tbuckley/cabot-search huggingface dataset:
Effect of Induced Renal Hemodynamic Alterations on Urine Protein Excretion in "Fixed and Reproducible" Orthostatic Proteinuria.
Authors: R. R. Robinson
Journal: Annals of Internal Medicine (1963)

s1 April 1963Effect of Induced Renal Hemodynamic Alterations on Urine Protein Excretion in "Fixed and Reproducible" Orthostatic Proteinuria.R. R. Robinson, M.D., W. G. Glenn, Ph.D.R. R. Robinson, M.D.Search for more papers by this author, W. G. Glenn, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-743_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSome 15 per cent of patients with asymptomatic proteinuria have "fixed and reproducible" orthostatic proteinuria. The recent description of altered glomerular structure in this disorder has suggested that its pathogenesis may well be different from that of the more common "transient" type of orthostatic proteinuria. The relative importance of renal circulatory adjustments to upright proteinuria was evaluated in 48 young males with fixed and reproducible orthostatic proteinuria.Differing responses of inulin and PAH clearance were induced by (1) unmodified orthostasis, (2) recumbent thigh tourniquet inflation, (3) upright positive-pressure to the lower extremities, and (4) orthostasis after prior hydralazine administration. Urine... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1963Volume 58, Issue 4Page: 743-743KeywordsExcretionHemodynamicsOrthostasisPathogenesisProteinsProteinuriaRenal circulationUrine Issue Published: 1 April 1963 PDF downloadLoading ...
319 Treatment with pegylated-interferon alfa 2B in relapsers to standard interferon + ribavirin in chronic hepatitis C: Efficacy and safety results from a randomized multicentric French study
Authors: I PORTAL, D BOTTAFRIDLUND, M BOULIERE, M ROTILY, P HALFON, P COUZIGOU, K BARANGE, V CANVA, D LARREY
Journal: Hepatology (2003)
High-Dosage Heparin Treatment of Large Burns
Authors: S. Berkessy
Journal: JAMA (1973)

<h3>To the Editor.—</h3> The article of M. J. Saliba et al (225:261-269, 1973) and the editorial of Francis D. Moore (225:294-295, 1973) reported and commented upon the heparin treatment of large burns in humans. The excellent results proved the value of the authors' method. I should like to underline another important advantage of the high-dosage heparin treatment in burns: the successful prevention of disseminated intravascular coagulation (DIS)-related acute renal insufficiency. In our patients with severe coagulation disorders due to obstetrical complications, the DIC-related renal insufficiency could be prevented only if the Lee-White clotting time was maintained above 30 minutes. Insufficient heparinization in burns, as well as in other forms of DIC, does not eliminate the danger of bilateral renal cortical necrosis. In addition, we did not encounter occult or manifest bleeding, if adequate doses of heparin were given during the treatment of DIC or during hemodialysis.
Europe’s research councils call for spending to be doubled to 0.25% of GDP
Authors: Rory Watson
Journal: BMJ (2007)

An initiative from the World Health Organization has been launched to make drugs as simply and safely available to children as they are to adults.Speaking last week at the launch in London, WHO's assistant director general, Howard Zucker, said that "there is a gap between the availability of children's medicines and the actual need.That gap is global and must be addressed."The problem is not new."It's a reality we've lived with for many years," Dr Zucker admitted.Most drugs are developed for and tested in adults.Less than a third come in a form appropriate for children.As a result, many children are treated using drugs that are effectively unlicensed.Medical staff may be obliged to estimate the appropriate fraction of an adult dose, and then crush tablets or extract part of the contents of a capsule.One study by WHO has shown that drug errors are three times as common in children as in adults (JAMA 2001;285:2114-20).Unicef claims that of the 10 million under 5s who will have died by the end of this year, specific products for children could have saved two thirds.Hans Hogerzeil, WHO's director of drugs policy and standards, listed areas in which more effort is needed, in which drugs do exist but were of unknown safety and efficacy.Examples include agents for dealing with tuberculosis; HIV; and several neglected conditions, such as schistosomiasis.Development is essential in areas in which adult drugs need to be adapted to make them suitable and safe for children.Illnesses in this category include malaria, neonatal infections that could be treated by antibiotics, and tuberculosis.Finally, said Dr Hogerzeil, improved access is the priority where drugs exist but are prevented from reaching the children who needed them because of cost."Make medicines child size" is at www.who.int/childmedicines/en. WHO launches� campaign to make drugs� s�afer for childrenUK NEWS GMC approves change in the standard of proof, p 1230 World NEWS �d�� �a�� a��o�� dr�g co�panies to pro�ote off��a�e� �ses, p 122� �d�� �a�� a��o�� dr�g co�panies to pro�ote off��a�e� �ses, p 122� , p 122� ��j.co�Go�iath �oves into hea�thcare records Go�iath �oves into hea�thcare records
Hypersensitivity to cefuroxime with good tolerance to other betalactams
Authors: C. Marcos Bravo, I. Luna Ortiz, R. González Vázquez
Journal: Allergy (1995)

A 60‐year‐old man developed an anaphylactic reaction immediately after administration of intramuscular sodium cefuroxime. By means of oral controlled challenge, the reaction was reproduced with a smaller dose of cefuroxime axetil. Cross‐reactivity with other betalactam antibiotics was ruled out by in vivo tests. This case supports once again the relevance of the side‐chain in betalactam allergy.
Cost Effectiveness in Maternal and Child Health
Authors: Arthur L. Levin
Journal: New England Journal of Medicine (1968)

THE link between the federal Government's decision to spend additional amounts on any aspect of health and a subsequent improvement in the health status of people is a tenuous one. Some authors suggest that a relation between increased federal expenditures and better health is not demonstrable. At the same time, health administrators are increasingly being called on by Congress and those responsible for the annual budget to answer questions such as the following: For a given additional amount of money spent, will program A or program B have a greater impact on lowering infant mortality, on increasing the numbers of . . .
Experimental Phylogeny of Neutrally Evolving DNA Sequences Generated by a Bifurcate Series of Nested Polymerase Chain Reactions
Authors: Gerdine F. O. Sanson, Silvia Y. Kawashita, Adriana Brunstein, Marcelo R. S. Briones
Journal: Molecular Biology and Evolution (2002)

A known phylogeny was generated using a four-step serial bifurcate PCR method. The ancestor sequence (SSU rDNA) evolved in vitro for 280 nested PCR cycles, and the resulting 15 ancestor and 16 terminal sequences (2,238 bp each) were determined. Parsimony, distance, and maximum likelihood analysis of the terminal sequences reconstructed the topology of the real phylogeny and branch lengths accurately. Divergence dates and ancestor sequences were estimated with very small error, particularly at the base of the phylogeny, mostly due to insertion and deletion changes. The substitution patterns along the known phylogeny are not described by reversible models, and accordingly, the probability substitution matrix, based on the observed substitutions from ancestor to terminal nodes along the known phylogeny, was calculated. This approach is an extension of previous studies using bacteriophage serial propagation, because here mutations were allowed to occur neutrally rather than by addition of a mutagenic agent, which produced biased mutational changes. These results provide for the first time biochemical experimental support for phylogenies, divergence date estimates, and an irreversible substitution model based on neutrally evolving DNA sequences. The substitution preferences observed here (A to G and T to C) are consistent with the high G+C content of the Thermus aquaticus genome. This suggests, at least in part, that the method here described, which explores the high Taq DNA polymerase error rate, simulates the evolution of a DNA segment in a thermophilic organism. These organisms include the bacterial rod T. aquaticus and several Archaea, and thus, the method and data set described here may well contribute new insights about the genome evolution of these organisms.
Implantable Cardioverter-Defibrillators: Implications for the Nonelectrophysiologist
Authors: Sergio L. Pinski
Journal: Annals of Internal Medicine (1995)

Purpose: To review clinical scenarios in which nonelectrophysiologist physicians may interact with patients who have implantable defibrillators. Data Sources: Peer-reviewed original articles and reviews addressing aspects of implantable defibrillator therapy that are relevant to the clinician. Data Synthesis: The capacity of implantable defibrillators to recognize and treat tachyarrhythmias can be temporarily disabled by placing a magnet on top of all devices. General surgery, radiotherapy, lithotripsy, and electroconvulsive therapy can usually be safely done under continuous electrocardiographic monitoring in patients with implantable defibrillators. The device should be deactivated before the procedure is done and reactivated and reassessed immediately afterward. Magnetic resonance imaging is usually contraindicated in patients with implantable defibrillators. The presence of an implantable defibrillator should not deter standard resuscitation techniques. Multiple defibrillator discharges in a short period of time represent a serious problem. Causes of multiple discharges include ventricular electric storm, inefficient defibrillation, nonsustained ventricular tachycardia, and inappropriate shocks caused by supraventricular tachyarrhythmias or oversensing of signals. These patients should be initially evaluated in a setting that allows electrocardiographic monitoring and cardiac resuscitation. The defibrillator should be deactivated if inappropriate firing is documented. Infections of implantable defibrillator systems are potentially life-threatening, and empiric oral antibiotic therapy should never be given when this possibility exists. Adjustment disorders specific to the defibrillator, including anxiety with secondary panic reaction; defibrillator dependence, abuse, or withdrawal; and imaginary shocks are not uncommon. Conclusions: Defibrillator therapy has become increasingly popular and complex. A basic understanding of these devices and skills in the short-term management of device-related problems is valuable for most physicians. These management guidelines will facilitate delivery of optimal care when specialized staff and material resources are not available.
Long-term graft patency (3 years) after coronary artery surgery. Effects of aspirin: results of a VA Cooperative study.
Authors: S Goldman, J Copeland, T Moritz, W Henderson, K Zadina, T Ovitt, K B Kern, G Sethi, G V Sharma, S Khuri
Journal: Circulation (1994)

BACKGROUND The long-term success of coronary bypass surgery is dependent on graft patency after surgery. This trial was designed to determine if aspirin improved saphenous vein graft or internal mammary artery (IMA) graft patency between 1 and 3 years after coronary artery bypass grafting (CABG). METHODS AND RESULTS After receiving aspirin 325 mg/d for 1 year after CABG and undergoing a 1-year postoperative cardiac catheterization, patients were randomized to receive either aspirin (325 mg) or placebo for 2 additional years. Angiography was performed 3 years after surgery to determine the primary end point-saphenous vein graft patency in 288 patients and IMA graft patency in 167 patients. At 3 years after CABG, the saphenous vein graft occlusion rate was 17.0% (62 of 365) for patients treated with aspirin compared with 19.7% (74 of 376) for those who received placebo (P = .404). For saphenous vein grafts that were patent at 1 year, the occlusion rate at 3 years was 4.8% (15 of 313) for patients treated with aspirin compared with 4.2% (13 of 310) for patients who received placebo (P = .757). At 3 years, the IMA graft occlusion rate was 10.3% (8 of 78) for patients treated with aspirin compared with 7.9% (7 of 89) for patients who received placebo (P = .594). For IMA grafts that were patent at 1 year, the occlusion rate was 4.3% (3 of 70) for patients treated with aspirin compared with 2.5% (2 of 81) for patients who received placebo (P = .541). CONCLUSIONS These data suggest that aspirin treatment does not improve saphenous vein graft or IMA graft patency between 1 and 3 years after CABG.
Pathology of Glomerular Disease
Authors: Ashton B. Morrison
Journal: JAMA (1984)

This is an up-to-date series of reviews of various aspects of disease of the glomeruli. It opens with an essay by the editor, Dr Rosen, on the classification of glomerular disease.  Despite the extensive accumulation of well-documented observations concerning the various light and electron microscopic changes and the patterns of immunofluorescence in glomerular disease, even the best efforts of the nosologist are thwarted by our limited understanding of the underlying mechanisms of the response of the glomerulus to injury. Dr Rosen offers in his contribution one of the best efforts available in this area. It is accompanied by useful tables culled from other sources, and, while comprehensive, remains brief and readable. Indeed he manages to draw attention to the congenital nephrotic syndromes, and the nail-patella syndrome, which are strangely omitted from the chapter addressing the topic of hereditary nephropathy.  The rest of the chapters cover the various aspects of glomerular
Sildenafil Increased Exercise Capacity during Hypoxia at Low Altitudes and at Mount Everest Base Camp
Authors: Hossein A. Ghofrani, Frank Reichenberger, Markus G. Kohstall, Eike H. Mrosek, Timon Seeger, Horst Olschewski, Werner Seeger, Friedrich Grimminger
Journal: Annals of Internal Medicine (2004)

Background: Alveolar hypoxia causes pulmonary hypertension and enhanced right ventricular afterload, which may impair exercise tolerance. The phosphodiesterase-5 inhibitor sildenafil has been reported to cause pulmonary vasodilatation. Objective: To investigate the effects of sildenafil on exercise capacity under conditions of hypoxic pulmonary hypertension. Design: Randomized, double-blind, placebo-controlled crossover study. Setting: University Hospital Giessen, Giessen, Germany, and the base camp on Mount Everest. Participants: 14 healthy mountaineers and trekkers. Measurements: Systolic pulmonary artery pressure, cardiac output, and peripheral arterial oxygen saturation at rest and during assessment of maximum exercise capacity on cycle ergometry 1) while breathing a hypoxic gas mixture with 10% fraction of inspired oxygen at low altitude (Giessen) and 2) at high altitude (the Mount Everest base camp). Intervention: Oral sildenafil, 50 mg, or placebo. Results: At low altitude, acute hypoxia reduced arterial oxygen saturation to 72.0% (95% CI, 66.5% to 77.5%) at rest and 60.8% (CI, 56.0% to 64.5%) at maximum exercise capacity. Systolic pulmonary artery pressure increased from 30.5 mm Hg (CI, 26.0 to 35.0 mm Hg) at rest to 42.9 mm Hg (CI, 35.6 to 53.5 mm Hg) during exercise in participants taking placebo. Sildenafil, 50 mg, significantly increased arterial oxygen saturation during exercise (P = 0.005) and reduced systolic pulmonary artery pressure at rest (P < 0.001) and during exercise (P = 0.031). Of note, sildenafil increased maximum workload (172.5 W [CI, 147.5 to 200.0 W]) vs. 130.6 W [CI, 108.8 to 150.0 W]); P < 0.001) and maximum cardiac output (P < 0.001) compared with placebo. At high altitude, sildenafil had no effect on arterial oxygen saturation at rest and during exercise compared with placebo. However, sildenafil reduced systolic pulmonary artery pressure at rest (P = 0.003) and during exercise (P = 0.021) and increased maximum workload (P = 0.002) and cardiac output (P = 0.015). At high altitude, sildenafil exacerbated existing headache in 2 participants. Limitations: The study did not examine the effects of sildenafil on normoxic exercise tolerance. Conclusions: Sildenafil reduces hypoxic pulmonary hypertension at rest and during exercise while maintaining gas exchange and systemic blood pressure. To the authors' knowledge, sildenafil is the first drug shown to increase exercise capacity during severe hypoxia both at sea level and at high altitude.
Abstract 3198: The CEE-Selector Assay: A tool for the identification of rare allele variants
Authors: Vassilios Alexiadis, Tim Watanaskul, Karena Kosco, Lyle Arnold
Journal: Cancer Research (2012)

Abstract Molecular assays for the identification of rare allele occurrences are important tools for proper cancer classification and treatment. A prime example is the T790M mutation in EGFR which leads to resistance to the tyrosine kinase inhibitors gefitinib (Iressa®) and erlotinib (Tarceva®) used in the treatment of non-small cell lung cancer (NSCLC). Identification of the T790 mutation in cancer-shed particles in blood (either as whole cells or subcellular vesicles) calls out the need for an alternative cancer treatment. We have developed a highly sensitive PCR-based assay which allows the identification of the T790M mutation in blood plasma (either when present in mRNA or genomic DNA). The assay combines Real-Time PCR as well as melt curve analysis of the mutant PCR product and is followed by sequencing to verify the presence of the mutation. The Selector Assay is based on a wild-type specific PCR blocker and allows the mutant template to be amplified in a high background of wild-type template. A few copies of T790M mutant can be detected in greater than a 1000-fold excess of wild-type. Data using the Selector Assay with clinical lung cancer samples showing the identification of T790M in genomic DNA as well as mRNA in blood plasma and in CTCs will be presented. The Selector Assay can be applied to other mutations relevant to cancer and is a valuable tool for clinical diagnostics. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3198. doi:1538-7445.AM2012-3198
Encephalopathy Following Jejunoileostomy
Authors: Asif Ayub
Journal: JAMA (1981)

A neurological syndrome characterized by episodes of confusion, slurred speech, and unsteadiness is described in patients who have undergone jejunoileostomy for obesity. This syndrome has been noted in seven of 110 patients studied, although it may be more common. It appears to subside spontaneously or may respond to oral food restriction, with or without intravenous fluid plus vitamins and minerals. Episodes tend to recur in a given patient. Reversible changes in the EEG have been observed. Pertinent clinical and laboratory findings are described but no definite etiologic factor has been identified. The possible mechanisms involved in this syndrome of metabolic encephalopathy following jejunoileostomy are discussed.
Impaired endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus.
Authors: M T Johnstone, S J Creager, K M Scales, J A Cusco, B K Lee, M A Creager
Journal: Circulation (1993)

BACKGROUND Endothelium-dependent vasodilation is abnormal in experimental models of diabetes mellitus. We postulated that abnormalities of endothelial function are also present in patients with insulin-dependent diabetes mellitus and may contribute to the pathogenesis of vascular disease in these individuals. METHODS AND RESULTS Vascular reactivity was measured in the forearm resistance vessels of 15 patients with insulin-dependent diabetes mellitus and 16 age-matched normal subjects. No patient had hypertension or dyslipidemia. Each subject was pretreated with aspirin to inhibit endogenous production of prostanoids. Methacholine chloride (0.3 to 10 micrograms/min) was administered via the brachial artery to assess endothelium-dependent vasodilation. Sodium nitroprusside (0.3 to 10 micrograms/min) and verapamil (10 to 300 micrograms/min) were infused intra-arterially to assess endothelium-independent vasodilation; phenylephrine (0.3 to 3 micrograms/min) was administered to examine vasoconstrictor responsiveness. Forearm blood flow was determined by venous occlusion plethysmography, and dose-response curves were generated for each drug. Basal forearm blood flow in diabetic and normal subjects was comparable (2.6 +/- 0.2 versus 2.1 +/- 0.3 mL x 100 mL-1 x min-1, respectively; P = NS). The forearm vasodilative response to methacholine was less in diabetic than in normal subjects. At the highest dose of methacholine, the forearm blood flow increased 9.5 +/- 1.1 mL x 100 mL-1 x min-1 in diabetic subjects and 15.3 +/- 1.4 mL.100 mL-1 x min-1 in normal subjects (P &lt; .01). The forearm blood flow responses to nitroprusside and verapamil and the forearm vasoconstrictor responses to phenylephrine were similar in diabetic and healthy subjects. In diabetic subjects, endothelium-dependent vasodilation correlated inversely with serum insulin concentration but not with glucose concentration, glycosylated hemoglobin, or duration of diabetes. CONCLUSIONS Endothelium-dependent vasodilation is abnormal in forearm resistance vessels of patients with insulin-dependent diabetes mellitus. This abnormality may be relevant to the high prevalence of vascular disease that occurs in these individuals.
Website of the week: Interactive patient simulators
Authors: M. Mullner
Journal: BMJ (2002)

When it comes to diagnosing and treating arrhythmias (p 719) and other potentially life threatening conditions, many doctors feel uneasy. You need lots of training and experience to feel confident in this area. The web lends itself to interactive skills assessment and learning.

Imagine you are making your hospital ward round and a patient collapses right in front of you. What would you …
Post-partum Intra-abdominal Separation of Uterus
Authors: J. J. S. Wassenaar
Journal: BMJ (1947)

Necropsy was performed at 2.30 p.m. on March 9; the ieport was as follows: "The body was that of a fat woman of average build.Rigor Amortis was absent.The peritoneal cavity contained &tbout 4 oz.(114 ml.) of blood-stained fluid; there was no evidence of fat necrosis.Liver: size normal; rather fatty.Gall-bladder: size normal; contained six faceted pigment stones.-Spleen: normal.Kidneys: both intensely congested and haemorrhagic.Suprarenals: congested.Pancreas: size normal; generally congested; the tail was very intensely haemorrhagic.Stomach.: very congested; mucous mnembrane eroded and, in places, desquamated; no perforation.Bowel: congested only; no perforation.Bladder: normal; con- tained about 2 oz.(57 ml.) of turbid urine which, on examination, showed copious albumin, sugar, ketones, and blood-microsc'opically there were numerous erythrocytes and epithelial cells.Pleural *cavities: normal.Lungs:
Never say die?
Authors: Priya Shetty
Journal: The Lancet (2007)

"I don't want to achieve immortality through my work", said Woody Allen, "I want to achieve it through not dying". He's not alone. Bryan Appleyard's latest book details a growing brigade of "immortalists" convinced that old age and death are mere technicalities that medical science will one day overcome. Appleyard seems alternately bemused and beguiled by this group of people who are either freaks or unique, depending on your view. The notion of immortality is as old as humanity, and the book embraces several strands of thinking from mythology, philosophy, and religion.