tbuckley/cabot-search huggingface dataset:
Polycythemia Vera in Acromegaly
Authors: Shinji Teramoto
Journal: Annals of Internal Medicine (1997)

Letters1 January 1997Polycythemia Vera in AcromegalyShinji Teramoto, MD and Yasuyoshi Ouchi, MDShinji Teramoto, MDUniversity of Tokyo; Tokyo 113, JapanSearch for more papers by this author and Yasuyoshi Ouchi, MDUniversity of Tokyo; Tokyo 113, JapanSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-1-199701010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Grellier and colleagues [1] recently found that complete remission of polycythemia vera in a patient with acromegaly was achieved by the surgical cure of acromegaly, suggesting that growth hormone, insulin-like growth factor 1, or both may induce polycythemia. The authors did not consider another possible cause of polycythemia: The condition may occur in acromegaly as a result of hypoxemia related to sleep apnea.Because obstructive sleep apnea occurs commonly in acromegaly [2], nocturnal sustained hypoxemia or periodical oxyhemoglobin desaturation is often found in acromegaly. Experimental data show that hypoxemia stimulates erythropoiesis. Furthermore, obstructive sleep apnea, hypoxic pulmonary ...References1. Grellier P, Chanson P, Casadevall N, Abboud S, Schaison G. Remission of polycythemia vera after surgical cure of acromegaly. Ann Intern Med. 1996; 124:495-6. Google Scholar2. Grunstein RR, Ho KY, Sullivan CE. Sleep apnea in acromegaly. Ann Intern Med. 1991; 115:527-32. Google Scholar3. Mickelson SA, Rosenthal LD, Rock JP, Senior BA, Friduss ME. Obstructive sleep apnea syndrome and acromegaly. Otolaryngology. 1994; 111:25-30. Google Scholar4. Grunstein RR, Ho KY, Sullivan CE. Effect of octreotide, a somatostatin analog, on sleep apnea in patients with acromegaly. Ann Intern Med. 1994; 121:478-83. Google Scholar5. Krieger J, Sforza E, Barthelmebs M, Imbs JL, Kurtz D. Overnight decrease in hematocrit after nasal CPAP treatment in patients with OSA Chest. 1990; 97:729-30. Google Scholar Author, Article, and Disclosure InformationAuthors: Shinji Teramoto, MD; Yasuyoshi Ouchi, MDAffiliations: University of Tokyo; Tokyo 113, Japan PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAcromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) DatabaseA Case of Idiopathic Myelofibrosis Associated with Acromegaly Patient 1 January 1997Volume 126, Issue 1Page: 87KeywordsAcromegalyHypoxiaInsulin like growth factor 1OxyhemoglobinPolycythemiaPolycythemia veraSleep apneaSomatostatinSurgeryVasoconstriction ePublished: 15 August 2000 Issue Published: 1 January 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Decreased Exercise Heart Rate and Blood Pressure Response in Diabetic Subjects With Cardiac Autonomic Neuropathy
Authors: Joel K Kahn, Benjamin Zola, Jack E Juni, Aaron I Vinik
Journal: Diabetes Care (1986)

Abnormal hemodynamic responses to exercise have been observed in diabetic subjects, but the pathogenesis and significance remain uncertain. We used maximal treadmill exercise to study 32 subjects with long-term insulin-dependent diabetes without clinical evidence of cardiac disease. Two of the 32 had occult ischemic heart disease revealed by stress electrocardiography and myocardial-perfusion scintigraphy and were excluded from subsequent analysis. In the remaining 30 subjects, we compared the responses to exercise of the 17 subjects with cardiac autonomic neuropathy diagnosed by noninvasive maneuvers (group 1) with the 13 without (group 2). At rest, the pressure-rate product (PRP) was higher in group 1 (114.0 ± 5.7 vs. 95.9 ± 5.3, P &amp;lt; .05). With maximal exercise the increase in heart rate ('44.6 ± 4.8 vs. 79.0 ± 5.4 beats/min, P &amp;lt; .001), systolic blood pressure (36.8 ± 5.9 vs. 55.0 ± 5.8 mmHg, P = .02), and the PRP (102.0 ± 7.3 vs. 182.0 ± 8.2, P &amp;lt; .001) were all lower in group 1 than in group 2, despite similar total treadmill times (631 ± 47 vs. 587 ± 40 s, P &amp;gt; .1). At each stage of exercise, the increase in heart rate and systolic blood pressure was lower in group 1 patients. The severity of cardiac autonomic neuropathy correlated inversely with the maximal increase in heart rate(γ = – .68, P &amp;lt; .001) and the PRP (γ = − .58, P &amp;lt; .005). Age, duration of diabetes, and the presence and severity of microvascular disease did not correlate with any of the hemodynamic parameters. Thus, cardiac autonomic neuropathy is associated with an impairment of the hemodynamic responses to exercise in diabetic subjects without ischemic heart disease.
Teaching Physicians to Practice What They Will Preach
Authors: JOANN G. Elmore
Journal: JAMA (1985)

<h3>To the Editor.—</h3> In readingThe Journal's Nov 23/30 article entitled "Do Physicians Preach What They Practice"?,<sup>1</sup>we wonder why medical students are not taught in medical school to practice what they will eventually be preaching? At Stanford (Calif) Medical School, we are trying to teach medical students how to take care of their own health. We have developed and are evaluating a medical school course on personal health that offers practical advice and assistance on aspects of one's own health. It becomes clear in medical school that the demands of being a physician, while providing some of the most exciting and fulfilling work, also challenge one's ability to live a healthy, wholesome, and wellrounded life. It is ironic that medical school may actually be hazardous to one's health. While students are learning to improve the health of others, they are often tearing away at their own emotional,
Universal Health Insurance Coverage or Economic Relief — A False Choice
Authors: Jonathan Gruber
Journal: New England Journal of Medicine (2009)

These are exciting times for advocates of universal health care coverage, with sizable Democratic majorities in both houses of Congress and a Democratic president who made universal coverage a central pledge of his campaign. Indeed, Senators Max Baucus (D-MT) and Edward Kennedy (D-MA) are hard at work on universal-coverage legislation, and Senators Ron Wyden (D-OR) and Robert Bennett (R-UT) have already submitted a bipartisan bill that would accomplish that goal. But despite this enthusiasm, many observers are skeptical that the United States can foot the bill for universal coverage in such economically trying times. Universal coverage, their argument runs, is . . .
Rheumatoid pleural effusion with "R.A. cells" in the pleural fluid.
Authors: D. S. Carmichael, D. N. Golding
Journal: BMJ (1967)

Granular white cells containing cytoplasmic inclusions may be found in the synovial fluid of many patients with rheumatoid arthritis.First reported by McCarty and by Hollander in Arthritis and Rheumatism (vol.6,[13][14] in 1963, their existence has been confirmed by others (Astorga and Bollet,
Dominant negative MORT1/FADD rescues mice from CD95 and TNF-induced liver failure
Authors: Marcus Schuchmann, Eugene E. Varfolomeev, Frank Hermann, Felix Rueckert, Dennis Strand, Heinz Koehler, Susanne Strand, Ansgar W. Lohse, David Wallach, Peter R. Galle
Journal: Hepatology (2003)

Derangement of the apoptotic program is considered an important cause of liver disease. It became clear that receptor-mediated apoptosis is of specific interest in this context, and CD95 and CD120a, both members of the tumor necrosis factor (TNF) receptor superfamily, are the most prominent cell death receptors involved. The death signal is induced upon ligand binding by recruitment of caspases via the adapter molecule MORT1/FADD to the receptor and their subsequent activation. To investigate the role of MORT1/FADD in hepatocyte apoptosis, we generated transgenic mice expressing liver-specific dominant negative mutant. Mice looked grossly normal; breeding and liver development were not different compared with wild-type littermates. Expression of the transgene completely protected animals from liver failure induced by the anti-Fas antibody Jo2, whereas control animals died as expected 3 to 6 hours after i.p. injection of 15 μg antibody from acute hemorrhagic liver failure. Histology demonstrated only moderate inflammatory changes in the transgenic animals, whereas severe hemorrhagic hepatitis was observed in controls. Similar results were obtained in a model of TNF-mediated liver failure, in which transgenic animals survived significantly better than wild-type animals. In conclusion, our experiments provide evidence that MORT1/FADD is indispensable for Fas and TNF-mediated hepatic injury. This is not only of great importance for targeting future therapies for liver disease but might also serve as an intriguing model to study other causes of liver injury.
Remarks ON THE POSSIBILITIES OF EXPLORATORY THORACOTOMY
Authors: G. E. Gask
Journal: BMJ (1925)

THE beginnimngs of tlhoracic surgery date from the very ealliest times of which we have records.It is evident that Hlilppocrates was familiar with pleural empyema, and his aceounts of the means of diagnosis and the various methods of operation by cautery or cutting are classical.'Army surgeons throughout the ages have been called upon to tr-eat wounds of the chest inflicted by spear, arrow, or rifle bullet.Celsus, Ambroise Pare, Wiseman, Guthrie, Larrey, and many others have left records of their various efforts.Yet in spite of the ever-recurring need and the obvious desirabilitv of finding a satisfactor-v treatment for injuries -I~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~77 is .+z. i.
Stress triggers different pathophysiological mechanisms in younger and older cardiomyopathic hamsters
Authors: Q. Chang, B. H. Natelson, J. E. Ottenweller, R. S. Conway
Journal: Cardiovascular Research (1995)

Because cardiomyopathic hamsters (CMHs) in the lesion-forming period of their disease are more susceptible to the lethal effects of stress than older CMHs, we tested the hypothesis that different pathophysiological effects of stress may occur: coronary vasospasm in younger CMHs and congestive heart failure in older ones.CMHs aged 2.5 and 6.5 months were stressed with 2 h supine cold immobilization for 5 consecutive days. Three, 5 and 7 days after stress, the hearts were excised and perfused using a modified Langendorff system. Maximum +/- dP/dt, developed pressure, ventricular relaxation time (Tau) and coronary vascular resistance (CVR) were recorded and CVR was also measured following coronary infusion of arginine vasopressin (AVP).Stress produced ventricular dysfunction (decreased maximum +/- dP/dt, developed pressure, and increased Tau) in older CMHs (P < 0.05) but not in younger CMHs. Baseline CVR in younger CMHs was significantly higher than in older CMHs (P < 0.01) and AVP infusion produced a bigger increase in CVR in younger stressed CMHs than in either younger nonstressed or older stressed CMHs (P < 0.05).The younger CMH heart exhibits greater resting vascular tone and stress produces coronary vasoconstriction that is consistent with coronary spasm. In contrast, the older CMH experiences a decrease in cardiac function which remains 7 days after stress and indicates an exacerbation of CHF from the mild form existing prior to stress. The lethal effects of stress may occur because of the activation of different pathological processes in younger and older CMHs.
What You Need to Know About Psychiatric Drugs
Authors: Burton C. Einspruch
Journal: JAMA (1992)

Occasionally, one reads the dust jacket of a publication, sometimes out of curiosity as to the appearance of an author or to gain biographical information, or, now and again, because of attractive graphics. This dust jacket prominently displays the statement "No one should swallow a single psychiatric prescription medicine without checking this book first." That nonsensical quotation is attributed to Joe Graedon, author of "The People's Pharmacy" series. In an introductory comment called "Caution to Patients," we find "Do not take any medications or change the way in which you are taking your medications without the full involvement of your physician." The book has an elegant mission, inasmuch as the authors hope it will provide "friendly" access to sophisticated information, ie, "the ability for patients to recognize, manage and avoid many side effects of drugs," the hope that the book will convince more people that they, too, could benefit from
Colin Gagen Ford
Authors: Ann McAra
Journal: BMJ (2004)

Former general practitioner Chislehurst, Kent (b 1934; q St Mary's Hospital, London, 1962; FRCS), died from pancreatitis as a result of alcoholic liver disease on 29 March 2004.​2004.




Figure 1




Leaving school at 16 after O levels, he joined Cable & Wireless and attended evening classes to gain science A levels. After national service with the Royal Marines he returned to complete A levels for medical school entry. He went into general practice, but returned to hospital medicine and an interest in orthopaedics. Considered “too old and too well qualified,” he did not succeed in obtaining a place on a training programme, and after several locums returned to general practice. He had a long battle with alcohol and retired on medical grounds. He leaves a wife and four children.
Breast cancer: a fighting chance
Authors: L Elliott
Journal: BMJ (1994)

In July 1991 I presented what I believed to be an alarming thickening of my left breast to my general practitioner. I was assured that my breasts were normal. In October I returned to the same practice. I saw a different doctor and he again reassured me that my breasts were normal. In February 1992 I returned once more to the practice. This time I presented a second lump in my armpit. I had breast cancer and what was more it had now spread to the lymph nodes.

Going back in time to my initial visit in July 1991, I was not happy with my doctor's comments, Breasts normal. I discussed with friends what I should do, given that I felt embarrassment to return too soon and undermine her verdict. I stopped breast feeding my 7 month old baby to see if there were any changes in the breast. There were none. At my second visit in October, the doctor explained that the thickening in the breast that I could feel was …
Population Genetics and Geographic Variation of Alcohol Dehydrogenase (Adh) Paralogs and Glucose-6-Phosphate Dehydrogenase (G6pd) in Drosophila mojavensis
Authors: L. M. Matzkin
Journal: Molecular Biology and Evolution (2003)

Populations of Drosophila mojavensis from the deserts of the Baja California peninsula and mainland Mexico utilize different cactus hosts with different alcohol contents. The enzyme alcohol dehydrogenase (ADH) has been proposed to play an important role in the adaptation of Drosophila species to their environment. This study investigates the role of ADH in the adaptation of the cactophilic D. mojavensis to its cactus host. In D. mojavensis and its sibling species, D. arizonae, the Adh gene has duplicated, giving rise to a larval/ovarian form (Adh-1) and an adult form (Adh-2). Studies of sequence variation presented here indicate that the Adh paralogs have followed different evolutionary trajectories. Adh-1 exhibits an excess of fixed amino acid replacements, suggesting adaptive evolution, which could have been a result of several host shifts that occurred during the divergence of D. mojavensis. A 17-bp intron haplotype polymorphism segregates in Adh-2 and has markedly different frequencies in the Baja and mainland populations. The presence of the intron polymorphism suggests possible selection for the maintenance of pre-mRNA structure. Finally, this study supports the proposed Baja California origination of D. mojavensis and subsequent colonization of the mainland accompanied by a host shift.
Validation of a computerized edge detection algorithm for quantitative two-dimensional echocardiography.
Authors: W Zwehl, R Levy, E Garcia, R V Haendchen, W Childs, S R Corday, S Meerbaum, E Corday
Journal: Circulation (1983)

An edge detection algorithm used in conjunction with digitized two-dimensional echocardiograms was applied to validate computerized two-dimensional echocardiographic (2DE) quantitation of cross-sectional areas of canine left ventricular chambers. Images were enhanced by space-time smoothing and dynamic range expansion, after which automatic edge detection was performed by convolving a Laplacian operator with the enhanced image. In an in vitro study of 29 myocardial slabs, computer-derived 2DE measurements of short-axis sections of the left ventricle were compared with manually derived 2DE data and validated against direct measurements of intraluminal areas of myocardial slabs. Correlations of both manually and computer-derived 2D echocardiograms vs direct measurements were equally satisfactory (r = .95 for both). Computer-derived measurements of perimeters tended to underestimate actual perimeters of the endocardial outlines of left ventricular sections. In 13 closed-chest anesthetized dogs, manually and computer-derived left ventricular short-axis areas measured by 2DE techniques showed a good correlation at both end-diastole (r = .91) and end-systole (r = .92). Left ventricular volumes reconstructed from 2DE images were compared with angiographically determined volumes. The computer-enhanced 2DE method correlated against angiography, with r = .93 for end-diastolic and r = .93 for end-systolic volumes. Left ventricular volume correlations between manually and computer-derived 2D echocardiograms were satisfactory, with r = .87 for end-diastole and r = .87 for end systole. We conclude that computerized enhancement and edge detection of 2D echocardiograms obtained in dogs provided accurate analysis of actual left ventricular cross-sectional areas and left ventricular volumes.
Targeting microRNAs in Pancreatic Cancer: Microplayers in the Big Game
Authors: Sheema Khan, None Ansarullah, Deepak Kumar, Meena Jaggi, Subhash C. Chauhan
Journal: Cancer Research (2013)

The prognosis of patients with pancreatic cancer is extremely poor, and current systemic therapies result in only marginal survival rates for patients. The era of targeted therapies has offered a new avenue to search for more effective therapeutic strategies. Recently, microRNAs (miRNA) that are small noncoding RNAs (18-24 nucleotides) have been associated with a number of diseases, including cancer. Disruption of miRNAs may have important implications in cancer etiology, diagnosis, and treatment. So far, focus has been on the mechanisms that are involved in translational silencing of their targets to fine tune gene expression. This review summarizes the approach for rational validation of selected candidates that might be involved in pancreatic tumorigenesis, cancer progression, and disease management. Herein, we also focus on the major issues hindering the identification of miRNAs, their linked pathways and recent advances in understanding their role as diagnostic/prognostic biomarkers, and therapeutic tools in dealing with this disease. miRNAs are expected to be robust clinical analytes, valuable for clinical research and biomarker discovery.
The hemodynamic effects of sotalol and quinidine: analysis by use of rest and exercise gated radionuclide angiography.
Authors: J J Mahmarian, M S Verani, T Hohmann, R Hill, B C Thornton, R Bolli, J B Young, R Roberts, C M Pratt
Journal: Circulation (1987)

This placebo-controlled, double-blind trial compared the hemodynamic effects of sotalol and quinidine with the use of rest and exercise gated radionuclide angiography. Patients had frequent ventricular premature depolarizations (greater than or equal to 30 VPDs/hour) and depressed cardiac function (mean ejection fraction 43 +/- 15%). Resting left ventricular ejection fraction and stroke volume index increased (p less than .002, p less than .001, respectively) during sotalol therapy, associated with a concomitant fall in heart rate (p less than .001). Quinidine also increased mean left ventricular ejection fraction, but less so than did sotalol (p less than .05). Quinidine significantly decreased left ventricular end-diastolic (p less than .05) and end-systolic (p less than .002) volumes, but had no effect on stroke volume index or heart rate. Neither drug affected cardiac index. Quinidine resulted in no symptomatic deterioration in left ventricular function or serious arrhythmia aggravation. In contrast, five patients on sotalol developed either decompensated congestive heart failure (two patients), arrhythmia aggravation (two patients), or hypotension associated with bradyarrhythmia (one patient). These patients had a unique hemodynamic profile that can be used to identify patients likely to have a poor outcome on sotalol. This profile reflected a lack of cardiac reserve, characterized by an inability to increase stroke volume and cardiac output with supine bicycle exercise.
Health Insurance Reform and the Tensions of Federalism
Authors: Christopher C. Jennings, Katherine J. Hayes
Journal: New England Journal of Medicine (2010)

The enactment of the Patient Protection and Affordable Care Act (ACA) marks the beginning of a new chapter in the centuries-long debate about the appropriate balance between the states and the federal government in the development, administration, and enforcement of domestic policy in the United States. As health care reform is implemented, a new set of federalism-related tensions will arise regarding the best ways to ensure health care coverage for all Americans, secure access to care, promote prevention and wellness, and modernize delivery systems in an effort to achieve better outcomes at lower cost.Today, government incentives for and oversight . . .
Public deaths, private doubts..
Authors: P. H Millard
Journal: BMJ (1995)

Death on Request is the story of a Dutch couple's passage through the various stages of a disabling neurological illness until the man's death, on his birthday, by lethal injection.

Dr Wilfred Van Oijen, a general practitioner in Amsterdam, let a television crew film him in his surgery, on his rounds, in his home, at the chemist's shop, and finally with the coroner as Cees, a 62 year old man with motor neurone disease, went through the stages that permit medically induced death. …