tbuckley/cabot-search huggingface dataset:
Complications of Steroid Therapy for Rheumatoid Arthritis
Authors: LARRY E. ALVES
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 May 1981Complications of Steroid Therapy for Rheumatoid ArthritisLARRY E. ALVES, M.D., EDWARD P. ROSE, M.D.LARRY E. ALVES, M.D.Search for more papers by this author, EDWARD P. ROSE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-5-713_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent article by Liebling and associates (1) indicates that their patients with rheumatoid arthritis had no significant complications during treatment with methylprednisolone. We have had two cases in which short-term high-dose steroid therapy was associated with severe complications. One case was in a 51-year-old patient who developed severe radicular pain thought to be lumbar disk herniation. The patient had had a stable pulmonary infiltrate for at least 4 years. After a trial of conservative therapy and as an alternative to myelography and surgery, she received 40 mg dexamethasone intramuscularly twice daily for 2 days, followed by...Reference1. LIEBLINGLIEBMCLAUGHLIN MEK. Pulse methylprednisolone in rheumatoid arthritis. Ann Intern Med. 1981;94:21-6. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Memorial Hospital Belleville, IL 62223 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCorticosteroid pulse therapy in active rheumatoid arthritisAdministration of Buprenorphine by Continuous Subcutaneous InfusionSurvey of the long term incidence of osteonecrosis of the hip and adverse medical events in rheumatoid arthritis after high dose intravenous methylprednisolone.Drug Information Analysis Serviceo 1 May 1981Volume 94, Issue 5Page: 713-713KeywordsRheumatoid arthritisSteroid therapySurgery Issue Published: 1 May 1981 PDF DownloadLoading ...
Vasodilator therapy in acute myocardial infarction. A comparison of sodium nitroprusside and nitroglycerin.
Authors: P W Armstrong, D C Walker, J R Burton, J O Parker
Journal: Circulation (1975)

Twenty-six patients with complicated acute myocardial infarction were studied in order to compare the hemodynamic effects of sodium nitroprusside (NP) and nitroglycerin (GTN). All patients received NP and 18 of the 26 also received GTN to evaluate both drugs in the same individuals. Both agents produced significant declines in mean arterial pressure, total peripheral resistance (TPR), and heart rate systolic blood pressure product. However, in the 18 patients who received both drugs GTN produced a greater fall (P less than 0.05) in pulmonary capillary wedge pressure (PCW) (25 to 15 mm Hg) than did NP (24 to 17 mm Hg) and a greater increment (P less than 0.01) in (see article) (0.98 to 1.43) than NP (0.98 to 1.16). These data confirm the potent vasodilatory effects of NP and GTN and suggest that NP has a relatively balanced effect on the arterial and venous circulation, and GTN seems to produce more potent venodilatation than arterial dilatation. These observations provide a basis for a more rational choice of vasodilator agents based on initial hemodynamic measurements in complicated acute myocardial infarction.
The Medical Detectives
Authors: Harriet S. Meyer
Journal: JAMA (1981)

<i>The Medical Detectives</i>is the latest collection of Berton Roueché's clinical and epidemiologic mysteries. As is traditional, all have appeared "in somewhat different form" in his<i>New Yorker</i>feature, "Annals of Medicine." Since the late 1940s, Roueché has delighted readers, physician and nonphysician alike, with his accounts of experts unraveling problems so uncanny one is astounded that an explanation exists. Communicable disease outbreaks, poisons, and specific illnesses are the familiar subjects of<i>The Medical Detectives</i>. We read of the epidemiologic investigation, the diagnostic process, and the patient's experience with illness as these events progress rather than, as with journal articles, "through the retrospectoscope." The stories unfold often largely in the words of the participants, who share their flashes of insight and serendipity. Roueché describes the people involved and provides local color, such as the small-town motels and late-night cups of coffee that apparently are the lot of the epidemiologic field
Actinomyces in Vaginal Smears
Authors: Prabodh K. Gupta
Journal: JAMA (1982)

The intrauterine device (IUD) is recognized as an effective, economical, and safe method of reversible contraception. It is the second most commonly used contraceptive method in the United States. Early 19th-century designs made of pewter and platinum have been replaced by plastic devices that may be medicated and may contain copper or hormones. Their effectiveness is apparently related to disturbance in endometrial function, implantation, or both. Although the physical forms vary, all such devices currently have a monofilamentous synthetic "tail" with which the IUD may communicate with the external environment. Additionally, the device may alter the intrauterine milieu, thus making it more conducive for the growth of certain microorganisms. <i>Actinomyces</i>belong to the family of higher bacteria and are susceptible to antibiotics. These anaerobes have been observed in the vaginal smears of current or immediate past users (within six to eight weeks) of IUDs (R. T. Burkman, MD, and colleagues,
Continuous Arterial Bruit as an Index of Collateral Blood Supply
Authors: H. V. Murdaugh, H. D. McIntosh
Journal: New England Journal of Medicine (1958)

THE occurrence of a continuous bruit over a partially obstructed artery is not a new clinical observation. The theoretical concept of the production of such a murmur has been well expressed by Myers and his co-workers.1 The purpose of this report is to evaluate the continuous bruit as a bedside means of estimating the adequacy of the collateral circulation bypassing a point of arterial obstruction.MethodsTwenty-nine patients with arteriosclerotic vascular disease with an associated bruit over a peripheral artery were studied. Bruits present over a femoral or axillary artery were evaluated before and after exercise of the involved extremity. . . .
Reviews and Notes: Cardiovascular Medicine: Varicose Veins and Related Disorders
Authors: Leonard M. Gutnik
Journal: Annals of Internal Medicine (1993)

Literature of Medicine15 October 1993Reviews and Notes: Cardiovascular Medicine: Varicose Veins and Related DisordersLeonard M. Gutnik, MDLeonard M. Gutnik, MDCentral Plains Clinic, Ltd., Sioux Falls, SD 57105.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-8-199310150-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Varicose Veins and Related DisordersDavid J. Tibbs; ed. 576 pages. Boston: Butterworth-Heinemann; 1992. $350.00.Circulatory problems can be chronic, and patients with these conditions can be frustrated and discouraged by their circumstances. This is further compounded by the unfortunate fact that residency training programs have been lax in including venous diseases in their curriculum. As a direct consequence of this, few physicians are comfortable treating these illnesses, although they may form a considerable part of a clinical practice.I am pleased to report that this text helps to fill a gap in the medical literature. Venous and lymphatic problems constitute a significant ... Author, Article, and Disclosure InformationAffiliations: Central Plains Clinic, Ltd., Sioux Falls, SD 57105. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1993Volume 119, Issue 8Page: 864-865KeywordsCardiology and cardiovascular diseasesDeep vein thrombosisEdemaForecastingLibrariesResidencyUlcersVeins ePublished: 15 August 2000 Issue Published: 15 October 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Effect of exposure to diesel exhaust particles on the susceptibility of the lung to infection.
Authors: V Castranova, J Y Ma, H M Yang, J M Antonini, L Butterworth, M W Barger, J Roberts, J K Ma
Journal: Environmental Health Perspectives (2001)

There are at least three mechanisms by which alveolar macrophages play a critical role in protecting the lung from bacterial or viral infections: production of inflammatory cytokines that recruit and activate lung phagocytes, production of antimicrobial reactive oxidant species, and production of interferon (an antiviral agent). In this article we summarize data concerning the effect of exposure to diesel exhaust particles on these alveolar macrophage functions and the role of adsorbed organic chemicals compared to the carbonaceous core in the toxicity of diesel particles. In vitro exposure of rat alveolar macrophages to diesel exhaust particles decreased the ability of lipopolysaccharide (LPS), a bacterial product] to stimulate the production of inflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha). Methanol extract exhibited this potential but methanol-washed diesel particles did not. Exposure of rats to diesel exhaust particles by intratracheal instillation also decreased LPS-induced TNF-alpha and IL-1 production from alveolar macrophages. In contrast, carbon black did not exhibit this inhibitory effect. Exposure of rats to diesel exhaust particles by inhalation decreased the ability of alveolar macrophages to produce antimicrobial reactive oxidant species in response to zymosan (a fungal component). In contrast, exposure to coal dust increased zymosan-stimulated oxidant production. In vivo exposure to diesel exhaust particles but not to carbon black decreased the ability of the lungs to clear bacteria. Inhalation exposure of mice to diesel exhaust particles but not to coal dust depressed the ability of the lung to produce the antiviral agent interferon and increased viral multiplication in the lung. These results support the hypothesis that exposure to diesel exhaust particles increases the susceptibility of the lung to infection by depressing the antimicrobial potential of alveolar macrophages. This inhibitory effect appears to be due to adsorbed organic chemicals rather than the carbonaceous core of the diesel particles.
Phospholipase A2 is involved in the mechanism of activation of neutrophils by polychlorinated biphenyls.
Authors: P K Tithof, E Schiamberg, M Peters-Golden, P E Ganey
Journal: Environmental Health Perspectives (1996)

Aroclor 1242, a mixture of polychlorinated biphenyls (PCBs), activates neutrophils to produce superoxide anion (O2-) by a mechanism that involves phospholipase C-dependent hydrolysis of membrane phosphoinositides; however, subsequent signal transduction mechanisms are unknown. We undertook this study to determine whether phospholipase A2-dependent release of arachidonic acid is involved in PCB-induced O2- production. We measured O2- production in vitro in glycogen-elicited, rat neutrophils in the presence and absence of the inhibitors of phospholipase A2: quinacrine, 4-bromophenacyl bromide (BPB), and manoalide. All three agents significantly decreased the amount of O2- detected during stimulation of neutrophils with Aroclor 1242. Similar inhibition occurred when neutrophils were activated with the classical stimuli, formyl-methionyl-leucyl-phenylalanine (fMLP) or phorbol myristate acetate. The effects of BPB and manoalide were not a result of cytotoxicity or other nonspecific effects, although data suggest that quinacrine is an O2- scavenger. Significant release of 3H-arachidonic acid preceded O2- production in neutrophils stimulated with Aroclor 1242 or fMLP. Manoalide, at a concentration that abolished O2- production, also inhibited the release of 3H-arachidonate. Aspirin, zileuton, or WEB 2086 did not affect Aroclor 1242-induced O2- production, suggesting that eicosanoids and platelet-activating factor are not needed for neutrophil activation by PCBs. Activation of phospholipase A2 and O2- production do not appear to involve the Ah receptor because a congener with low affinity, but not one with high affinity for this receptor, stimulated the release of arachidonic acid and O2-. These data suggest that Aroclor 1242 stimulates neutrophils to produce O2- by a mechanism that involves phospholipase A2-dependent release of arachidonic acid.
Oral nuclear factor-κB decoy oligonucleotides delivery system with chitosan modified poly(d,l-lactide-co-glycolide) nanospheres for inflammatory bowel disease
Authors: Kohei Tahara, Sota Samura, Kaori Tsuji, Hiromitsu Yamamoto, Yusuke Tsukada, Yohei Bando, Hiroyuki Tsujimoto, Ryuichi Morishita, Yoshiaki Kawashima
Journal: Biomaterials (2010)
The Diagnostic Value of Grading Hyperperfusion and the Rim Sign in Cholescintigraphy
Authors: PAUL J. BOHDIEWICZ
Journal: Clinical Nuclear Medicine (1993)

Biliary scans of 84 hospitalized patients believed to likely have acute cholecystitis, including 55 scans that had a radionuclide angiography phase, were retrospectively evaluated to determine the frequency of the rim sign and hyperperfusion, and to test the hypothesis that more intense hyperperfusion or rim sign is associated with a greater severity of gallbladder pathology ( “complicated” acute cholecystitis). In 65 of the 84 cases there was surgical intervention (including 43 from the 55 cases whose scans had a radionuclide angiography phase). “Complicated” acute cholecystitis was considered present if there was gangrene, perforation, empyema, necrosis, ulceration, or fibrous exudation. Each scan was evaluated for the presence of a rim sign and arterial hyperperfusion to the region of the gallbladder fossa. The intensities of these secondary signs of acute cholecystitis were then graded as “mild” or “marked.” Subdividing the rim sign and hyperperfusion into a “marked” category considerably improved the specificity, positive predictive value, and likelihood ratio (positive) for the diagnosis of acute cholecystitis, but even more so for the complicated subgroup when marked hyperperfusion or marked rim sign were the criteria used for a positive study. Approximately 50% of the patients with acute cholecystitis had hyperperfusion and a rim sign, and approximately 15% had marked hyperperfusion and a marked rim sign. Of the patients with acute cholecystitis, the only ones with marked hyperperfusion or a marked rim sign were those who had complicated acute cholecystitis. The data demonstrate an association between greater intensity of the rim sign or hyperperfusion and greater severity of gallbladder pathology in patients with acute cholecystitis. Nevertheless, identification of a mild degree of the rim sign or hyperperfusion also appears to be of clinical significance.
Self-help interventions for symptoms of depression, anxiety and psychological distress in patients with physical illnesses: A systematic review and meta-analysis
Authors: F. Matcham, L. Rayner, J. Hutton, A. Monk, C. Steel, M. Hotopf
Journal: Clinical Psychology Review (2014)

Psychological distress, depression and anxiety are common in most physical diseases, and self-help interventions, if effective, might be an important approach to improve outcomes as they are inexpensive to provide to large numbers of patients. The primary aim of this review was to assess randomised controlled trials examining the impact of self-help interventions on symptoms of depression, anxiety and psychological distress in patients with physical illness. Systematic searches of electronic databases resulted in twenty-five eligible studies for meta-analysis (n = 4211). The results of the primary meta-analyses revealed a significant improvement in depression symptoms, in favour of the intervention group (SMD = − 0.13, 95% CI: − 0.25, − 0.02, p = 0.02, I2 = 50%). There were no significant differences in symptoms of anxiety (SMD = − 0.10, 95% CI: − 0.24, 0.05, p = 0.20, I2 = 63%) or psychological distress (SMD = − 0.14, 95% CI: − 0.40, 0.12, p = 0.30, I2 = 72%) between intervention and control conditions. Several subgroup and sensitivity analyses improved effect sizes, suggesting that optimal mental health outcomes may be obtained in patients without neurological conditions, and with interventions based on a therapeutic model (such as cognitive behavioural therapy), and with stress management components. This review demonstrates that with appropriate design and implementation, self-help interventions may potentially improve symptoms of depression in patients with physical conditions.
Oxygen modulates prostacyclin synthesis in ovine fetal pulmonary arteries by an effect on cyclooxygenase.
Authors: P W Shaul, W B Campbell, M A Farrar, R R Magness
Journal: Journal of Clinical Investigation (1992)

Prostacyclin (PGI2) plays an integral role in O2 mediation of pulmonary vasomotor tone in the fetus and newborn. We hypothesized that O2 modulates PGI2 synthesis in vitro in ovine fetal intrapulmonary arteries, with decreasing O2 causing attenuated synthesis. A decline in PO2 from 680 to 40 mmHg caused a 26% fall in basal PGI2 synthesis. PGI2 synthesis maximally stimulated by bradykinin, A23187, and arachidonic acid were also attenuated at low PO2, by 35%, 33%, and 35%, respectively. PGE2 synthesis was equally affected. In contrast, varying O2 did not alter PGI2 synthesis with exogenous PGH2, which is the product of cyclooxygenase and the substrate for prostacyclin synthetase. Prostaglandin-mediated effects of O2 on cAMP production were also examined. Decreasing PO2 to 40 mmHg caused complete inhibition of basal cAMP production, whereas cAMP production stimulated by exogenous PGI2 was not affected. In parallel studies of mesenteric arteries, PGI2 synthesis and cAMP production were enhanced at low O2. Thus, PGI2 synthesis in fetal intrapulmonary arteries is modulated by changes in O2, with decreasing O2 causing attenuated synthesis. This process is due to an effect on cyclooxygenase activity, it causes marked parallel alterations in cAMP production, and it is specific to the pulmonary circulation.
Peanut Oral Immunotherapy (OIT) of Food Allergy (FA) Carries a Significant Risk of Eosinophilic Esophagitis (EoE)
Authors: R.L. Wasserman, R.W. Sugerman, N. Mireku-Akomeah, A.R. Gallucci, D.M. Pence, N.A. Long
Journal: Journal of Allergy and Clinical Immunology (2011)
B7/BB-1 expression and hepatitis activity in liver tissues of patients with chronic hepatitis C
Authors: K Mochizuki, N Hayashi, K Katayama, N Hiramatsu, T Kanto, E Mita, T Tatsumi, N Kuzushita, A Kasahara, H Fusamoto, T Yokochi, T Kamada
Journal: Hepatology (1997)

Cytotoxic T lymphocytes (CTL) are closely related to the mechanism of liver injury in chronic viral hepatitis. Recently, it has been suggested that antigen-specific T cell activation requires both presentation of antigen by major histocompatibility complex (MHC) molecules and the delivery of costimulatory signals. Such signals are provided by B7/BB-1, one of the most important accessory molecules, sufficient for causing antigen-specific MHC-restricted T cell activation. To evaluate the role of B7/BB-1 in chronic hepatitis C, we immunohistochemically studied its expression in liver tissues obtained from 61 patients with hepatitis C virus (HCV) infection and compared them based on hepatitis activity. In HCV-infected liver, B7/BB-1 was strongly expressed in the cytoplasm of hepatocytes. B7/BB-1-positive cells accompanied liver-infiltrating lymphocytes and were mainly detected in the periportal region. B7/BB-1 expression was closely correlated with the activity of viral hepatitis as evaluated from scores of periportal or intralobular inflammation and necrosis, or serum alanine transferase (ALT) levels. Further study by immunostaining with anti-HCV core and anti-human leukocyte antigen (HLA) class I antibody showed B7/BB-1 positive cells near HCV core antigen- and HLA class I-positive cells, with B7/BB-1-positive cells mostly included among HLA class I-positive cells. These findings suggested that B7/BB-1 expression by hepatocytes may be induced by HCV infection and may trigger generation and activation of CTL, which may cause damage to HCV-infected HLA class I-expressing hepatocytes.
The Patient-Centered Medical Home Neighbor: A Subspecialty Physician's View
Authors: Hal F. Yee
Journal: Annals of Internal Medicine (2011)

To achieve the benefits of the patient-centered medical home (PCMH) model, the American College of Physicians has issued a policy paper addressing the relationship between specialist and subspecialist physicians and PCMH practices. This paper represents a significant step toward improving care coordination and quality by demonstrating that this model is supported by numerous specialties and subspecialties, recognizing the importance of building a strong medical neighborhood, and providing a framework that will foster improvements in care at the interface of PCMHs and PCMH neighbors (PCMH-Ns). Construction of a well-functioning medical neighborhood will, however, require some refinements. First, the proposed interaction typology between PCMHs and PCMH-Ns must be expanded to include innovative forms of interaction that do not depend on traditional office visits, but for which there are clear incentives. Second, the recommended care coordination agreements must be better standardized for the sake of practicality. Finally, genuine dialogue between PCMH and PCMH-N practices needs to be realized.
Ouabain Binding and Cation Transport in Human Erythrocytes
Authors: Jerry D. Gardner, Diane R. Kiino
Journal: Journal of Clinical Investigation (1973)

In the present studies we have explored the relation between ouabain binding and the inhibition of potassium influx in intact human erythrocytes. The rate at which bound ouabain molecules dissociate from the erythrocyte membrane is not altered by complete replacement of choline with sodium or by partial replacement with potassium. These findings indicate that the effects of these cations on ouabain binding reflect alterations in the rate of association of ouabain molecules with the erythrocyte membrane. Variations in the cation composition of the incubation solution did not alter the relation between the fraction of the glycosidebinding sites occupied by ouabain or the fraction of ouabain-sensitive potassium influx which was inhibited. That is, irrespective of the affinity of the erythrocyte membrane for ouabain molecules and irrespective of the magnitude of glycoside-sensitive potassium influx, occupation of a given fraction of the glycoside-binding sites by ouabain results in the inhibition of an equal fraction of the ouabain-sensitive potassium transport sites.
Home on the Second Day: The Bradford Experiment
Authors: G. W. Theobald
Journal: BMJ (1959)

STRESS ULCERS IN STOMACH MEDIBJTsH described, and fully as justified as in those patients with known hyperacidity who run the risk of post-operative erosion of the oesophagus (Lodge, 1955). SummaryThe occurrence of acute peptic ulceration in six previously eupeptic patients is described.The gastric lesion followed cerebral haemorrhage in two cases, diffuse encephalomyelitis in one, fractured neck of femur in one, and operation for carcinoma in two others.Post-mortem examination showed no evidence of previous ulceration, and the acute erosions have therefore been accepted as examples of the so-called stress ulcer.Though there is ample evidence to connect the neuro-endocrine system of the body with the development of stress ulcer, the exact mode of produc- tion is unknown.It is suggested that antacid therapy merits consideration in cases where trauma, operation, or cerebral lesions may initiate this dangerous sequence.