tbuckley/cabot-search huggingface dataset:
Sympathetic activity is reduced by nCPAP in hypertensive obstructive sleep apnoea patients
Authors: J. Heitmann, K. Ehlenz, T. Penzel, H.F. Becker, L. Grote, K.H. Voigt, J. Hermann Peter, C. Vogelmeier
Journal: European Respiratory Journal (2004)

There is increasing evidence that nasal continuous positive airway pressure (nCPAP) lowers blood pressure in obstructive sleep apnoea (OSA) patients, not only during sleep but also in the daytime. However, both the mechanisms of blood pressure reduction and the considerable differences in the magnitude of the effect in the studies presented to date are not fully understood. Therefore, the authors prospectively studied the effect of nCPAP on noradrenaline plasma levels (NA pl ), blood pressure and heart rate (HR) in 10 normotensive and eight hypertensive OSA patients before and after 41.6±16.9 days of nCPAP therapy. Polysomnography and invasive blood pressure were continuously monitored over 24 h in the supine position before and with nCPAP. NA pl were analysed every 15 min. In hypertensives, nCPAP reduced NA pl by 36±25%, lowered mean arterial blood pressure substantially (night-time: −8.89±14.09 mmHg; daytime: −7.94±10.47 mmHg) and decreased HR by 6.6±5.4 beats·min −1 , whereas in normotensives there were only minor changes. The decrease in heart rate was associated with a decrease in mean arterial blood pressure and noradrenaline plasma levels, suggesting a causal effect of nasal continuous positive airway pressure therapy. This nasal continuous positive airway pressure effect occurs mainly in hypertensive obstructive sleep apnoea patients, whereas the effect is small in normotensives. This may explain, at least in part, some of the discrepant results in previous treatment studies.
Pancreatic surgery, not pancreatitis, is the primary cause of diabetes after acute fulminant pancreatitis.
Authors: J Eriksson, M Doepel, E Widen, L Halme, A Ekstrand, L Groop, K Hockerstedt
Journal: Gut (1992)

Acute fulminant pancreatitis is associated with significant morbidity and mortality. To examine the outcome of conservative and surgical treatment of this disorder, 36 patients who survived an initial episode were restudied after a mean of six years. Fifty three per cent had developed diabetes mellitus, half of whom required insulin therapy. Pancreatic resection was associated with a 100% frequency of diabetes, while only 26% of those treated with peritoneal lavage developed this (p less than 0.001). Insulin secretion and sensitivity were assessed using the hyperglycaemic glucose clamp technique. First phase insulin secretion was impaired in surgically treated patients (mean (SEM) 14 (5) microU/ml x 10 minutes) compared with conservatively treated patients and control subjects (144 (66) and 87 (12) microU/ml x 10 minutes, respectively; p less than 0.05). Second phase and 'maximal' insulin secretion were also impaired among the surgically treated patients compared with the conservatively treated patients and the controls. Insulin sensitivity was reduced among the surgically treated patients (2.88 (58) mg/kg.minute) when compared with conservatively treated patients and healthy control subjects (5.87 (1.02) and 6.45 (0.66) mg/kg.minute; p less than 0.05). Pancreatic resection is associated with a very high frequency of diabetes compared with peritoneal lavage, and these results favour conservative treatment of active fulminant pancreatitis whenever possible.
The Intern Blues: The Private Ordeals of Three Young Doctors
Authors: Susan Reitz O'Neil
Journal: JAMA (1989)

Next time you get nostalgic for internship, pick up Robert Marion's<i>The Intern Blues</i>and you'll be cured. The book is a collection of taped diaries kept by three pediatric interns training in New York City. The diaries were kept at the request of Dr Marion, who was faculty advisor for the interns. The book is very close to home for someone like myself who trained in a large pediatric residency program. The growth and changes experienced by these interns are universal to interns in any type of training program, however. Fresh out of medical school, few physicians feel they are ready for the responsibilities placed on them in internship. By facing those responsibilities, each develops a personal style and method for handling the pressures of medicine. After reading this book, I feel I have shared a very personal journey with these interns through their first year after medical school.
Enhancement by cholera toxin of IgA secretion from intestinal crypt epithelium.
Authors: S R Hamilton, D F Keren, J K Boitnott, S M Robertson, J H Yardley
Journal: Gut (1980)

Studies of the effects of cholera toxin on the intestine have produced conflicting results regarding stimulation of IgA secretion. In the present study rabbit ileal loops were perfused with saline, and the IgA content of the perfusate was assessed by immunoradiometric assay. Crypt epithelial IgA content in biopsies was studied by immunofluorescence. Cumulative loop fluid IgA production 300 minutes after exposure to cholera toxin was 6216 +/- 993 microgram/cm compared with 4646 +/- 953 microgram/cm in controls (P &lt; 0 . 20). However, rate of fluid IgA production above baseline at 300 minutes was 1742 +/- 181 microgram/h/cm in cholera loops and 1049 +/- 310 microgram/h/cm in controls, and the mean difference between the cholera and control loops was statistically significant (P &lt; 0 . 05). In biopsies, mean rank of crypt epithelial IgA at 300 minutes was decreased compared with controls (P &lt; 0 . 05). The findings of increased rate of fluid IgA production and decreased epithelial IgA suggest that a single dose of cholera toxin enhanced secretion of IgA from crypt epithelium into the intestinal lumen, although the magnitude of the enhancement was not great.
How Much Longer Must Medicine&amp;rsquo;s Science Be Bound by a Seventeenth Century World View?
Authors: George L Engel
Journal: Psychotherapy and Psychosomatics (1992)

The exclusion of nonmaterial human phenomena mandated by medical science's continuing allegiance to a 17th century scientific world view has constituted a major obstacle to medicine's scientific maturation as a human discipline. But 20th century conceptual changes even in physics (not to mention the influence of the theory of evolution) now renders that exclusion untenable and in effect legitimizes efforts to devise scientific means appropriate for the human domain. Practical as well as theoretical issues involved in such an undertaking are discussed within the framework of a 20th century scientific world view as represented by the biopsychosocial model, a counterpart to the traditional biomedical model.
Molecular phylogeny of extant gymnosperms and seed plant evolution: analysis of nuclear 18S rRNA sequences
Authors: S. M. Chaw, A. Zharkikh, H. M. Sung, T. C. Lau, W. H. Li
Journal: Molecular Biology and Evolution (1997)

To study the evolutionary relationships among the four living gymnosperm orders and the interfamilial relationships in each order, a set of 65 nuclear 18S rRNA sequences from ferns, gymnosperms, and angiosperms was analyzed using the neighbor-joining and maximum-parsimony methods. With Selaginella as the outgroup, the analysis strongly indicates that the seed plants form a monophyletic group with the ferns as a sister group. Within the seed plants the angiosperms are clearly a monophyletic group. Although the bootstrap support for the monophyly of the gymnosperm clade is moderate, the monophyly is further supported by its lack of angiosperm-specific indels. Within the gymnosperms there appear to be three monophyletic clades: Cycadales-Ginkgoales, Gnetales, and Coniferales. The cycad-ginkgo clade is the earliest gymnosperm lineage. Given the strong support for the sister group relationship between Gnetales and Coniferales, it is unlikely that Gnetales is a sister group of the angiosperms, contrary to the view of many plant taxonomists. Within Coniferales, Pinaceae is monophyletic and basal to the remaining conifer families, among which there are three monophyletic clades: Phyllocladaceae-Podocarpaceae, Araucariaceae, and Sciadopityaceae-Taxaceae-Cephalotaxaceae-Taxodiacea e-Cupressaceae. Within the latter clade, Sciadopityaceae may be an outgroup to the other four families. Among the angiosperms, no significant cluster at the level of subclass was found, but there was evidence that Nymphaeaceae branched off first. Within the remaining angiosperms, the monocots included in this study are nested and form a monophyletic group. This study attests to the utility of nuclear 18S rRNA sequences in addressing relationships among living gymnosperms. Considerable variation in substitution rates was observed among the ferns and seed plants.
HIV Vaccines: Inch by Inch
Authors: Brigid Kane
Journal: Annals of Internal Medicine (2000)

Current Clinical Issues19 September 2000HIV Vaccines: Inch by InchBrigid KaneBrigid KaneAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-6-200009190-00102 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the first 6 months of 1999, approximately 10 000 new AIDS cases were diagnosed in the United States and 8000 persons died of AIDS. Estimates from the United Nations Programme on HIV/AIDS and the World Health Organization are even more sobering: At the end of 1999, global figures indicated that 33.6 million people were living with HIV and that 2.6 million persons with AIDS had died during that year alone. From the beginning of the epidemic through December 1999, an estimated 16.3 million people have died of AIDS.“It is hard to conceive of worldwide control of HIV infection ... Author, Article, and Disclosure InformationAuthors: Brigid Kane PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLa vacunología en los albores del siglo XXI (II) 19 September 2000Volume 133, Issue 6Page: 489-490KeywordsAIDSAntiretroviral therapyClinical trialsDNAGlycoproteinsHIVHIV vaccinesImmune responseVaccine developmentVaccines ePublished: 19 September 2000 Issue Published: 19 September 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...
Concurrent sickle cell anemia and alpha-thalassemia. Effect on pathological properties of sickle erythrocytes.
Authors: S H Embury, M R Clark, G Monroy, N Mohandas
Journal: Journal of Clinical Investigation (1984)

The concurrence of sickle cell anemia and alpha-thalassemia results in less severe hemolytic anemia apparently as a result of reduced intraerythrocytic concentration of hemoglobin S and its retarded polymerization. We have evaluated the effect of alpha-globin gene number on several interrelated properties of sickle erythrocytes (RBC) that are expected to correlate with the hemolytic and rheologic consequences of sickle cell disease. The irreversibly sickled cell number, proportion of very dense sickle RBC, and diminished deformability of sickle RBC each varied directly with alpha-globin gene number. Sickle RBC density was a direct function of the mean corpuscular hemoglobin concentration (MCHC). Even in nonsickle RBC, alpha-globin gene number varied directly with RBC density. Despite differences in alpha-globin gene number, sickle RBC of the same density had the same degree of deformability and dehydration. These data indicate that the fundamental effect of alpha-thalassemia is to inhibit the generation of sickle RBC having high density and MCHC, and that the other beneficial effects of sickle RBC are secondary to this process. The less consistent effect on overall clinical severity reported for subjects with this concurrence may reflect an undefined detrimental effect of alpha-thalassemia, possibly on the whole blood viscosity or on sickle RBC membrane-mediated adherence phenomena.
A new apparatus for the delivery of high intensity UVA and UVA+UVB irradiation, and some dermatological applications
Authors: G. PLEWIG, C. HOFMANN, O. Braun-Falco, G. Nath, A. KREITMAIR
Journal: British Journal of Dermatology (1978)

A new apparatus consisting of a 200 W super pressure mercury lamp and a flexible light guide with a liquid light-conducting core is presented. Its transmission for UVA irradiation is more than threefold as compared to conventional quartz fibre optic bundles. The light guide is capable of transmitting density levels exceeding I W/cm2. UVA and UVB are transmitted. By inserting a filter platelet (WG 345) into the light guide the UVB is cut off. The output of the unfiltered guide is 700 mW (3570 mW/cm2), of the filtered guide 400 mW (2040 mW/cm2), centered mainly at 366 nm. The light apparatus proved useful for several dermatological applications. It replaces in many respects conventional Kromayer lamps, especially because the flexible light guide, which is 160 cm long and weighs only 210 g, can be brought into direct contact with the skin. Results of determining the minimal erythema dose (MED), of phototesting (8-MOP photoallergy, persistent light reactor, erythropoietic protoporphyria) and of photochemotherapy are given.
Preliminary Results of a New Covered Biliary Metal Stent for Malignant Biliary Obstruction
Authors: C. S. Shim, Y. H. Lee, Y. D. Cho, H. K. Bong, J. O. Kim, J. Y. Cho, Y. S. Kim, J. S. Lee, M. S. Lee, S. G. Hwang, K. M. Shin
Journal: Endoscopy (1998)

The biliary stents in current use have a tendency to be blocked, so we designed a self-expandable metal stent covered with polyurethane to overcome the risk of tumor ingrowth of uncovered self-expandable metal stents. To evaluate the success and the effectiveness of the new membrane-covered self-expandable metal stent (covered modified Gianturco biliary stent), we studied patients with biliary obstruction caused by biliopancreatic carcinoma.We retrospectively evaluated 47 patients with malignant biliary obstruction to receive either a newly developed self-expandable metal stent covered with polyurethane (21 cases) or an uncovered metal stent (Strecker stent or Wallstent, 26 cases) by the endoscopic transpapillary route.The success rate of stent insertion and drainage effect of stent showed no statistical difference in patients with a new membrane-covered self-expandable metal stent compared with those with an uncovered metal stent (90.4% vs. 88.5%, P > 0.05; and 100% vs. 95.6%, P > 0.05, respectively). The median patency of the stent was slightly prolonged in patients with a membrane-covered self-expandable metal stent, but there was no statistical difference between two groups (267 vs. 233 days, P > 0.05). The rate of early complication related to stent insertion showed no significant difference between the two groups. During the follow-up period, stent occlusion due to tumor ingrowth occurred in two patients (10.5%) in the membrane-covered, self-expandable stent group, compared with six patients (26.1%) in the uncovered metal stent group. The membrane-covered metal stent was removed successfully and a polyethylene stent was reinserted in one patient who had developed tumor overgrowth.A new, membrane-covered, self-expandable metal stent has a tendency towards better long-term patency than the uncovered metal stent, and it can effectively prevent tumor ingrowth into the stent. Also it is possible to remove an occluded membrane-covered stent. However, a case-controlled study, including a larger patient number, and long-term follow-up are needed.
Thromboembolic Complications After Fontan Operations
Authors: David N. Rosenthal, Alan H. Friedman, Charles S. Kleinman, Gary S. Kopf, Lynda E. Rosenfeld, William E. Hellenbrand
Journal: Circulation (1995)

Background Despite the increasing recognition of thromboembolic complications of the Fontan procedure, data characterizing such events are limited. The total cavopulmonary connection is believed to be less prone to this complication than other modifications of Fontan operations. We examined our experience with thromboembolism after Fontan operations to better characterize these events and their relation to the type of Fontan operation performed. Methods and Results We retrospectively identified 70 patients who underwent a Fontan operation between January 1978 and March 1994. Patients were divided into three groups: (1) total cavopulmonary connection, (2) atriopulmonary connection, and (3) conduit interposition. Fourteen patients (20%) developed a thromboembolic complication during a mean (±SD) follow-up of 5.2±4.7 years. The rate of thrombosis was similar in each group. The time from Fontan operation to thrombosis averaged 6.1±5.0 years. The overall rate of thromboembolic events was 3.9 per 100 patient-years. Twelve of the 14 thrombi were located within the venous circulation, 1 was in the left ventricle, and the location of 1 was undetermined. Six of the patients (43%) were asymptomatic, 3 (21%) presented with cerebrovascular events, and 5 (36%) presented with other symptoms. Thromboembolic events occurred from the perioperative period to 15 years after surgery. Conclusions Thromboembolic complications occur frequently after the Fontan operation and its modifications and are a cause of significant morbidity. The time of presentation varies greatly. The rate of thrombosis appears to be similar in all modifications of the Fontan operation.
CORRELATION OF PEMPHIGOID AND PEMPHIGU S ANTIBODY TITRES WITH ACTIVITY OF DISEASE
Authors: W. MITCHELL SAMS, ROBERT E. JORDON
Journal: British Journal of Dermatology (1971)

SUMMARY.— Four patients with pemphigoid have been followed clinically and serologically for a sufficient period to indicate that pemphigoid antibody titre does not necessarily parallel the clinical activity of the disease. In contrast, for pemphigus, there does seem to be such a correlation.
Correction: Misspelled Name
Authors: MARSHALL E. KADIN
Journal: Annals of Internal Medicine (1976)

Comments and Corrections1 February 1976Correction: Misspelled NameMARSHALL E. KADIN, M.D.MARSHALL E. KADIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-2-226 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I wish to call to your attention an error in the October 1975 issue. My name was misspelled in the references section (p. 552) of the article, "Cutaneous T-CeIl Lymphomas: The Sézary Syndrome, Mycosis Fungoides, and Related Disorders" (Ann Intern Med83:534-552). Reference 62 shows the spelling of my name as VADINMS. This reference should read: KADINME, NEWCOMSR, GOLDSB, et al: Origin of Hodgkin's cell.Lancet2:167-168, 1974.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cancer Research Institute University of California, San Francisco San Francisco, California 94143 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1976Volume 84, Issue 2Page: 226-226KeywordsLymphoma ePublished: 1 December 2008 Issue Published: 1 February 1976 PDF downloadLoading ...
Randomized 4-week exercise program in patients with impaired left ventricular function.
Authors: M Jetté, R Heller, F Landry, G Blümchen
Journal: Circulation (1991)

BACKGROUND This study was designed to determine the controlled effects of a short-term exercise rehabilitation program on patients with moderate-to-severe left ventricular dysfunction after a recent myocardial infarction. METHODS AND RESULTS Thirty-nine male patients 51 +/- 8 years old with a large anterior myocardial infarction less than 10 weeks old were recruited for the study. The patients were randomly assigned to either one of two training or control groups on the basis of their resting ejection fraction: training, less than 30%; control, less than 30%; training, 31-50%; or control, 31-50%. Patients were evaluated for filling pressures, radionuclide ventriculography, heart volume, echocardiography, and work capacity. Patients who underwent training participated in an intensive 4-week in-hospital exercise program, whereas the control patients were restricted to a minimal activity program. Results indicated that there were no significant improvements in resting, submaximal, and maximal hemodynamic measurements as a result of the program. Mean work capacity and peak oxygen consumption improved significantly in the less-than-30% training group but was accompanied by a significant increase in mean pulmonary wedge pressure. Resting ejection fraction improved markedly in both less-than-30% training and control patients, but ejection fraction measures were not associated with work capacity. Training did not cause further deterioration in ventricular function. CONCLUSIONS It was concluded that in the present study, exercise training had little or no effect on hemodynamic measurements and that the training effects achieved in patients with left ventricular dysfunction are most likely due to corrected impaired vasodilation, not necessarily to cardiac function. The importance of using a control group in this type of study and the wide interindividual variations in training responses are emphasized.
Phorbol myristate acetate, dioctanoylglycerol, and phosphatidic acid inhibit the hydroosmotic effect of vasopressin on rabbit cortical collecting tubule.
Authors: Y Ando, H R Jacobson, M D Breyer
Journal: Journal of Clinical Investigation (1987)

We explored the role for protein kinase C (PKC) in modulating vasopressin (AVP)-stimulated hydraulic conductivity (Lp) in rabbit cortical collecting tubule (CCT) perfused in vitro at 37 degrees C. In control studies, 10 microU/ml AVP increased Lp (mean +/- SE, X 10(-7) centimeters/atmosphere per second) from 4.4 +/- 0.9 to 166.0 +/- 10.4. Pretreatment with dioctanoylglycerol (DiC8) suppressed AVP stimulated peak Lp (peak Lp, 21.9 +/- 3.1). Pretreatment with 10(-9) and 10(-7) M 4 beta-phorbol 12 beta-myristate 13 alpha-acetate (PMA) also blocked the increase in Lp in a dose-dependent fashion (peak Lp, 59.3 +/- 7.5 and 18.6 +/- 4.8, respectively). Inactive phorbol ester, 4 alpha-phorbol 12 beta,13 alpha-didecanoate (10(-7) M), had no effect. PMA also suppressed the increase in Lp induced by 10(-4) M 8-p-chlorophenylthio-cyclic AMP (CcAMP): peak Lp was 169.4 +/- 14.9 in control, 79.2 +/- 5.5 with 10(-9) M PMA, and 25.7 +/- 2.9 with 10(-7) M PMA. Furthermore, when 10(-7) M PMA was added to the bath 10 min after exposure to AVP, the Lp response to AVP was blocked. Peak Lp was 52.4 +/- 9.6 with PMA vs. 165.1 +/- 10.0 in control. Phosphatidic acid (PA), which is thought to stimulate phosphatidylinositol (PI) turnover, produced similar inhibitory effects on AVP as well as CcAMP-stimulated Lp: PA suppressed 10-microU/ml AVP-induced peak Lp from a control value of 159.6 +/- 7.9 to 88.9 +/- 15.8, and 10(-4) M CcAMP induced peak Lp from 169.4 +/- 14.9 to 95.5 +/- 7.7. We conclude that PMA, at concentrations known to specifically activate PKC, suppresses the hydroosmotic effect of AVP on CCT; This suppression is primarily a post-cAMP event; Inhibition of AVP-stimulated Lp by DiC8 and PA also suggests an inhibitory role for the PKC system; The ability of pre- and post-AVP administration of PMA to blunt the AVP response suggests that agents that act through modulation of PI turnover in CCT may regulate the hydroosmotic effect of AVP.