tbuckley/cabot-search huggingface dataset:
Combining Physostigmine with Meperidine for Sedation and Analgesia During Colonoscopy
Authors: I. Yardeni, E. Melzer, V. Smolyarenko, A. Zeidel, A. Chervinsky, Y. Binder, B. Beilin
Journal: Endoscopy (2005)

Background and Study Aim: Opiate or benzodiazepine drugs are often used during colonoscopy, but they are associated with respiratory depression and prolonged recovery. Physostigmine, a tertiary anticholinesterase agent, is known to enhance analgesia and to reverse the central nervous system depressant effects of these drugs. This study compared the effect of giving meperidine alone with the effect of giving meperidine in combination with physostigmine in patients who were undergoing complete colonoscopy. Patients and Methods: A total of 44 outpatients undergoing elective colonoscopy were randomly assigned to receive analgesia with either meperidine 0.5 mg/kg intravenously (group 1, n = 24) or physostigmine 10 micrograms/kg intravenously, followed 5 minutes later by meperidine 0.5 mg/kg intravenously (group 2; n = 20). The patients were assessed with regard to oxygen saturation, hemodynamic changes, pain perception and sedation scores, readiness to go home, and adverse effects. Results: The group 1 patients’ oxygen saturations consistently fell, both during the procedure and in the recovery period; in group 2, oxygen saturations remained stable throughout the procedure and recovery period (95.88 % ± 0.99 vs. 98.15 ± 0.99, P < 0.001). Patients in group 2 reported lower pain perception scores during the procedure (measured using a visual analog scale) than patients in group 1 (1.46 ± 0.31 vs. 1.75 ± 0.41; F 1,42 = 6.484, P < 0.015) and were less sedated during recovery (F 1,41 = 6.56, P < 0.015). No significant differences were found between the two groups with regard to heart rate or arterial blood pressure. All patients in group 2 were ready to go home after 25 minutes in the recovery area; three patients in group 1 were not ready to leave at 25 minutes and left the facility after 60 minutes. Four patients suffered from minor side effects of physostigmine (sweating and nausea). Conclusions: Combining physostigmine with meperidine as preparatory treatment for patients undergoing colonoscopy prevents respiratory depression, improves analgesia, and shortens recovery time, with only mild side effects.
Dietary pulmonary hypertension.
Authors: J M Kay
Journal: Thorax (1994)

In 1967 Kay et al postulated that some cases of unexplained pulmonary hypertension might be due to the ingestion of drugs or other toxic substances.'This concept, later termed dietary pulmonary hypertension,23 was advanced fol- lowing the observation that the oral administration to rats of the pyrrolizidine alkaloid monocrotaline produced severe pulmonary hypertension.'There are no reports of pyrrolizidine alkaloids causing pulmonary hypertension in human subjects, but there have been two epidemics ofpulmonary hypertension caused by the ingestion of other substances, and several reports of pulmonary hypertension associated with the administration of drugs (table).The two epidemics of pulmonary hypertension were related to the ingestion of an appetite suppressing drug aminorex,4 and to the ingestion of denatured rapeseed oil.5 Pul- monary hypertension has also been reported in two obese patients taking phenformin.6 Severe pulmonary hypertension associated with haemo- lytic anaemia and renal failure occurred in a 46 year old man with carcinoma of the colon who was treated with mitomycin.7 Pulmonary veno-occlusive disease has been described in patients receiving chemotherapy with BCNU5 and bleomycin alone,9 or in combination with mitomycin and cisplatin,'°or mitomycin, cisplatin and vinblastine."1The effects of pyr- rolizidine alkaloids, anorexigens, L-tryptophan, and toxic oil on the pulmonary vasculature are considered in the following review.Pyrrolozidine alkaloids and the pulmonary circulation Alkaloids are plant constituents other than simple amines which contain a basic nitrogen atom.They occur widely and are present in approximately 5% of all plant species.'2The Pulmonary hypertension associated with drugs and toxic substances Drug or substance Pulmonary vascular pathology Aminorex Pulmonary arteriopathy with plexiform lesions BCNU Pulmonary veno-occlusive disease Bleomycin Pulmonary veno-occlusive disease Combination chemotherapy Pulmonary veno-occlusive disease Dexfenfluramine Pulmonary arteriopathy with plexiform lesions Fenfluramine Pulmonary arteriopathy with plexiform lesions L-tryptophan Vascular and perivascular chronic inflammation Mitomycin Intracapillary thrombi Phendimetrazine Pulmonary artery medial hypertrophy and intimal fibrosis Phenformin Propylhexedrine Spanish toxic oil Pulmonary artery medial hypertrophy, intimal proliferation with foam cells, perivascular chronic inflammation
The effects of the cardiac myosin activator, omecamtiv mecarbil, on cardiac function in systolic heart failure: a double-blind, placebo-controlled, crossover, dose-ranging phase 2 trial
Authors: John GF Cleland, John R Teerlink, Roxy Senior, Evgeny M Nifontov, John JV Mc Murray, Chim C Lang, Vitaly A Tsyrlin, Barry H Greenberg, Jamil Mayet, Darrel P Francis, Tamaz Shaburishvili, Mark Monaghan, Mitchell Saltzberg, Ludwig Neyses, Scott M Wasserman, Jacqueline H Lee, Khalil G Saikali, Cyril P Clarke, Jonathan H Goldman, Andrew A Wolff, Fady I Malik
Journal: The Lancet (2011)
Mutations in LRP2, which encodes the multiligand receptor megalin, cause Donnai-Barrow and facio-oculo-acoustico-renal syndromes
Authors: Sibel Kantarci, Lihadh Al-Gazali, R Sean Hill, Dian Donnai, Graeme C M Black, Eric Bieth, Nicolas Chassaing, Didier Lacombe, Koen Devriendt, Ahmad Teebi, Maria Loscertales, Caroline Robson, Tianming Liu, David T MacLaughlin, Kristin M Noonan, Meaghan K Russell, Christopher A Walsh, Patricia K Donahoe, Barbara R Pober
Journal: Nature Genetics (2007)
Complications of Silicone Implant
Authors: Alan R. Schned
Journal: JAMA (1985)

<h3>To the Editor.—</h3> We read the recent article inThe Journalreviewing complications of long-term silicone implant arthroplasty<sup>1</sup>and would like to mention our report of silicone lymphadenopathy.<sup>2</sup>Our case was unique in the association of necrobiotic rheumatoid nodules with silicone particles within enlarged axillary lymph nodes. This association suggested to us that the silicone particles might be inciting the rheumatoid nodules in a manner analogous to the relationship between silica and rheumatoid nodules in the lung.<sup>3</sup> Nalbandian et al<sup>1</sup>referred to an isolated report of immunoblastic lymphoma associated with superimposed silicone particles. A large-cell lymphoma has subsequently developed in our patient also, with silicone particles identifiable within the lymphomatous infiltration. We are, however, like Nalbandian et al,<sup>1</sup>inclined to attribute this concurrence to the known increased risk of lymphoma in rheumatoid arthritis rather than to invoke silicone particles as an etiologic factor. We are
Endoscopic ultrasound-guided fine needle aspiration of peritoneal nodules in patients with ascites of unknown cause
Authors: S. Rana, D. Bhasin, R. Srinivasan, K. Singh
Journal: Endoscopy (2011)

Ascites can pose a difficult diagnostic problem and in some patients, despite extensive work-up, diagnostic laparoscopy or laparotomy is required. We evaluated the usefulness of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of peritoneal nodules in 12 patients with undiagnosed ascites (9 men, 3 women; mean [SD] age 47.5 [11.8] years). On EUS, peritoneal deposits, noted as hyperechoic rounded lesions compared with surrounding anechoic ascitic fluid, were observed in 10/12 patients (83.3%). Cytological examination of EUS-FNA samples from these deposits revealed metastatic adenocarcinoma in four patients, poorly differentiated carcinoma in one patient and pseudomyxoma peritonei in one patient. It also revealed inflammatory cells without granulomas in four patients, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis was positive in 2/4 patients (50%). Deposits were larger and clearly defined in malignant ascites in comparison with tubercular ascites. No complications of EUS-FNA were observed.
Principles of Medical Psychiatry
Authors: Charles Kent Smith
Journal: JAMA (1989)

The concept put forward by this book is that "medical psychiatry" defines the psychiatrist as a medical specialist who assumes primary clinical responsibility for the diagnosis and treatment of psychiatric disorders within the medically ill population. It is the authors' view that this type of practice will grow in importance. The authors assume that the medical psychiatrist will take on a great deal of medical responsibility for the patient. This model appears to be more common than it once was, but a change along these lines would still be a fairly significant change within the discipline of psychiatry. I would not agree with the foreword of the book, which states, "If Psychiatry does not assume the responsibility for individuals with both physical and mental illness, then Primary Care physicians will, albeit with less sophistication in their diagnosis and treatment of patients with mental complaints." Rather, it would make more sense
Annals Now and Then
Authors: Frank Davidoff
Journal: Annals of Internal Medicine (1996)

Editorials1 January 1996Annals Now and ThenFrank Davidoff, MD, EditorFrank Davidoff, MD, EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-1_Part_1-199601010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Readers will note significant changes in Annals' design, beginning with this issue. These changes were made partly for aesthetic reasons; we make no apology for the journal looking clean, bold, and open, and being a pleasure to use. At the same time, we are also very much aware that over the years Annals has established its own distinctive visual style, and we've been careful to preserve the best and most characteristic elements of that style.More importantly, we've made these changes with a serious professional purpose in mind: to render the content as accessible and usable as possible. The meta-message ...References1. Mulrow CD. The medical review article: state of the science. Ann Intern Med. 1987; 106:485-8. Google Scholar2. Chalmers I, Altman DG, eds. Systematic Reviews. London: BMJ Publications: 1995. Google Scholar Author, Article, and Disclosure InformationAuthors: Frank Davidoff, MD, Editor PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byKnowledge Management: How to Keep up With the LiteratureWriting a Review Article for AJRCCM 1 January 1996Volume 124, Issue 1_Part_1Page: 67-68KeywordsBlood pressureConflicts of interestDisclosureFoodHormonesInformation storage and retrievalResearch designResearch fundingStatistical methodsSystematic reviews ePublished: 15 August 2000 Issue Published: 1 January 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Role of PGE2 in the modulation of the adrenergic response in man
Authors: G. G N. SERNERI, G MASOTTI, S CASTELLANI, L SCARTI, F TROTTA, M MANNELLI
Journal: Cardiovascular Research (1983)

The influence of sympathetic stimulation (SS) (achieved by 2 min cold application) on the plasma concentration of PGE2, PGF2α (radioimmunoassay), noradrenaline (NA) and adrenaline (A) (radioenzymatic assay) and on forearm vascular resistance (indirect measurement, FVR) was studied in 16 healthy volunteers before and after cyclooxygenase inhibition by indomethacin (200 mg per day orally for 3 days) and lysine acetylsalicylate (corresponding to 10 mg·kg−1 of acetylsalicylic acid -ASA- iv). SS induced a sharp increase in PGE2 (from 8.1 ±4.3 pg·ml−1 before SS to 23.9±6.5, P<0.001 2 min after the beginning of SS and then to 18.9± 10.2, P<0.001 to 8.4±3.9, NS, 4and 12 min respectively after the beginning of SS). Plasma levels of PGF2α remained undetectable both before and after SS. The increase in PGE2 was associated with a simultaneous increase in NA (from 13.4±24.2 to 204.1±67.2 pg·ml−1, P<0.001 during SS and 140.6±39.5, NS at the end of the experiment), whereas A did not vary significantly. FVR increased significantly only during SS. ASA did not affect PGE2 and NA plasma levels at rest or after SS. No PGE2 was detected during IND administration either before or after SS. IND significantly increased NA plasma concentration at the observation made 12 min after the beginning of SS (185.2±64.3 pg·ml−1 vs basal values of 135.9±46.2 pg·ml−1, P<0.05). FVR after SS was found to be higher and remained elevated for a significantly longer period after IND in comparison with the control period and after ASA. These findings indicate that, in man, PGE2 may be involved in modulating the adrenergic response by intervening at the pre-junctional level, probably facilitating the disposal of the neurotransmitter.
Irritable bowel syndrome as a cause of chronic pain in women attending a gynaecological clinic.
Authors: C M Farquhar, P W Reginald, R W Beard
Journal: BMJ (1987)

A;g~~4 5Map showing distribution of significant leukaemia incidence ratios (incidence ratio > 1 -0; p<005) at ages 0-14 in 143 electoral wards in West Berkshire and Basingstoke and North Hampshire District Health Authorities.Figures are numbers of cases.
Molecular mechanisms of contraction.
Authors: M I Noble, G H Pollack
Journal: Circulation Research (1977)

MECHANICAL phenomena in muscle are frequently interpreted by invoking cross-bridge mechanisms.These interpretations imply that tension development and shortening are brought about by the action of physical cross-links formed transiently between the interdigitating thick and thin filaments that comprise the contractile apparatus.Recently, we have noticed a growing number of experimental observations which can be reconciled with the cross-bridge mechanism only if additional submechanisms are invoked.This increasing complexity makes us wonder whether the possibility of an altogether different and less complex mechanism ought not to be summarily dismissed.The cross-bridge mechanism arose out of early electron micrographic observations: These showed that radial projections from the thick filaments appeared to terminate on the thin filaments. 1" 3 As these links were the only visible means by which interaction of filaments could take place, it was suggested that they might function as the generators of contractile force and provide the means by which actin in thin filaments could interact with myosin in the thick filaments. 2 This suggestion inspired a detailed exposition of crossbridge dynamics in which each link was postulated to attach and detach many times per second, producing shortening and/or tension with each stroke. 4 The elements of this scheme were consistent not only with the basic structure, but with the energetics, mechanics, and biochemistry of muscle as well.However, the scheme ultimately proved inadequate in light of more recent data. 5' 6 which underscored the need for more elaborate structural models. 7" 9 One such model is shown in Figure 1A-C.A theory of cross-bridge dynamics compatible with these newer structural features was proposed by Huxley and Simmons. 10and is now being accorded a great deal of attention.The scheme (Fig. ID) assumes that the arm of
Clinical relevance of gestational thrombocytopenia of &lt;100,000/μl
Authors: Eyal Anteby, Oded Shalev
Journal: American Journal of Hematology (1994)

Abstract We identified 22 women with thrombocytopenia of &lt;100,000/μl found incidentally during pregnancy and prospectively monitored their platelet count and clinical outcome for a minimum of 6 months postpartum. During the study period, four women became pregnant twice, accounting for a total of 26 pregnancies. The lowest platelet count during pregnancy was 65,600/μl ± 19,400 (mean ± SD), and at delivery 84,500/μl ± 32,300 ( P &lt; 0.02). The thrombocytopenia was virtually asymptomatic in all patients during the pregnancy and delivery, whether vaginal or surgical. Neonatal platelet counts (n = 18) were normal (270,700/μl ± 69,900), and none of the newborns (n = 24) had a bleeding diathesis. Normalization of the platelet count (i.e., &gt;150,000/μl) was documented in 18 patients within 1 month postpartum, in five within 3 months postpartum, and in two as late as 5 months after delivery. One woman did not recover from the thrombocytopenia and eventually developed other stigmata of an autoimmune disease. Long‐term follow‐up showed recurrence of thrombocytopenia in four patients: three in the context of a subsequent pregnancy and one who developed idiopathic thrombocytopenic purpura. Retrospective analysis of blood counts obtained from 12 previous pregnancies demonstrated thrombocytopenia of a similar degree to the index pregnancy. We conclude that gestational thrombocytopenia of &lt;100,000/μl is clinically a benign phenomenon that can recur in subsequent pregnancies and is not accompanied by neonatal thrombocytopenia. In some cases, however, pregnancy‐associated thrombocytopenia may be a manifestation of an autoimmune disease with its attendant implications for the neonate. Since the differential diagnosis between the two conditions may be difficult to establish when first encountered during pregnancy, a conservative approach emphasizing careful surveillance and guarded reassurance is justified as long as the platelet counts are &gt;50,000/μl. © 1994 Wiley‐Liss, Inc.
Closing in on a “familial cholestasis gene”
Authors: Joseph Wagstaff, Maureen M. Jonas
Journal: Hepatology (1995)

It is now feasible to map disease genes by screening the genome for linkage disequilibrium between the disease and marker alleles. This report presents the first application of this approach for a previously unmapped locus. A gene for benign recurrent intrahepatic cholestasis ( BRIC ) was mapped to chromosome 18 by searching for chromosome segments shared by only three distantly related patients. The screening results were confirmed by identifying an extended haplotype conserved between the patients. Probability calculations indicate that such segment sharing is unlikely to arise by chance. Searching the genome for segments shared by patients is a powerful empirical method for mapping disease genes. Computer simulations suggest that, in appropriate populations, the approach may be used to localize genes for common diseases. A locus for progressive familial intrahepatic cholestasis (PFIC), also known as Byler disease, has been mapped to a 19 cM region of chromosome 18 by a search for shared segments, using patients from the Amish kindred in which the disorder was originally described. A similar liver disease, benign recurrent intrahepatic cholestasis (BRIC), recently has been mapped to the same region, suggesting that these two diseases are caused by mutations in the same gene. Although PFIC and BRIC are clinically distinct diseases, episodic attacks of jaundice and pruritus, with elevated concentrations of bile acid in serum, are seen in both disorders. In PFIC patients, these attacks result in progressive liver damage and death. The clinical and biochemical features of PFIC and BRIC are suggestive of a defect in primary bile acid secretion. The biology of bile secretion is of great interest because of its vital importance in digestion of dietary fats as well as in secretion of xenobiotics and metabolic waste products. Cloning of the gene (or genes) responsible for PFIC and BRIC will likely provide important insights into this pathway. (Reprinted by permission of Oxford University Press).
Neovascularization From Coronary Artery Leaking to Fungus Ball in the Lung
Authors: Kwang Kon Koh, Seung Hwan Han, Jeong Ho Kim, Sang Jin Lee, Jin Yong Kim
Journal: Circulation (2006)

A 68-year-old woman came to the clinic for evaluation of an operation risk.She had the sensation of a mass in her abdomen for 10 years, and ventral hernia was diagnosed.Her weight was 96 kg and her height was 157 cm; her body mass index was 38.95 kg/m 2 .She had a history of diabetes for 3 years.She also had a history of aspergillosis, which had been cured 10 years ago.She reported no chest pain on exercise.Chest radiography demonstrated a fungus ball in the left upper lung (Figure 1).Radionuclide imaging (technetium 99m sestamibi scan) showed reversible, moderate-sized perfusion defects in the apical to mid-inferior area, suggesting right coronary artery lesion.The echocardiogram showed no abnormal findings.The coronary angiogram revealed neovascularization from the distal left circumflex artery and proximal right coronary artery to the left upper lung (Figure 2).There was no significant stenosis in the left and right coronary arteries.To confirm the site where the neovascularization leaked, we performed a multislice computed coronary angiogram.Axial images of the thorax in the mediastinal and lung settings showed close proximity between the left atrioventricular groove and a cavity mass.However, we failed to observe clear neovascularization flow because of the patient's body fat and because the vessels had a very thin diameter.Instead, we confirmed a definite fungus ball in the left upper lung (Figure 3).We concluded neovascularity from both coronary arteries leaking to a fungus ball in the left lung.
A REPORT ON THE "INFLUENZA" EPIDEMIC OF 1918
Authors: O. H. Gotch, H. E. Whittingham
Journal: BMJ (1918)

Malfunction of a computer-assisted digital gamma camera is reported. Despite what appeared to be adequate acceptance testing, an error in the system gave rise to switching of images and identification text. A suggestion is made for using a hot marker, which would avoid the potential error of misinterpretation of patient images.
Benefits of Male Circumcision
Authors: Jeffrey D. Klausner, Brian J. Morris
Journal: JAMA (2012)

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