tbuckley/cabot-search huggingface dataset:
Assessment of Diabetes-Related Distress
Authors: William H Polonsky, Barbara J Anderson, Patricia A Lohrer, Garry Welch, Alan M Jacobson, Jennifer E Aponte, Carolyn E Schwartz
Journal: Diabetes Care (1995)

To describe a new measure of psychosocial adjustment specific to diabetes, the Problem Areas in Diabetes Survey (PAID), and to present initial information on its reliability and validity.Before their routine clinic appointments, 451 female patients with type I and type II diabetes, all of whom required insulin, completed a self-report survey. Included in the survey was the PAID, a 20-item questionnaire in which each item represents a unique area of diabetes-related psychosocial distress. Each item is rated on a six-point Likert scale, reflecting the degree to which the item is perceived as currently problematic. A total scale score, hypothesized to reflect the overall level of diabetes-related emotional distress, is computed by summing the total item responses. To examine the concurrent validity of the PAID, the survey also included a series of standardized questionnaires assessing psychosocial functioning (general emotional distress, fear of hypoglycemia, and disordered eating), attitudes toward diabetes, and self-care behaviors. All subjects were assessed for HbA1, within 30 days of survey completion and again approximately 1-2 years later. Finally, long-term diabetic complications were determined through chart review.Internal reliability of the PAID was high, with good item-to-total correlations. Approximately 60% of the subject sample reported at least one serious diabetes-related concern. As expected, the PAID was positively associated with relevant psychosocial measures of distress, including general emotional distress, disordered eating, and fear of hypoglycemia, short- and long-term diabetic complications, and HbA1, and negatively associated with reported self-care behaviors. The PAID accounted for approximately 9% of the variance in HbA1. Diabetes-related emotional distress, as measured by the PAID, was found to be a unique contributor to adherence to self-care behaviors after adjustment for age, diabetes duration, and general emotional distress. In addition, the PAID was associated with HbA1 even after adjustment for age, diabetes duration, general emotional distress, and adherence to self-care behaviors.These findings suggest that the PAID, a brief, easy-to-administer instrument, may be valuable in assessing psychosocial adjustment to diabetes. In addition to high internal reliability, the consistent pattern of correlational findings indicates that the PAID is tapping into relevant aspects of emotional distress and that its particular feature, the measurement of diabetes-related emotional distress, is uniquely associated with diabetes-relevant outcomes. These data are also consistent with the hypothesis that diabetes-related emotional distress, separate from general emotional distress, is an independent and major contributor to poor adherence. Given that the study was limited to female patients using insulin, further examination of the clinical usefulness of the PAID will need to focus on more heterogeneous samples.
T-Cell Subsets
Authors: Lowell L. Williams
Journal: JAMA (1982)

To the Editor.—  I'm OKT3, you're OKT4... Dr Goodwin surely jests in his diatribe against the T-cell subsets as he bemoans the volume and triviality of these determinations. His complaints seem similar to those bandied about regularly when a new procedure points to new understanding of metabolic processes, requiring an intellectual adjustment.  As for the plethora of articles on the subject of T cells, every new insight into body function leads to an initial accumulation of data to answer the basic three questions: What? When? Where? After these are tabulated the crucial questions How? and Why? can be addressed. Medical residents, who obviously make Dr Goodwin uneasy, are still close enough to the learning process to be both flexible in applying new techniques and curious in continuing to ask why.  Identification of T-cell function may be closer to the reality of medicine than even Dr Goodwin's preferred creatinine clearance testing
Back Pain in an Adolescent
Authors: Ernest M. Weitz
Journal: JAMA (1980)

<h3>To the Editor.—</h3> I have read the letter from F. K. Peterson, Jr, MD (243:1188, 1980), regarding a 15-year-old boy with back pain after exercise. Peterson states the pain was in the right side of the lower back without radiation to the buttock, although there was tenderness opposite the L-4 spinous process on the right and positive straight leg-raising at 70° on the right, with pain referred to the right buttock. The kick on the right side was likewise restricted. I believe findings such as these probably represent irritation of the nerve root on the right, possibly caused by lateral disk protrusion. Irwin M. Siegel, MD, answered that this is due to "low-back strain." I fail to comprehend how an alleged low-back strain can impair straight leg raising and cause the pain to be referred to the buttock. I am in complete agreement with his treatment program. I think, however,
LIMITATIONS OF AVAILABLE METHODS FOR CT ANGIOGRAPHIC ANALYSIS FOR DETECTION OF IN-STENT RESTENOSIS AFTER LEFT MAIN CORONARY STENTING
Authors: Kushal Dighe, Payam Dehghani, Danny Marcuzzi, Vikram Prabhudesai, Tej Sheth, Ian Billingsley, Warren Ball, Waseem Sharieff, Asim Cheema
Journal: Journal of the American College of Cardiology (2013)
Nitrate Therapy for Congestive Heart Failure
Authors: Joseph A. Franciosa, Leonard A. Nordstrom, Jay N. Cohn
Journal: JAMA (1978)

A randomized double-blind crossover trial included 16 patients with severe congestive heart failure who received isosorbide dinitrate or placebo for eight weeks, and then the opposite treatment for eight more weeks. All patients received their usual maintenance therapy with digitalis and diuretics. Seven morbid events occurred during 85 patient-weeks of isosorbide dinitrate therapy compared with 17 during 76 patient-weeks of placebo. Severity of congestive heart failure improved in all eight patients who received isosorbide dinitrate compared with two patients who showed improvement and five whose symptoms became worse with placebo. No significant differences in physical findings, cardiac dimensions, or resting hemodynamics were observed. Maximal exercise duration increased significantly by 2.54 minutes with isosorbide dinitrate therapy, and rose insignificantly by 1.24 minutes with placebo. This preliminary trial suggests that long-term vasodilator therapy may be clinically beneficial in congestive heart failure. (<i>JAMA</i>240:443-446, 1978)
Epicardial Border Zone Overexpression of Skeletal Muscle Sodium Channel SkM1 Normalizes Activation, Preserves Conduction, and Suppresses Ventricular Arrhythmia
Authors: David H. Lau, Chris Clausen, Eugene A. Sosunov, Iryna N. Shlapakova, Evgeny P. Anyukhovsky, Peter Danilo, Tove S. Rosen, Caitlin Kelly, Heather S. Duffy, Matthias J. Szabolcs, Ming Chen, Richard B. Robinson, Jia Lu, Sinhu Kumari, Ira S. Cohen, Michael R. Rosen
Journal: Circulation (2008)

Background— In depolarized myocardial infarct epicardial border zones, the cardiac sodium channel (SCN5A) is largely inactivated, contributing to low action potential upstroke velocity (V̇ max ), slow conduction, and reentry. We hypothesized that a fast inward current such as the skeletal muscle sodium channel (SkM1) operating more effectively at depolarized membrane potentials might restore fast conduction in epicardial border zones and be antiarrhythmic. Methods and Results— Computer simulations were done with a modified Hund-Rudy model. Canine myocardial infarcts were created by coronary ligation. Adenovirus expressing SkM1 and green fluorescent protein or green fluorescent protein alone (sham) was injected into epicardial border zones. After 5 to 7 days, dogs were studied with epicardial mapping, programmed premature stimulation in vivo, and cellular electrophysiology in vitro. Infarct size was determined, and tissues were immunostained for SkM1 and green fluorescent protein. In the computational model, modest SkM1 expression preserved fast conduction at potentials as positive as −60 mV; overexpression of SCN5A did not. In vivo epicardial border zone electrograms were broad and fragmented in shams (31.5±2.3 ms) and narrower in SkM1 (22.6±2.8 ms; P =0.03). Premature stimulation induced ventricular tachyarrhythmia/fibrillation &gt;60 seconds in 6 of 8 shams versus 2 of 12 SkM1 ( P =0.02). Microelectrode studies of epicardial border zones from SkM1 showed membrane potentials equal to that of shams and V̇ max greater than that of shams as membrane potential depolarized ( P &lt;0.01). Infarct sizes were similar (sham, 30±2.8%; SkM1, 30±2.6%; P =0.86). SkM1 expression in injected epicardium was confirmed immunohistochemically. Conclusions— SkM1 increases V̇ max of depolarized myocardium and reduces the incidence of inducible sustained ventricular tachyarrhythmia/fibrillation in canine infarcts. Gene therapy to normalize activation by increasing V̇ max at depolarized potentials may be a promising antiarrhythmic strategy.
For-Profit Medicine
Authors: Eli Ginzberg
Journal: New England Journal of Medicine (1988)

IN the past two decades the U.S. health care system has made revolutionary advances in diagnosis and therapy — for example, the development of new imaging devices and surgical techniques for the treatment of cardiovascular disease. On the organizational side have been the emergence and growth of for-profit health care delivery corporations, initially in hospitals and later extending to the provision of ambulatory care services.Only a few years after the advocates of the new corporations prophesied that the nation's health care system would soon be dominated by a few "SuperMeds,"1 the four largest for-profit hospital chains — Hospital Corporation . . .
Three peptides from the atrial natriuretic factor prohormone amino terminus lower blood pressure and produce diuresis, natriuresis, and/or kaliuresis in humans.
Authors: D L Vesely, M A Douglass, J R Dietz, W R Gower, M T McCormick, G Rodriguez-Paz, D D Schocken
Journal: Circulation (1994)

BACKGROUND Three peptides consisting of amino acids 1-30, 31-67, and 79-98 of the 126-amino acid atrial natriuretic factor prohormone (proANF), which have blood pressure-lowering, diuretic, natriuretic, and/or kaliuretic properties in animals, were investigated to determine if they have similar properties in humans. METHODS AND RESULTS Thirty-six healthy, normotensive human volunteers (18 men and 18 women, ages 20 to 58 years) were divided into six similar groups based on age, sex, weight, blood pressure, and heart rate. After a 60-minute baseline period, 100 ng of proANFs 1-30, 31-67, 79-98, or ANF/kg body wt per minute was given intravenously for 60 minutes followed by a 3-hour postinfusion data collection period. Each of the atrial natriuretic peptides decreased systolic and diastolic blood pressures (P &lt; .05), with proANF 31-67 causing the largest decrease. Urine flow increased 4- to 12-fold and was still significantly increased (P &lt; .01) for 2 to 3 hours after stopping the respective infusions of proANFs 1-30, 31-67, and 79-98. Atrial natriuretic factor (ANF) increased urine flow 4- to 11-fold but by 2 hours after infusion was significantly increased in only 1 of 6 subjects. Sodium excretion increased 3- to 8-fold, 3- to 6-fold, 0- to 2-fold (NS), and 3- to 11-fold, respectively, with proANFs 1-30, 31-67, 79-98, and ANF. Natriuretic effects of proANFs 1-30 and 31-67 were significantly prolonged (P &lt; .001) compared with ANF. ProANFs 1-30, 31-67, 79-98, and ANF increased potassium excretion 2- to 3-fold, 0-fold, 3- to 4-fold, and 2-fold, respectively. High-performance gel permeation chromatography followed by the respective radioimmunoassays revealed that proANFs 1-30, 31-67, 79-98, and 68-98, as well as ANF circulate as distinct peptides. CONCLUSIONS ProANFs 1-30, 31-67, and 79-98, as well as ANF have significant blood pressure-lowering and diuretic properties. ProANFs 1-30 and 31-67 also have natriuretic properties in humans that are significantly (P &lt; .001) prolonged compared with ANF. ProANF 79-98, although not possessing any natriuretic property, is the strongest stimulator of potassium excretion of the four atrial natriuretic peptides.
Current status of reproductive behaviour in Africa
Authors: C. Bambra
Journal: Human Reproduction Update (1999)

The current annual population growth rate of 3.2% in Africa will double the population by the year 2025. The majority of this population is below 15 years of age, and Africa concurrently also has the highest incidence of infertility in the world. Sexual behaviour, which has been poorly studied in Africa, has a direct impact on reproductive health [including fertility, infertility and sexually transmitted diseases (STDs)]. The multiple cultures and religions which characterize the African continent also affect reproductive health. Factors that have a significant effect on reproductive health in Africa include greater prevalence of extramarital/commercial sexual activity, polygamy, lower prevalence of contraceptives, reliance on traditional practices, high incidence of STDs and teenage pregnancies. High risk reproductive behaviours are predominantly displayed by adolescents, and the prevalence of STDs, including HIV (human immunodeficiency virus), is very high in this group. Pregnancy-related complications are the major cause of health-related problems in 15-19 year old girls. Maternal mortality rates in most countries remain high. Literacy rates affect these behaviours. It is apparent that changing the sexual behaviour of adolescents is one way of reversing the adverse trends, such as STD transmission, unwanted pregnancy and poor general reproductive health.
Developmental Regulation of Lck Targeting to the CD8 Coreceptor Controls Signaling in Naive and Memory T Cells
Authors: Martin F. Bachmann, Awen Gallimore, Susanne Linkert, Vincenzo Cerundolo, Antonio Lanzavecchia, Manfred Kopf, Antonella Viola
Journal: The Journal of Experimental Medicine (1999)

The question of whether enhanced memory T cell responses are simply due to an increased frequency of specific cells or also to an improved response at the single cell level is widely debated. In this study, we analyzed T cell receptor (TCR) transgenic memory T cells and bona fide memory T cells isolated from virally infected normal mice using the tetramer technology. We found that memory T cells are qualitatively different from naive T cells due to a developmentally regulated rearrangement of the topology of the signaling machinery. In naive cytotoxic T cells, only a few CD8 molecules are associated with Lck and the kinase is homogeneously distributed inside the cell. However, in vivo priming of naive T cells induces the targeting of Lck to the CD8 coreceptor in the cell membrane and the consequent organization of a more efficient TCR signaling machinery in effector and memory cells.
THE OPERATIVE TREATMENT OF ECLAMPSIA.
Authors: CHARLES SUMNER BACON
Journal: JAMA (1904)

In threatened eclampsia before the outbreak of convulsions operative interference is sometimes necessary. The indications for such interference may be either maternal or fetal. If in the later months of pregnancy well-known symptoms of intoxication occur that arise from the pathologic condition characteristic of eclampsia, and if these symptoms persist in spite of diet and the use of eliminants like purgatives and diaphoretics and other appropriate treatment, the termination of pregnancy may become necessary. While not entering into a discussion of this indication more in detail, I will say that it should receive greater attention than is ordinarily given it. I do not believe that the emptying of the uterus is often required, for I think that radical appropriate treatment, and most important of all, rest in bed, will generally tide the patient over the dangerous period, yet certain cases will arise, especially when the eyes are involved or when
Cardiopulmonary Dynamics in Patients with Anastomosis of the Superior Vena Cava to the Right Pulmonary Artery
Authors: RAMON V. CANENT, MADISON S. SPACH, W. GLENN YOUNG
Journal: Circulation (1964)

The cardiopulmonary dynamics of the circulation through the right lung were studied in six patients with severe cyanotic congenital heart disease who had undergone surgery with anastomosis of the superior vena cava to the right pulmonary artery. Pressure gradients across the right lung varied with respiratory changes in a way opposite from normal in that increasing intrathoracic pressure was associated with increased pressure gradients across the right lung. Radiocardiographic and cinefluorographic studies indicated that periods of changing intrathoracic pressure (spontaneous breathing and intermittent positive-pressure respiration) augmented flow, whereas absence of respiratory motion or sustained increased intrathoracic pressure (Valsalva maneuver) impeded flow through the right lung. The diminution of flow through the right lung during periods of sustained increased intrathoracic pressure occurred in the presence of an increased pressure gradient between the right pulmonary artery and left atrium.
Iron Deficiency, Iron Overload
Authors: J. Sorbie, L. S. Valberg
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 February 1972Iron Deficiency, Iron OverloadJ. SORBIE, M.D., L. S. VALBERG, M.D.J. SORBIE, M.D.Search for more papers by this author, L. S. VALBERG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-2-333 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In his recent editorial (1) Dr. V. F. Fairbanks reviewed the tests available for iron deficiency. We are pleased that he gave favourable consideration to the new cobalt excretion test (2). Clinical trials of a 6-hour cobalt excretion test are well underway, and results indicate that this simple procedure is just as sensitive for detecting iron deficiency as the 24-hour test.But Dr. Fairbanks overlooked one aspect of the test. He stated that the cobalt excretion test was unsuitable for identification of states of iron overload. It is true that in exogenous iron overload caused by blood...References1. FAIRBANKS V: Diagnostic tests for iron deficiency. Ann Intern Med 75:640-642, 1971 LinkGoogle Scholar2. SORBIEOLATUNBOSUNCORBETT JDW: Cobalt excretion test for the assessment of body iron stores. Can Med Assoc J 104:777-782, 1971 MedlineGoogle Scholar3. OLATUNBOSUNCORBETTLUDWIG DWJ: Alteration of cobalt absorption in portal cirrhosis and idiopathic hemochromatosis. J Lab Clin Med 75:754-762, 1970 MedlineGoogle Scholar4. WILLIAMSMANENTIWILLIAMS RFH: Iron absorption in idiopathic haemochromatosis before, during, and after venesection therapy. Br Med J 2:78-81, 1966 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1972Volume 76, Issue 2Page: 333-334KeywordsBloodClinical trialsExcretionIron deficiency Issue Published: 1 February 1972 PDF downloadLoading ...
Lessons from the U.K.
Authors: Martin Roland
Journal: New England Journal of Medicine (2008)

The editors asked several experts to share their perspectives on the crisis in U.S. primary care. Their articles, which address this crisis from six different angles, follow. We also brought the five U.S. contributors together for a roundtable discussion of the problems and potential solutions for training, practice, compensation, and systemic change. A video of the discussion and reader comments can be seen at www.nejm.org.The United Kingdom takes the importance of primary care for granted. The U.K. government is effectively the country's single payer, and successive administrations have been convinced by mounting evidence that primary care promotes high-quality, cost-effective, and equitable health care.1 If anything, the U.K. government has become more convinced over the past 15 years that strong primary care needs to be at the heart of the country's health care system — quite the reverse of the situation in the United States. U.K. primary care physicians now have average earnings of $220,000 (in U.S. dollars), which is more than many specialists earn. . . .
Moderate-intensity physical activity and fasting insulin levels in women: the Cross-Cultural Activity Participation Study.
Authors: M L Irwin, E J Mayer-Davis, C L Addy, R R Pate, J L Durstine, L M Stolarczyk, B E Ainsworth
Journal: Diabetes Care (2000)

OBJECTIVE: The purpose of this study was to determine the association between moderate-intensity physical activity (PA) and fasting insulin levels among African-American (n = 47), Native American (n = 46), and Caucasian women (n = 49), aged 40-83 years, enrolled in the Cross-Cultural Activity Participation Study. Associations by race/ethnicity, levels of central obesity, and cardiorespiratory fitness were also examined. RESEARCH DESIGN AND METHODS: Physical activity scores were obtained from detailed PA records that included all PA performed during two consecutive 4-day periods scheduled 1 month apart. Using MET intensity (the associated metabolic rate for a specific activity divided by a standard resting metabolic rate), PA was expressed as MET-min (the product of the minutes for each activity times the MET intensity level) per day of energy expended in moderate (3-6 METs) and moderate/vigorous (&amp;gt; or = 3 METs) PA. Fasting insulin levels were determined by radioimmunoassay. Data were analyzed by multiple linear regression analysis. RESULTS: After adjusting for race/ethnicity, age, educational attainment, and site, an increase of 30 min of moderate-intensity PA was associated with a 6.6% lower fasting insulin level (P &amp;lt; 0.05). The association was similar among races/ethnicities, centrally lean and centrally obese women, and women with low and high cardiorespiratory fitness levels. CONCLUSIONS: These findings lend support to the 1995 Centers for Disease Control and Prevention and American College of Sports Medicine recommendations for an accumulation of 30 min/day in moderate-intensity PA. They also contribute to the growing literature suggesting that moderate amounts of PA have a significant role in reducing the burden of hyperinsulinemia and diabetes among ethnic populations at highest risk for these conditions.