota, provided a unique opportunity to study the prevalence of coronary heart disease and the frequency and mode of death resulting from this disease. In this community of approximately 30,000 population, necropsy was done in 73 per cent of all resident deaths during the years 1947 through 1952. Included in this group were 691 necropsies that represented 67 per cent of the 1,026 deaths of persons 20 years of age or older. Coronary heart disease caused death in 221 patients (23 per cent of all necropsies and 32 per cent of all necropsies on adults). These 221 coronary deaths in adults represented 41 per cent of the men and 22 per cent of the women. The coronary deaths were attributed to acute coronary failure (sudden death) in 94 patients (43 per cent), acute myocardial infarction in 87 patients (39 per cent), congestive heart failure in 32 patients (14 per cent) and thromboembolism in eight patients (4 per cent). The 87 patients dying during acute myocardial infarction died of congestive heart failure (30 per cent), myocardial rupture (24 per cent), acute coronary failure (23 per cent), and thromboembolism (14 per cent), with the remaining 9 per cent dying of a combination of acute myocardial infarction and additional serious systemic disease. The greatest number of deaths from coronary heart disease occurred during the seventh decade of life in men and the eighth decade in women. At least one coronary artery exhibited from 25 to 100 per cent obstruction from atherosclerosis in 513 hearts (74 per cent of the adult necropsies). These necropsies, representing two thirds of all deaths in adults in this community, disclosed that significant coronary-artery disease was present in three of four adults and was the cause of death in four of 10 men and two of 10 women.
Reply to Krakamp et al.: Is Water Immersion Necessary in Colorectal Cancer Staging Using Balloon-Sheathed Miniprobes?
Authors: L.-J. Tseng, Y. T. Jao
Journal: Endoscopy (2004)

Previous reports have shown that miniprobe ultrasonography is superior to conventional endoscopy ultrasonography (EUS) in the staging of colorectal cancer, especially in tumors with tight strictures and in flat or small lesions [1] [2] [3]. In our experience, most colon cancers are moderately advanced (higher than the T2 stage) at presentation and are usually accompanied by tight stricture formation. Conventional EUS is unable to pass through the stricture in about 11 % of these lesions, so that clear cross-sectional images are obtained in only 89 % of cases [3]. In our study, however, clear cross-sectional images were obtained using a balloon-sheathed miniprobe in 96.5 % of the patients.
Lymphocytes bearing Fc gamma receptors in rheumatoid arthritis. III. Immunoregulatory function associated with Facb rosette-forming cells.
Authors: L J Eales, N J Goulding, N D Hall, V R Winrow, I M Hunneyball
Journal: Annals of the Rheumatic Diseases (1985)

A subpopulation of mononuclear cells (PBMNC) that expresses Fc receptors with specificity for the C gamma 2 region of IgG may be detected by rosette formation with calf erythrocytes coated with the Facb fragment of rabbit IgG. These Facb-R+ cells are found in increased numbers in the peripheral blood of patients with rheumatoid arthritis (RA). Studies have been carried out to identify the functional properties of these cells in healthy and rheumatoid subjects. Facb-R+ cells were shown to lack both natural killer and antibody-dependent cytotoxic activity. Depletion of Facb-R+ cells from both healthy and rheumatoid PBMNC resulted in a marked suppression of pokeweed mitogen (PWM) stimulated IgG synthesis but had no effect on T cell proliferation induced by phytohaemagglutinin, concanavalin A, or PWM. The addition of Facb fragments to PBMNC cultures also caused inhibition of PWM-driven IgG production. In this assay rheumatoid PBMNC were significantly less sensitive to Facb-mediated suppression than healthy control cells. Our results suggest that Facb-R+ cells are involved in the antibody-mediated feedback regulation of immunoglobulin synthesis and that this mechanism is impaired in patients with RA.
The renal thiazide-sensitive Na-Cl cotransporter as mediator of the aldosterone-escape phenomenon
Authors: Xiao-Yan Wang, Shyama Masilamani, Jakob Nielsen, Tae-Hwan Kwon, Heddwen L. Brooks, Søren Nielsen, Mark A. Knepper
Journal: Journal of Clinical Investigation (2001)

The kidneys "escape" from the Na-retaining effects of aldosterone when circulating levels of aldosterone are inappropriately elevated in the setting of normal or expanded extracellular fluid volume, e.g., in primary aldosteronism. Using a targeted proteomics approach, we screened renal protein extracts with rabbit polyclonal antibodies directed to each of the major Na transporters expressed along the nephron to determine whether escape from aldosterone-mediated Na retention is associated with decreased abundance of one or more of renal Na transporters. The analysis revealed that the renal abundance of the thiazide-sensitive Na-Cl cotransporter (NCC) was profoundly and selectively decreased. None of the other apical solute-coupled Na transporters displayed decreases in abundance, nor were the total abundances of the three ENaC subunits significantly altered. Immunocytochemistry showed a strong decrease in NCC labeling in distal convoluted tubules of aldosterone-escape rats with no change in the cellular distribution of NCC. Ribonuclease protection assays (RPAs) revealed that the decrease in NCC protein abundance was not associated with altered NCC mRNA abundance. Thus, the thiazide-sensitive Na-Cl cotransporter of the distal convoluted tubule appears to be the chief molecular target for regulatory processes responsible for mineralocorticoid escape, decreasing in abundance via a posttranscriptional mechanism.
Intrinsic Human Elimination Half-Lives of Polychlorinated Biphenyls Derived from the Temporal Evolution of Cross-Sectional Biomonitoring Data from the United Kingdom
Authors: Roland Ritter, Martin Scheringer, Matthew MacLeod, Claudia Moeckel, Kevin C. Jones, Konrad Hungerbühler
Journal: Environmental Health Perspectives (2010)

BackgroundMost empirical estimates of human elimination kinetics for persistent chemicals reflect apparent elimination half-lives that represent the aggregated effect of intrinsic elimination, ongoing exposure, and changes in body weight. However, estimates of intrinsic elimination at background levels are required for risk assessments for the general population.ObjectiveTo estimate intrinsic human elimination half-lives at background levels for nine polychlorinated biphenyl (PCB) congeners, we used a novel approach based on population data.MethodsWe used a population pharmacokinetic model to interpret two sets of congener-specific cross-sectional age–concentration biomonitoring data of PCB concentrations measured in lipid and blood samples that were collected from 229 individuals in 1990 and 2003. Our method is novel because it exploits information about changes in concentration in the human population along two dimensions: age and calendar time.ResultsOur approach extracted information about both elimination kinetics and exposure trends from biomonitoring data. The longest intrinsic human elimination half-lives estimated in this study are 15.5 years for PCB‐170, 14.4 years for PCB‐153, and 11.5 years for PCB‐180.ConclusionsOur results are further evidence that a maximum intrinsic elimination half-life for persistent chemicals such as PCBs exists and is approximately 10–15 years. A clear conceptual distinction between apparent and intrinsic half-lives is required to reduce the uncertainty in elimination half-lives of persistent chemicals. The method presented here estimates intrinsic elimination half-lives and the exposure trends of persistent pollutants using cross-sectional data available from a large and growing number of biomonitoring programs.
The Glaucomas: Basic Sciences
Authors: Benjamin H. Ticho
Journal: JAMA (1996)

Glaucoma Glaucoma is a lot like hypertension. In its most common form, glaucoma sneaks up on its victims, producing symptoms only in the end stage but frequently with devastating consequences. Like hypertension, glaucoma requires a unique kind of physician for its world of late or occasionally sudden presentation, poor compliance, erratic responses, and unusual manifestations. Glaucoma properly treated rarely produces improved vision, so practitioners must be satisfied with statistical victories and presumably successful prevention (presumably, because success can only be determined in retrospect). This new textbook edition, with volumes on basic sciences, diagnosis, and treatment, improves on the first edition in organization, scope, and editorial features. Glaucoma has its own set of risk factors, including racial, age, familial, and systemic predelictions. However, glaucoma frequently breaks its own rules, with perverse behavior that stymies attempts at early detection, reliable treatment, and prognostication. The driving concept behind the new edition of<i>The</i>
Clinical Pathology: Interpretation and Application
Authors: Frances K. Widmann
Journal: JAMA (1967)

Clinical pathology is, perhaps, the most complex of medical disciplines, since it touches on virtually every disease and most of the separate medical sciences. This fourth edition of a well-known clinical pathology text attempts to organize the complexity of laboratory medicine. New, since the previous edition five years ago, is the section entitled Genetic, Endocrine, and Metabolic Disorders, in which new discoveries and long-known principles are integrated under appropriate categories. Instead of presenting the material as Studies in Surgery, and Studies in Obstetrics, the authors now distribute the information according to the affected system. Their intent is to show how laboratory procedures illuminate pathophysiologic changes and to guide the clinician in the optimum use of laboratory resources. The individual reader will have to decide if they succeed. I think their success is partial at best.  The reader who consults appropriate chapters may become oppressed by the complexity of his problem,