tbuckley/cabot-search huggingface dataset:
Laboratory Critical Limits
Authors: Richard H. Fine
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Dr Kost's<sup>1</sup>article and Dr Lundberg's<sup>2</sup>editorial summarized some interesting data and made some valid suggestions for notifying clinicians about critical, panic, and/or vital laboratory results. The thrust of their remarks primarily addresses hospitalized patients. In ambulatory care, a situation often arises in which a critical result is obtained on the evening run by the laboratory, when the clinic is closed and the physician not in the house. In our outpatient clinics at San Francisco General Hospital, we have identified a group of tests that we call PANIC values, which cannot wait until the next working day for clinical action. We use the following protocol for these critical results, which might be of use to fellow clinicians: The following "supercritical" abnormal results must be reported immediately to the ordering provider or to the GMC [general medical clinic] on call attending physician (see GMC On Call
ELECTROCONVULSIVE THERAPY IN ELDERLY PATIENTS
Authors: RUTH EHRENBERG, MILES J. O. GULLINGSRUD
Journal: American Journal of Psychiatry (1955)

Mental illness in patients over 65 years is not necessarily "organic" and irreversible. So-called "functional" psychoses in the elderly respond well to electroconvulsive therapy and a high percentage of cases can be restored to the community at the pre-illness level. A group of patients treated with conventional electric shock at the Boston State Hospital from January 1948 to December 1953 is reviewed. In this group of 112 patients from 65 to 83 years of age, with an average age of 71.3 years, 78.5% were able to leave the hospital and 55% of them are out for more than a year. Relapses occurred in 37.5% of recovered cases but most of them again responded readily to treatment. One patient died as an immediate result of treatment. In 3 patients who suffered from severe physical illness electric shock may have contributed to their deaths. In these patients their life expectancy was very poor even before treatment and their severe physical illness rather than their age was responsible for the unfortunate outcome. In aged people in a reasonable state of health the risk involved appears to be minimal. The occurrence of only 4 fractures in 1,329 EST's appears to indicate that diminished muscle bulk compensates for the seemingly increased risk of osteoporosis and makes the use of curare-like drugs unnecessary.
Omega 3 fatty acids and cardiovascular disease
Authors: Jehangir N Din, David E Newby, Andrew D Flapan
Journal: BMJ (2004)

Editor—Farmed fish such as salmon and trout generally have as much if not more omega 3 fatty acids per gram than wild fish.1 However, because farmed fish contain more total fat than wild fish, they have a smaller proportion of omega 3 when calculated as a percentage of total fat. We think that the absolute amount of omega 3 per gram of fish is the more relevant figure.

Supplementation of animal feed with fish oils will not address concerns about the depletion of fish stocks since this will clearly entail the harvesting of even more fish. However, we wanted to highlight that this is a potential approach to increase the dietary consumption of omega 3 oils in people unwilling or unable to eat fish. We acknowledge that the juxtaposition of these two independent points in the text box is rather misleading.

We intentionally focused our article on the marine derived omega 3 fatty acids because of the larger and clearer evidence base. We cannot assume that α linolenic acid confers the same benefits as it is a structurally distinct short chain polyunsaturated fatty acid with only limited conversion in humans to the longer chain eicosapentanoic acid and docosahexanoic acid.2

Whereas α linolenic acid may confer cardiac protection as part of a Mediterranean diet,3 the direct benefits of α linolenic acid have not been firmly established. We agree that ongoing concerns about fish stocks highlight the need for further trials of α linolenic acid in coronary heart disease.
Effect of Socioeconomic Risk Factors on the Difference in Prevalence of Diabetes Between Rural and Urban Populations in Bangladesh
Authors: M Abu Sayeed, Liaquat Ali, M Zafirul Hussain, M A Rumi, Akhtar Banu, A K Azad Khan
Journal: Diabetes Care (1997)

OBJECTIVE To compare the prevalence of diabetes between the poor and rich of rural and urban populations in Bangladesh. RESEARCH DESIGN AND METHODS A total of 1,052 subjects from urban and 1,319 from rural communities (age ≥ 20 years) of different socioeconomic classes were investigated. Capillary blood glucose levels, fasting and 2 h after a 75-g glucose drink (2-h blood glucose [BG]), were measured. Height, weight, waist, hips, and blood pressure were also measured. RESULTS Age-adjusted (30–64 years) prevalence of NIDDM was higher in urban (7.97% with 95% CI 6.17–9.77) than in rural subjects (3.84%, CI 2.61–5.07), whereas impaired glucose tolerance (IGT) prevalence was higher in rural subjects. In either urban or rural areas, the highest prevalence of NIDDM was observed among the rich, and the lowest prevalence was observed among the poor socioeconomic classes. The rural rich had much higher prevalence of IGT than their urban counterpart (16.5 vs. 4.4%, CI 6.8–17.4). Increased age was an important risk factor for IGT and NIDDM in both rural and urban subjects, whereas the risk related to higher BMI and waist-to-hip ratio (WHR) was less significant in rural than urban subjects. Using logistic regression and adjusting for age, sex, and social class, the urban subjects had no excess risk for NIDDM. In contrast, an excess risk for glucose intolerance (2-h BG ≥ 7.8 mmol/l) was observed in the rural subjects. CONCLUSIONS Adjusting for age, sex, and social class, the prevalence of NIDDM among urban subjects did not differ significantly from that among rural subjects. Increased age, higher socioeconomic class, and higher WHR were proven to be independent risk factors for glucose intolerance in either area.
Transmission of Pulsatile Blood Pressure and Flow through the Isolated Lung
Authors: JOHN E. MALONEY, DEREK H. BERGEL, JON B. GLAZIER, JOHN M. HUGHES, JOHN B. WEST
Journal: Circulation Research (1968)

A horizontal isolated lung preparation has been used to examine the transmission of pulsatile blood pressure and flow. Arterial and venous pressure and flows were measured with pressure transducers and electromagnetic flowmeters. After a sudden increase in pulmonary arterial pressure, delays of several seconds were observed before venous flow began to increase. Flow then increased slowly over a period of 1 to 9 seconds to a new steady level. The transmission of pulsatile flow was independent of the outlet pressure and identical for perfusion in the forward and reverse directions. Flow transmission fell from about 75% at a frequency of 0.03 cps to approximately 10% at a frequency of 1 cps. Pressure transmission down to the collapsible vessels was measured when alveolar pressure exceeded venous pressure. At 0.1 cps approximately 50% of the incident pressure wave was transmitted, and at 1 cps this was reduced to 30%. It was concluded that the lung passed well only the low-frequency components of the applied input and that in a vertical lung only about 30% of the mean to peak pressure pulse would be transmitted down to the small vessels and therefore affect the distribution of blood flow.
Connective tissue growth factor is a Smad2 regulated amplifier of transforming growth factor β actions in hepatocytes-But without modulating bone morphogenetic protein 7 signaling
Authors: Olav A. Gressner, Birgit Lahme, Monika Siluschek, Katharina Rehbein, Ralf Weiskirchen, Axel M. Gressner
Journal: Hepatology (2009)

In vivo knockdown of connective tissue growth factor (CTGF/CCN2) was recently shown to attenuate the formation of experimental liver fibrosis. The secreted, cysteine-rich growth factor is proposed to adversely modulate the binding of profibrogenic transforming growth factor β (TGF-β) and its natural antagonist bone morphogenetic protein (BMP) to their cognate receptors in several cellular systems, but the functionality of CTGF in modulation of the TGF-β/BMP signaling pathways is still unknown. This study aims at characterizing a potentially differential modulating role of CTGF on TGF-β– and BMP7-dependent transactivation of reporter gene [Ad-(CAGA)12-MLP-luc, Ad-hCTGF-luc, and Ad-(BRE)2-luc reporter gene] expression in rat hepatocytes. In this context, emphasis is also placed on the differential roles of Smad2 and Smad3 in the TGF-β–dependent transactivation of the endogenous CTGF gene and the CTGF gene reporter, as investigated following adenoviral infection of wild-type and dominant negative Smad2/3 or treatment with the specific inhibitor of Smad3 or ALK5-specific (SB-431542) inhibitor. In this analysis, we found (1) a selective transcriptional activation of the CTGF promoter by Smad2 (but not Smad3); (2) the failure of BMP7 to inhibit the transcriptional activation of the Smad3-selective (CAGA)12-luc reporter by TGF-β, as well as the failure of TGF-β to inhibit the transcriptional activation of the Smad5-selective (BRE)2-luc reporter by BMP7; and (3) the sensitization of hepatocytes toward TGF-β type I receptor (ALK5)/Smad2 and Smad3-mediated TGF-β signaling by CTGF, whereas BMP type I receptor (ALK1)/Smad5-mediated BMP7 signaling is not modulated. Conclusion: CTGF acts as a Smad2-dependent sensitizer of TGF-β actions that does not influence BMP7 signaling in hepatocytes. (HEPATOLOGY 2009.)
P1157 IMPACT OF BASELINE VARIABLES ON RESPONSE TO FALDAPREVIR PLUS PEGYLATED INTERFERON a-2a AND RIBAVIRIN IN PATIENTS WITH HIV/HCV GENOTYPE-1 COINFECTION IN A PHASE III TRIAL
Authors: C. Tural, J.K. Rockstroh, M. Nelson, S. Bhagani, P. Ingiliz, V. Soriano, M. Núñez, M.-A. Valantin, J. Valdez Madruga, A. Rauch, J. Furtado, M. Battegay, J.O. Stern, A.-M. Quinson, W. Böcher, R. Vinisko, M. Manero, D. Dieterich
Journal: Journal of Hepatology (2014)
Characterization of Hepatic Adenoma With Atypical Appearance on CT and MRI by Radionuclide Imaging
Authors: NORIHIKO KUME, KAZUYOSHI SUGA, KAZUYA NISHIGAUCHI, KENSAKU SHIMIZU, NAOFUMI MATSUNAGA
Journal: Clinical Nuclear Medicine (1997)

The appearance of hepatic adenomas on CT and MRI are highly variable because of their varied histopathology, and images of adenomas are at times indistinguishable from those of other hepatic tumors. The authors present two patients with hepatic adenomas with extremely atypical CT and MRI manifestations demonstrating a"nodule-in-nodule" appearance. Radionuclide imaging in both patients showed decreased Ga-67 uptake in the adenomas compared to normal liver, negative colloid(Tc-99m phytate) uptake in the adenomas, and early uptake and subsequent retention of Tc-99m PMT. This correctly characterized the unique histopathologic features of the resected tumors. Radionuclide imaging using a combination of radiotracers may play an important role in aiding the diagnosis of this rare benign tumor, despite variable CT and MRI appearances.
Body weight and endocrine function in anorexia nervosa.
Authors: R D Leslie, A J Isaacs, J Gomez, R I Bayliss
Journal: BMJ (1978)

justifiably concerned that her baby was convulsing in utero.It was subsequently noticed that her baby was frequently affected by hiccups following a feed.The hiccups occurred at a rate of one per second and lasted for several minutes at a time; this phenomenon persisted to the age of three months.It is known that the fetus drinks liquor in utero, and hiccups have been demonstrated by real-time ultrasound scanning.'Hiccuping in utero might explain the observations of these mothers and such an explanation by her doctor would help to allay genuine anxieties.Real-time scanning would be valuable to confirm this diagnosis when the technique is available.
Enhanced soluble interleukin‐5 receptor alpha expression in nasal polyposis
Authors: P. Gevaert, C. Bachert, G. Holtappels, C. P. Novo, J. Van der Heyden, L. Fransen, S. Depraetere, H. Walter, P. van Cauwenberge, J. Tavernier
Journal: Allergy (2003)

Background: Alternative splicing of the interleukin‐5 receptor alpha (IL‐5R α )‐subunit leads to the generation of a signalling, membrane‐anchored (TM) isoform, or a secreted [soluble (SOL)], antagonistic variant. Given the key role of IL‐5 in eosinophil function, we investigated SOL IL‐5R α expression pattern in an eosinophil‐associated disease such as nasal polyposis (NP). Methods: An SOL IL‐5R α enzyme‐linked immunosorbent assay and quantitative real‐time polymerase chain reaction (PCR) were established and applied in serum, nasal secretion and nasal tissue of controls ( n = 12), and NP patients ( n = 42) with or without asthma. Results: Analysis of serum, nasal secretion, and nasal tissue samples revealed that SOL IL‐5R α protein concentrations were significantly increased in NP vs control tissue. Within the NP group, there was a significant up‐regulation of SOL IL‐5R α in patients with systemic airway disease. These findings were confirmed at the mRNA level, using an optimized real‐time reverse‐transcriptase PCR procedure. Conclusions: This report demonstrates SOL IL‐5R α transcript and protein up‐regulation in NP. Soluble IL‐5R α differentiates nasal polyps with or without concomitant asthma. As SOL IL‐5R α is strongly up‐regulated for disease and has antagonistic properties in vitro , our studies shed new light on the mechanisms of specific immunomodulatory therapies, such as anti‐IL‐5.
Biochemical Diagnosis of Alcoholism
Authors: Michael J. Eckardt
Journal: JAMA (1981)

Quadratic discriminant analysis was conducted between 121 medically documented male alcoholics who presented for treatment and 130 male nonalcoholic outpatients who were concerned about the possibility of venereal disease. Analysis of γ-glutamyl transpeptidase (GGT) and mean corpuscular volume (MCV) resulted in correct classification of 94% of nonalcoholics but only 36% of alcoholics. In contrast, analysis of 24 commonly ordered clinical laboratory tests produced correct classification of 100% of nonalcoholics and 98% of alcoholics. Transforming the laboratory-determined values to a normal-abnormal dichotomy on the basis of reference values improved the classification accuracy of GGT and MCV to 77%. However, consideration of ten of the other tests resulted in an accuracy of 98% for alcoholics and 95% for nonalcoholics. (<i>JAMA</i>1981;246:2707-2710)
Breathlessness and chest pain in a patient with sickle cell disease
Authors: H. Ranu, H. Buyck, F. Willis, B. Madden
Journal: BMJ (2011)

A 47 year old woman with sickle cell disease presented to the accident and emergency department with shortness of breath and chest pain. She had been admitted many times in the past with similar symptoms and had needed treatment, including simple and exchange blood transfusions. She had developed side effects after different forms of iron chelation treatment in the past.

On admission her oxygen saturations were 93% on room air (decreasing to 82% on walking to the toilet), systemic blood pressure was 90/50 mm Hg, and heart rate was 100 beats/min. She had a low grade fever. Her jugular venous pressure was raised, with a gallop rhythm and a loud second heart sound. Breath sounds were quiet and she found it painful to breathe in. Her haemoglobin was 68 g/L (reference range 115-150), with haemoglobin S 55.8%, white cell count was 18×109/L (4-11), and serum ferritin was 26 964 pmol/L (27-337). Chest radiography showed basal alveolar shadowing.



### 1 What is the differential diagnosis in this patient?

#### Short answer

The differential diagnosis includes an acute chest syndrome, a pulmonary embolism including a fat embolus, and pulmonary infection.

#### Long answer

Acute chest syndrome is one of the most common reasons for hospital admission in patients with sickle cell disease.1 It is defined by the presence of a new pulmonary infiltrate consistent with alveolar consolidation and is often accompanied by cough, chest pain, wheeze, fever, and an increased respiratory rate.2 It is commonly precipitated by community acquired infection, with an infectious cause being identified in more than half of patients admitted with the syndrome, most often atypical bacteria …
Experimental Chemotherapy of Oxyuriasis
Authors: O. D. Standen
Journal: BMJ (1953)

In clinical trials of piperazine hydrate, gentian violet, and diphenan against oxyuriasis in 136 children, piper- azine hydrate syrup and gentian violet showed marked oxyuricidal properties, while diphenan was inactive.Owing to lack of toxicity and side-effects, to ease of administration, and to its excellent therapeutic proper- ties, piperazine hydrate syrup at a dose level of 50-75 mg./kg.per day is considered to be the drug of choice for oxyuriasis in children.Of 31 children treated at levels greater than 50 mg./kg.daily 97% were cured.The use of suppositories is unnecessary.Spontaneous cure may be expected in 19% of cases of oxyuriasis.The facilities provided by Dr. Philip R. Evans in the Depart- ment of Child Health at Guy's Hospital and the Evelina
Lipid transfer protein and vicilin are important walnut allergens in patients not allergic to pollen
Authors: Elide A. Pastorello, Laura Farioli, Valerio Pravettoni, Anna M. Robino, Joseph Scibilia, Donatella Fortunato, Amedeo Conti, Linda Borgonovo, Anders Bengtsson, Claudio Ortolani
Journal: Journal of Allergy and Clinical Immunology (2004)
Changes in catecholamine-induced lipolysis in isolated human fat cells during the first year of life.
Authors: C Marcus, B Karpe, P Bolme, T Sonnenfeld, P Arner
Journal: Journal of Clinical Investigation (1987)

Catecholamine-induced lipolysis in isolated human adipocytes during the first year of life was investigated. During this period fat cell size increased markedly. Basal and catecholamine-induced glycerol release were positively correlated with age when lipolysis was expressed per cell. However, when lipolysis was expressed per unit of cell surface area (micrometer squared), this correlation was observed only for noradrenaline. Basal lipolysis and the effect of the pure beta-agonist, isoprenaline, were identical in infants and adults. From 0 to 2 mo of age noradrenaline had very little lipolytic effect. The addition of the alpha-2-adrenoceptor antagonist, yohimbine, to noradrenaline equalized lipolysis per micrometer squared in infants and adults and the alpha-2-adrenoceptor sensitivity was significantly enhanced in infants. In both groups the lipolytic adrenoceptor was of the beta-1 type. In conclusion, adipocytes from infants have a poor lipolytic response to noradrenaline partly because of the small fat cells but mainly because of an enhanced alpha-2-adrenoceptor activity.
Screening for Hypercholesterolemia
Authors: T A Pearson, S Bowlin, W R Sigmund
Journal: Annual Review of Medicine (1990)

The detection of individuals with hypercholesterolemia has received world-wide support as a means of determining who would benefit from dietary and pharmacologic interventions. However, the clinician or public health practitioner should be aware of several issues that must be resolved before cholesterol screening can attain maximal impact. This review examines whether hypercholesterolemia is a condition worthy of screening programs and discusses the promises and pitfalls of individual and mass screening approaches.
Research clarifies potential role of oestrogen in brain activity associated with memory
Authors: S. Gottlieb
Journal: BMJ (1999)

Research using functional magnetic resonance imaging has shown that giving standard doses of oestrogen to postmenopausal women increases activity in regions of the brain associated with memory ( JAMA 1999;281:1197-1202). These findings offer the best evidence yet that the hormone can affect the neural circuits involved in human memory and could help in treating Alzheimer's disease.

Researchers at Yale University School of Medicine in New Haven, Connecticut, examined brain activity in 46 women as they memorised and then recalled …
417 ALPHA-FETO-PROTEIN LEVELS DURING TREATMENT WITH SORAFENIB IN PATIENTS WITH ADVANCED HEPATOCELLULAR CARCINOMA
Authors: A. Weinmann, P. Schrabback, H. Schulze-Bergkamen, M. Schuchmann, C. Dueber, G. Otto, P.R. Galle, M. Woerns
Journal: Journal of Hepatology (2008)
Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence
Authors: Ian Colman, Benjamin W Friedman, Michael D Brown, Grant D Innes, Eric Grafstein, Ted E Roberts, Brian H Rowe
Journal: BMJ (2008)

To examine the effectiveness of parenteral corticosteroids for the relief of acute severe migraine headache and prevention of recurrent headaches.
TCT-533 Drug-Eluting Balloon for treatment of superficial femoral artery in-stent restenosis. Two years results from an Italian registry.
Authors: Vittorio Virga, Eugenio Stabile, Luigi Salemme, Angelo Cioppa, Giuseppe Giugliano, Tullio Tesorio, Linda Cota, Grigore Popusoi, Armando Pucciarelli, Linda Brevetti, Anna Sannino, Vittorio Schiano, Giancarlo Biamino, Giovanni Esposito, Paolo Rubino
Journal: Journal of the American College of Cardiology (2013)
Functional implications of decreased renal cortical atrial natriuretic peptide binding in experimental diabetes.
Authors: A Benigni, N Perico, J Dadan, M Gabanelli, M Galbusera, P Boccardo, T Mennini, G Remuzzi
Journal: Circulation Research (1990)

Glomerular hyperfiltration in streptozotocin-induced diabetes mellitus in rats may be mediated by atrial natriuretic peptide (ANP). We wanted to evaluate plasma levels of ANP and plasma volume in relation to renal ANP receptor density and affinity in rats 6 weeks after induction of diabetes. Plasma levels of immunoreactive ANP were significantly higher in hyperglycemic diabetic (75.2 +/- 8.3 pg/ml) than in control animals (34.7 +/- 8.1 pg/ml; p less than 0.01). Administration of insulin to keep diabetic rats normoglycemic normalized plasma levels of immunoreactive ANP (30.5 +/- 5.2 pg/ml). In contrast, plasma volume did not show significant differences among the groups (hyperglycemic diabetes, 46.6 +/- 3.8; normoglycemic diabetes, 42.4 +/- 3.2; controls, 43.2 +/- 2.0 ml/kg body wt). No correlation was found between plasma levels of immunoreactive ANP and plasma volume. By autoradiography a significant reduction in the number of renal cortical ANP receptors was observed in hyperglycemic diabetic rats as compared with controls. At variance, ANP receptor affinity did not change either in the cortex or in the medulla in hyperglycemic diabetics in comparison with control animals. The pathophysiological implication of cortical ANP receptor down-regulation was underscored by the blunted response of glomerular filtration rate to ANP infusion in diabetic animals as compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Asthma and Chronic Bronchitis
Authors: H. S. Russell
Journal: BMJ (1934)

Dr. Thorowgood is a believer, and very properly so, in the nervous origin of a great many cases of bronchial asthma.In this little volume he has discussed the various theories of that disease, and given his reasons for the faith that is in him.Having had a very long experience of the Chest Hospital, he has naturally seen a great deal of asthma, with and without bronchitis, and his chapters on treatment have, therefore, a special value.
Sorafenib is a potent inhibitor of FIP1L1-PDGFRα and the imatinib-resistant FIP1L1-PDGFRα T674I mutant
Authors: Els Lierman, Cedric Folens, Elizabeth H. Stover, Nicole Mentens, Helen Van Miegroet, Werner Scheers, Marc Boogaerts, Peter Vandenberghe, Peter Marynen, Jan Cools
Journal: Blood (2006)