tbuckley/cabot-search huggingface dataset:
Distinct Quantitative Computed Tomography Emphysema Patterns Are Associated with Physiology and Function in Smokers
Authors: Peter J. Castaldi, Raúl San José Estépar, Carlos S. Mendoza, Craig P. Hersh, Nan Laird, James D. Crapo, David A. Lynch, Edwin K. Silverman, George R. Washko
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Rationale: Emphysema occurs in distinct pathologic patterns, but little is known about the epidemiologic associations of these patterns. Standard quantitative measures of emphysema from computed tomography (CT) do not distinguish between distinct patterns of parenchymal destruction.Objectives: To study the epidemiologic associations of distinct emphysema patterns with measures of lung-related physiology, function, and health care use in smokers.Methods: Using a local histogram-based assessment of lung density, we quantified distinct patterns of low attenuation in 9,313 smokers in the COPDGene Study. To determine if such patterns provide novel insights into chronic obstructive pulmonary disease epidemiology, we tested for their association with measures of physiology, function, and health care use.Measurements and Main Results: Compared with percentage of low-attenuation area less than −950 Hounsfield units (%LAA-950), local histogram-based measures of distinct CT low-attenuation patterns are more predictive of measures of lung function, dyspnea, quality of life, and health care use. These patterns are strongly associated with a wide array of measures of respiratory physiology and function, and most of these associations remain highly significant (P < 0.005) after adjusting for %LAA-950. In smokers without evidence of chronic obstructive pulmonary disease, the mild centrilobular disease pattern is associated with lower FEV1 and worse functional status (P < 0.005).Conclusions: Measures of distinct CT emphysema patterns provide novel information about the relationship between emphysema and key measures of physiology, physical function, and health care use. Measures of mild emphysema in smokers with preserved lung function can be extracted from CT scans and are significantly associated with functional measures.
Book Review The Encyclopedia of Alternative Health Care By Kristin Gottschalk Olsen. 325 pp. New York, Pocket Books, 1990. $8.95. Health Schemes, Scams and Frauds By Stephen Barrett and the Editors of<i>Consumer Reports.</i>245 pp. Mount Vernon, N.Y., Consumer Reports Books, 1990. $13.95.
Authors: Robert Baker
Journal: New England Journal of Medicine (1991)
Radiographic Appearance of Lanthanum
Authors: Simon Cerny, Ulrich Kunzendorf
Journal: New England Journal of Medicine (2006)

An 82-year-old man with hypertension, coronary artery disease, congestive heart failure, chronic constipation, degenerative joint disease of the hips, and a 5-year history of hemodialysis for end-stage renal disease presented with worsening hip pain. The results of his physical examination were unrevealing. Findings on radiography of the pelvis without contrast medium did not provide a reason for his increased hip pain but did show diffuse opacifications throughout the colon. Questioning revealed that his renal failure had induced hyperphosphatemia, which was initially managed with calcium acetate, but 6 months earlier this medication had been changed to lanthanum carbonate (1.5 g orally . . .
Two-dimensional echocardiographic assessment of vegetative endocarditis.
Authors: B W Gilbert, R S Haney, F Crawford, J McClellan, H A Gallis, M L Johnson, J A Kisslo
Journal: Circulation (1977)

Real-time, two-dimensional echocardiography was used to document the presence and assess the size and location of vegetative lesions of the cardiac valves and chambers in seven patients with bacterial endocarditis. Anatomic correlation (surgical or autopsy) was accurate in all patients. Two-dimensional echocardiography was shown to be of particular value in determining morphologic characteristics of the lesions since this technique provides spatial information concerning moving cardiac structures. The results of two-dimensional echocardiography were most helpful in determining selected aspects of the clinical care provided for each patient. These data demonstrate that real-time, two-dimensional echocardiography, in combination with M-mode imaging techniques, may be of great potential value in the detection of vegetative endocarditis. Furthermore, reliable assessment of lesion size and location may, in time, become a valuable method for following the morphologic changes that occur in vegetative lesions, and thus determine the efficacy of antibiotic therapy. This information may also provide a means for evaluating certain patients for surgical intervention.
Simulation of Breast Cancer
Authors: Murray Seltzer
Journal: JAMA (1974)

<h3>To the Editor.—</h3> In their recent article, "Breast Carcinoma Simulation" (229: 682, 1974), Stolz et al discussed a patient whose congestive heart failure produced mammographic skin changes usually associated with malignancy. We also have observed these phenomena in a 66-year-old diabetic woman treated with dialysis because of dependent chronic renal failure and congestive heart failure. The patient was hospitalized for approximately three weeks when mastodynia developed with marked pitting edema of the areolae. Xeromammography was performed (Fig 1, top) and the patient was then instructed to wear a brassiere for continuous support 24 hours a day. Xeromammography was then repeated after four days (Fig 1, bottom), with marked resolution of the problem as shown by the decreased edema. While we are in complete agreement with Stolz et al that these phenomena are quite impressive when observed, we believe that xeromammography offers as good or better illustration of skin edema, thus
Cellular basis for the negative inotropic effects of tumor necrosis factor-alpha in the adult mammalian heart.
Authors: T Yokoyama, L Vaca, R D Rossen, W Durante, P Hazarika, D L Mann
Journal: Journal of Clinical Investigation (1993)

To define the mechanism(s) responsible for the negative inotropic effects of tumor necrosis factor-alpha (TNF alpha) in the adult heart, we examined the functional effects of TNF alpha in the intact left ventricle and the isolated adult cardiac myocyte. Studies in both the ventricle and the isolated adult cardiac myocyte showed that TNF alpha exerted a concentration- and time-dependent negative inotropic effect that was fully reversible upon removal of this cytokine. Further, treatment with a neutralizing anti-TNF alpha antibody prevented the negative inotropic effects of TNF alpha in isolated myocytes. A cellular basis for the above findings was provided by studies which showed that treatment with TNF alpha resulted in decreased levels of peak intracellular calcium during the systolic contraction sequence; moreover, these findings did not appear to be secondary to alterations in the electrophysiological properties of the cardiac myocyte. Further studies showed that increased levels of nitric oxide, de novo protein synthesis, and metabolites of the arachidonic acid pathway were unlikely to be responsible for the TNF alpha-induced abnormalities in contractile function. Thus, these studies constitute the initial demonstration that the negative inotropic effects of TNF alpha are the direct result of alterations in intracellular calcium homeostasis in the adult cardiac myocyte.
A CYTOCHEMICAL STUDY OF THE L.E. BODIES OF SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Gabriel C. Godman, Arline D. Deitch
Journal: The Journal of Experimental Medicine (1957)

The composition, with respect to nucleic acids, of the L.E. bodies resulting from the action of the plasma of patients with systemic lupus erythematosus on substrate leukocyte nuclei in different kinds of preparations was compared microspectrophotometrically with that of control lymphocyte nuclei. Binding of the basic dye methyl green to DNA was uniformly found to be depressed in L.E. bodies as compared with control nuclei. Since Feulgen-revealed DNA, which served as a standard of reference, was relatively unchanged in amount, the Feulgen:methyl green ratios of L.E. bodies were higher than those of lymphocyte nuclei. Acetylation, which covers basic groups of proteins, was found to increase methyl green uptake by DNA of L.E. bodies to values approximating those of control nuclei, with consequent revision, after acetylation of the Feulgen: methyl green ratios of L.E. bodies to values similar to those of lymphocyte nuclei. Ribonuclease was found to reduce methyl green staining; extraction with dilute acid had little effect. These data have been interpreted to indicate (a) the presence in L.E. bodies of DNA-associated proteins whose basic groups compete with the cationic dye for binding sites of DNA and so inhibit methyl green staining, and (b) the DNA itself is not detectibly altered in state or degree of polymerization. Photometric comparison of the mean Feulgen-stainable DNA content per L.E. body with that of control nuclei showed that DNA is not lost in the L.E. transformation of nuclei.
CCR2 mediates hematopoietic stem and progenitor cell trafficking to sites of inflammation in mice
Authors: Yue Si, Chia-Lin Tsou, Kelsey Croft, Israel F. Charo
Journal: Journal of Clinical Investigation (2010)

HSCs are BM-derived, self-renewing multipotent cells that develop into circulating blood cells. They have been implicated in the repair of inflamed parenchymal tissue, but the signals that regulate their trafficking to sites of inflammation are unknown. As monocytes are recruited to sites of inflammation via chemoattractants that activate CCR2 on their surface, we investigated whether HSCs are also recruited to sites of inflammation through CCR2. Initial analysis indicated that in mice, CCR2 was expressed on subsets of HSCs and hematopoietic progenitor cells (HPCs) and that freshly isolated primitive hematopoietic cells (Lin-c-Kit+ cells) responded to CCR2 ligands in vitro. In vivo analysis indicated that after instillation of thioglycollate to cause aseptic inflammation and after administration of acetaminophen to induce liver damage, endogenous HSCs/HPCs were actively recruited to the peritoneum and liver, respectively, in WT but not Ccr2-/- mice. HSCs/HPCs recovered from the peritoneum successfully engrafted into the BM of irradiated primary and secondary recipients, confirming their self renewal and multipotency. Importantly, administration of exogenous WT, but not Ccr2-/-, HSCs/HPCs accelerated resolution of acetaminophen-induced liver damage and triggered the expression of genes characteristic of the macrophage M2 or repair phenotype. These findings reveal what we believe to be a novel role for CCR2 in the homing of HSCs/HPCs to sites of inflammation and suggest new functions for chemokines in promoting tissue repair and regeneration.
Effect of high-fibre diet on haemostatic variables in diabetes.
Authors: H C Simpson, J I Mann, R Chakrabarti, J D Imeson, Y Stirling, M Tozer, L Woolf, T W Meade
Journal: BMJ (1982)

walks because of the initial training effect.The time chosen to assess exercise tolerance by walking tests is not critical.Shorter times are easier for both patient and investigator and are as reproducible but discriminate slightly less well and have less of a training role.The six-minute walk may represent a sensible compromise.
GW25-e1086 Pulmonary Function Differences in Patients with Chronic Right Heart Failure Secondary to Pulmonary Arterial Hypertension and Chronic Left Heart Failure
Authors: Liu Weihua, Luo Qin, Zhao Qing, Xi Qunying, Xue Haifeng, Zhao Zhihui, Liu Zhihong
Journal: Journal of the American College of Cardiology (2014)
Effect of β-Blockers on Free Radical–Induced Cardiac Contractile Dysfunction
Authors: M. Flesch, C. Maack, B. Cremers, A. T. Bäumer, M. Südkamp, M. Böhm
Journal: Circulation (1999)

Background —We examined the effects of hydroxyl radicals (OH·) on human myocardial contractility and on sarcoplasmic reticulum Ca 2+ -ATPase (SERCA) activity and the effects of the β-receptor antagonists metoprolol, carvedilol, and its metabolite BM-910228. Methods and Results —Isometric force of contraction was determined in isolated human myocardium. H 2 O 2 1 mmol/L and Fe 3+ -nitrilotriacetic acid (Fe 3+ -NTA) 0.1 mmol/L used for generation of OH· induced a decrease in basal force of contraction and an increase in diastolic tension in atrial and left ventricular myocardial preparations. After challenge with OH·, the maximum positive inotropic response to Ca 2+ 1.8 to 15 mmol/L was decreased by 60% and by 39%, respectively. The effects of OH· could be blocked by catalase. Carvedilol and its metabolite BM-910228 attenuated the OH·-induced impairment of the inotropic response to Ca 2+ in atrial myocardial preparations. Metoprolol had no significant effect. The stimulation frequency (0.5 to 3.0 Hz)–dependent increase in force of contraction and decrease in diastolic tension were abolished after exposure of atrial trabeculae to OH·. In parallel, SERCA activity was decreased by OH· concentration-dependently, as determined in myocardial membrane preparations. BM-910228 partially restored the force-frequency relationship and preserved SERCA activity. Conclusions —OH· radicals induce an impairment of contraction and relaxation and an attenuation of the force-frequency relationship in human myocardium accompanied by an inhibition of SERCA. Carvedilol and BM-910228 partly prevented OH·-induced contractile dysfunction. These observations could explain the improvement of ejection fraction in heart failure trials with carvedilol without a restoration of β-adrenergic receptor density.
Recognition and Treatment of Peripheral Nerve Injuries in Civilian Practice
Authors: W. Eugene Stern
Journal: JAMA (1961)

Of primary concern in peripheral nerve injuries is evaluation according to mechanism of injury, evidence of clinical dysfunction, and quality of responce to diagnostic tests. Surgical intervention may be necessary in open or closed injuries and is elected in either case when the return of function has not been demonstrated or is not expected on the basis of the mechanism of injury. Surgical exploration may be part of diagnosis and is usually indicated in open wounds. A nerve which is divided surgically for the excision of a tumor or other lesion may well be sutured primarily. Delayed suture, however, is preferable in the case of injury either sharply incised or heavily contused. Stretch injuries rarely require operative treatment, but they, with all others, will demand thoughtful supportive therapy.
THE CLINICAL SIGNIFICANCE OF HIGH AND LOW PULSE-PRESSURES WITH SPECIAL REFERENCE TO CARDIAC LOAD AND OVERLOAD
Authors: WILLARD J. STONE
Journal: JAMA (1913)

<h3>METHOD AND PURPOSE OF STUDY</h3> The attempt has been made, in an analysis of comparative pulse-pressure observations in 170 persons, to determine what, if any, clinical significance was to be attached to certain high and low auscultatory readings. For convenience of classification, the patients have been grouped as in the accompanying tabulation: Number of Patients Conditions Studied 1. Normal circulatory conditions........61 2. Acute infections ....................26 3. Arterial hypotension ................ 9 4. Arterial hypertension ...............51 5. Myocardial and valvular lesions: (a) With compensation ........... 9 (b) With decompensation ..........14 The readings were taken as follows: With the patient at rest, compression was made with a 12 cm. arm-band and the systolic pressure taken by palpation. The compression was then released and, after an interval sufficient for reestablishment of the circulation in the arm, the stethoscope was lightly applied over the brachial artery below the arm-band. Compression was reapplied and the systolic pressure taken by auscultation. The
Can further benefit be achieved by adding flosequinan to patients with congestive heart failure who remain symptomatic on diuretic, digoxin, and an angiotensin converting enzyme inhibitor? Results of the flosequinan-ACE inhibitor trial (FACET).
Authors: B M Massie, M R Berk, S C Brozena, U Elkayam, J F Plehn, M L Kukin, M Packer, B E Murphy, G W Neuberg, R M Steingart
Journal: Circulation (1993)

BACKGROUND Angiotensin converting enzyme inhibitors, diuretics, and digoxin are each effective in treating congestive heart failure, but many patients remain symptom-limited on all three medications. This trial was designed to determine whether the addition of oral flosequinan, a new direct-acting arterial and venous vasodilator with possible dose-dependent positive inotropic effects, improves exercise tolerance and quality of life in such patients. METHODS AND RESULTS In a randomized, double-blind multicenter trial, 322 patients with predominantly New York Heart Association class II or III congestive heart failure and left ventricular ejection fractions of 35% or less, who were stabilized on a diuretic, angiotensin converting enzyme inhibitor, and digoxin, were treated with 100 mg flosequinan once daily, 75 mg flosequinan twice daily, or matching placebo. Efficacy was evaluated with serial measurements of treadmill exercise time, responses to the Minnesota Living With Heart Failure Questionnaire (LWHF), and clinical assessments during a baseline phase and a 16-week treatment period. After 16 weeks, 100 mg flosequinan once daily produced a significant increment in median exercise time (64 seconds at 16 weeks) compared with placebo (5 seconds), whereas the higher-dose flosequinan group did not show a statistically significant increase. Flosequinan (100 mg once daily) also improved the overall LWHF score significantly compared with placebo; both active therapies decreased the physical component, but 75 mg flosequinan twice daily was associated with a trend toward worsening of the emotional component. Most clinical assessments tended to improve on active therapy. CONCLUSIONS These results indicate that additional symptomatic benefit can be attained by adding flosequinan to a therapeutic regimen already including a converting enzyme inhibitor. Because in the future most patients will fall into this category, flosequinan is a potential adjunctive agent in the management of severe congestive heart failure. However, because recent evidence indicates that the flosequinan dose studied in the present trial has an adverse effect on survival, the benefit-to-risk ratio must be assessed in individual patients.
New helpline set up by doctors for doctors
Authors: Z. Kmietowicz
Journal: BMJ (2002)

A new confidential and anonymous helpline run voluntarily by doctors has been set up for doctors in England.

The Doctors' SupportLine offers informal support for doctors with any concerns–from burnout, depression, and anxiety to work difficulties and family worries. It has been set up jointly by the charity Primary Care Mental Health and Education and the self help group Doctors' Support Network, with a grant …
Thyroid Physiology During Generalized Infection.
Authors: George E. Shambaugh
Journal: Annals of Internal Medicine (1966)

s1 May 1966Thyroid Physiology During Generalized Infection.George E. Shambaugh III, William R. BeiselGeorge E. Shambaugh IIISearch for more papers by this author, William R. BeiselSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-5-1160_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAcute infection induces storm in thyrotoxicosis or coma in myxedema. Reported alterations in thyroid function during acute infection in humans are limited to a fall in basal metabolic rate, a possible reduction in thyroxine-binding prealbumin (TBPA), but an unaltered disappearance rate of triiodothyronine. To investigate systematically the changes in thyroid physiology during generalized infection, a number of specific studies were carried out using as an experimental model the rat infected subcutaneously with a virulent type I-A-5 pneumococcus.Depression of thyroid gland function was evidenced by impaired uptake and release of131I and a fall in serum protein-bound iodine. Neither uptake... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: George E. ShambaughIII; William R. Beisel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1966Volume 64, Issue 5Page: 1160-1161KeywordsComaFallsPneumococcusSerum proteinsStormsThyroidTriiodothyronine ePublished: 1 December 2008 Issue Published: 1 May 1966 PDF downloadLoading ...
RECENT EXPERIENCE WITH ADVANCEMENT OF THE RECTI MUSCLES.
Authors: C. H. BEARD
Journal: JAMA (1898)

To review the several ingenious theories as to the causes of strabismus; to endeavor to dispose of the intricate and subtle anatomic and physiologic problems pertaining to the imperfectly known branch of ophthalmology; to discuss all the pros and cons concerning the relative merits of tenotomy and advancement, as well as of the methods other than surgical for the treatment of the affection, would be highly agreeable; such, however, is not my present intention. I have, from time to time, in the past stated my convictions in these matters, and shall on occasion, continue so to do, always striving meanwhile for something better yet, to offer in lieu thereof, not disdaining to iterate and reiterate in accordance with such poor light as we possess, for I believe the theme demands it. The subject of this paper was suggested to me by the worthy chairman of this Section, and in order
ABC of 1 to 7. Paediatric dermatology.
Authors: S K Goolamali, H B Valman
Journal: BMJ (1982)

Atopic eczemaAtopic eczema affects about 5% of the population.Some 70% of patients have a family history of atopy, shown by eczema, asthma, or hay fever.Atopic eczema is characterised by itching and red vesicular patches with a marked predilection for the face and the flexures.A remission often occurs between 2 and 4 years but may be shortlived, and recurrence in childhood may be severe and cause gradual lichenification of the skin with greater involvement of the hands and feet.Atopic children have a lower threshold
Editing may ruin an obituary
Authors: A Lahiri
Journal: BMJ (1996)

EDITOR,—In common with many of Jim Raftery's friends, I was extremely disappointed by his obituary in the BMJ, which, after editing, did not portray him as I knew him.1 Jim's setting up of one of the first successful deputising services in general practice in the late 1960s and early ‘70s was an enormous achievement. Instead of receiving accolades, however, he was criticised, although all general practitioners who used the service have acknowledged its tremendous impact. Jim was …