tbuckley/cabot-search huggingface dataset:
Patatin-Like phospholipase domain-containing 3 I148M polymorphism, steatosis, and liver damage in chronic hepatitis C
Authors: Luca Valenti, MariaGrazia Rumi, Enrico Galmozzi, Alessio Aghemo, Benedetta Del Menico, Stella De Nicola, Paola Dongiovanni, Marco Maggioni, Anna Ludovica Fracanzani, Raffaela Rametta, Massimo Colombo, Silvia Fargion
Journal: Hepatology (2010)

Abstract Steatosis has been reported to negatively influence the natural history of chronic hepatitis C (CHC), but controversy remains over its causal role due to the confounding effect of adiposity, insulin resistance, and diabetes. The rs738409 C&gt;G patatin-like phospholipase domain-containing 3 ( PNPLA3 ) single nucleotide polymorphism (SNP), encoding for the I148M protein variant, influences liver fat without affecting insulin resistance and body composition. The aim of this study was to evaluate the effect of the rs738409 CG genotype on liver fat and fibrosis in CHC patients. We also explored the possible effect of PNPLA3 genotype on other steatosis-related complications, namely, treatment failure and hepatocellular carcinoma (HCC) development. To this end we considered two independent series of 325 and 494 CHC patients with available DNA and liver biopsy followed at tertiary referral centers in northern Italy. The rs738409 genotype was determined by a Taqman assay. The rs738409 GG genotype, observed in 10% of patients, was associated with steatosis independently of age, sex, body mass index (BMI), diabetes, alcohol intake, and viral genotype (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.4-2.7; P &lt; 0.001). The association with rs738409 genotype was confirmed for severe steatosis, was independent of alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) values, and was observed in all viral genotypes but the 3. The rs738409 GG genotype was associated with fibrosis stage and cirrhosis (OR 1.47, 95% CI 1.2-1.9; P = 0.002), treatment response (n = 470; OR 0.63, 95% CI 0.4-0.8; P = 0.006), and HCC occurrence (n = 325; OR 2.16, 95% CI 1.3-3.6; P = 0.002), independently of confounders. Conclusion: The rs738409 PNPLA3 genotype influences steatosis development in CHC and is independently associated with cirrhosis and other steatosis-related clinical outcomes, such as lack of response to antiviral treatment and possibly HCC. (Hepatology 2011)
Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity
Authors: Arlet V. Nedeltcheva, Jennifer M. Kilkus, Jacqueline Imperial, Dale A. Schoeller, Plamen D. Penev
Journal: Annals of Internal Medicine (2010)

Background: Sleep loss can modify energy intake and expenditure. Objective: To determine whether sleep restriction attenuates the effect of a reduced-calorie diet on excess adiposity. Design: Randomized, 2-period, 2-condition crossover study. Setting: University clinical research center and sleep laboratory. Patients: 10 overweight nonsmoking adults (3 women and 7 men) with a mean age of 41 years (SD, 5) and a mean body mass index of 27.4 kg/m2 (SD, 2.0). Intervention: 14 days of moderate caloric restriction with 8.5 or 5.5 hours of nighttime sleep opportunity. Measurements: The primary measure was loss of fat and fat-free body mass. Secondary measures were changes in substrate utilization, energy expenditure, hunger, and 24-hour metabolic hormone concentrations. Results: Sleep curtailment decreased the proportion of weight lost as fat by 55% (1.4 vs. 0.6 kg with 8.5 vs. 5.5 hours of sleep opportunity, respectively; P = 0.043) and increased the loss of fat-free body mass by 60% (1.5 vs. 2.4 kg; P = 0.002). This was accompanied by markers of enhanced neuroendocrine adaptation to caloric restriction, increased hunger, and a shift in relative substrate utilization toward oxidation of less fat. Limitation: The nature of the study limited its duration and sample size. Conclusion: The amount of human sleep contributes to the maintenance of fat-free body mass at times of decreased energy intake. Lack of sufficient sleep may compromise the efficacy of typical dietary interventions for weight loss and related metabolic risk reduction. Primary Funding Source: National Institutes of Health.
Thyroxine in Goiter,<i>Helicobacter pylori</i>Infection, and Chronic Gastritis
Authors: Marco Centanni, Lucilla Gargano, Gianluca Canettieri, Nicola Viceconti, Antonella Franchi, Gianfranco Delle Fave, Bruno Annibale
Journal: New England Journal of Medicine (2006)

Malabsorption of thyroxine has been described in patients treated with drugs that modify an acidic environment. We determined whether there is an increased need for thyroxine in patients with euthyroid multinodular goiter and impaired secretion of gastric acid.We assessed the dose of thyroxine required to obtain a low level of thyrotropin (0.05 to 0.20 mU per liter) in 248 patients with multinodular goiter. Of these 248 patients, 53 also had Helicobacter pylori-related gastritis and 60 had atrophic gastritis of the body of the stomach (31 with evidence of H. pylori infection and 29 without such evidence). The reference group comprised 135 patients with multinodular goiter and no gastric disorders. In addition, variation in the level of serum thyrotropin was prospectively studied in 11 patients treated with thyroxine before and after H. pylori infection and both before and during treatment with omeprazole in 10 patients treated with thyroxine who had gastroesophageal reflux.The daily requirement of thyroxine was higher (by 22 to 34 percent) in patients with H. pylori-related gastritis, atrophic gastritis, or both conditions than in the reference group. In prospective studies, the occurrence of H. pylori infection in the 11 patients treated with thyroxine led to an increase in the level of serum thyrotropin (P=0.002), an effect that was nearly reversed on eradication of H. pylori infection. In a similar way, omeprazole treatment was associated with an increase in the level of serum thyrotropin in all 10 patients treated with thyroxine, an effect that was reversed by an increase in the thyroxine dose by 37 percent.Patients with impaired acid secretion require an increased dose of thyroxine, suggesting that normal gastric acid secretion is necessary for effective absorption of oral thyroxine.
Neutrophils in the Blood Bank
Authors: Dane R. Boggs
Journal: New England Journal of Medicine (1977)

IN this issue of the Journal, Herzig and Alavi and their respective associates provide the most definitive evidence published to date that transfusion of neutrophils is a beneficial adjunct in the treatment of infected, neutropenic patients. As the authors state, previous studies have provided convincing data in laboratory animals and suggestive data in man on this benefit. However, I agree with the authors that previous reports of human studies have suffered from flaws in experimental design. I doubt if anyone knowledgeable about neutrophils and their role in combating infections has ever doubted that an adequate number of adequately functional, . . .
Cefazolin and Staphylococcus aureus Endocarditis
Authors: William Hewitt
Journal: JAMA (1977)

<h3>To the Editor.—</h3> Bryant and Alford (237:569, 1977) suggest that cefazolin sodium should not be used for treatment of<i>Staphylococcus aureus</i>endocarditis. We disagree. Because of its long half-life (allowing less frequent administration), relative lack of pain on intramuscular injection, and very high blood levels, cefazolin is often the antibiotic used in treating patients with inadequate veins. It should be recognized that failure of therapy or relapse in cases of<i>S aureus</i>endocarditis is not infrequent with any antibiotic. We and others (G. C. Cobbs, personal communication)<sup>1</sup>have seen patients with persistently positive blood cultures after one to two weeks of treatment with large doses of methicillin, nafcillin, oxacillin, cephalothin, or vancomycin. Some of these patients eventually respond to continuation of the same treatment, but therapy is usually altered.<sup>1</sup>Slow responses and relapses may be related to abscesses in the spleen, heart, or other organs. How significant are
A CASE OF LARYNGEAL GROWTH.
Authors: F. C. RAYNOR
Journal: JAMA (1892)

The following history of a case of laryngeal growth presents unusual and interesting features, and I therefore bring it before the Association for consideration: Ida M. M., age 12, school girl, came under the care of Dr. Sherwell and myself at the Skin and Throat Clinic of the Brooklyn Eye and Ear Hospital, July 18, 1889. She complained of hoarseness, slight hacking cough, and dyspnoea on exertion, which she had first noticed about six months previous. She was small for her age, and somewhat anaemic; her mother died of phthisis, father and two sisters healthy. On laryngoscopical examination was found a papillomatous growth on the top of the right vocal cord, near the anterior commissure. It extended upward into the ventricle, was oblong in shape and had an attachment of about three-eighths by one-fourth inches. It was pale in color, contrasting strongly with the adjacent tissues, which were all congested. She
Physiological determinants of race walking performance in female race walkers.
Authors: T Yoshida, M Udo, K Iwai, I Muraoka, K Tamaki, T Yamaguchi, M Chida
Journal: British Journal of Sports Medicine (1989)

The purpose of this study was to determine the relationship between race pace on a 5 km walking performance and velocity at the lactate threshold (V-LT), VO2 at the lactate threshold (VO2-LT), velocity at which blood lactate corresponded to 4 mM level (V-OBLA), VO2 at which blood lactate corresponded to 4 mM level (VO2-OBLA), walking economy (steady state VO2 at a standard velocity) and maximal oxygen uptake (VO2max) in eight female race walkers. A multiple stepwise linear regression analysis was employed to predict the race pace on a 5 km walking performance as dependent variable. Since V-OBLA was highly correlated to 5 km race walking performance (r = 0.94, P less than 0.001), it was selected as the first predictor. When VO2max was added to V-OBLA as the second predictor the predictive accuracy increased significantly, but multiple R did not increase significantly by adding variables of walking economy or other parameters as independent variance. As a result, the combination of V-OBLA and VO2max as independent variables accounted for the greatest amount of total variance (97 per cent). It is suggested that blood lactate variable such as V-OBLA can account for a large portion of the variance in race pace on a 5 km walking performance.
Seat-belt hernia. A ventral hernia following an automobile crash
Authors: E. S. Hurwitt
Journal: JAMA (1965)

THE USE of automobile seat belts has been shown to be effective in reducing mortality and severity of injuries sustained during automobile accidents, and has found increasing acceptance throughout the United States as well as other parts of the world. With the increase in use of automobile seat belts, one may anticipate finding a gradually increasing number of injuries attributable to the snubbing action of the seat belt itself. The case to be reported in this paper involves a young woman whose life was undoubtedly saved by a lap-type seat belt during a spectacular automobile accident. Approximately seven months later an unusual ventral hernia developed in the left upper quadrant of the abdomen, presumably caused by the snubbing action of the seat belt during the accident. This case is apparently unique, and possibly representative of a type of injury to be seen much more commonly in the future. <h3>Report of</h3>
Cost-effectiveness Analysis of Directly Observed Therapy for Patients with Tuberculosis at Low Risk for Treatment Default
Authors: DAVID C. SNYDER, DANIEL P. CHIN
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

To determine the incremental cost of directly observed therapy (DOT) for patients with tuberculosis at low risk for treatment default, we applied a model of DOT effectiveness to 1,377 low-risk patients in California during 1995. The default rate for this cohort, which consisted of those with no recent history of substance abuse, homelessness, or incarceration, was 1.7%. The model predicted that DOT and self-administered therapy (SAT) cured 93.1 and 90.8% of these patients, respectively. DOT would initially cost $1.83 million more than SAT, but avert $569,191 in treatment cost for relapse cases and their contacts, for a net incremental cost of $1.27 million ($919 per patient treated), or $40,620 per additional case cured. The cost-effectiveness of DOT was sensitive to the default rate and relapse rate after completing SAT. DOT would generate cost savings only when the default and relapse rates were more than 32.2 and 9.2%, respectively. Given the low default rate and resulting high incremental cost of DOT, provision of DOT to low-risk patients in California should be evaluated in the context of resource availability, competing program priorities, and program success in completing self-administered therapy with a low relapse rate.
Psoriasis: are clinicians too busy to assess disease severity?
Authors: G. J. Parkins, J. A. Leman
Journal: BMJ (2014)

Clinical guidelines are expensive to produce, both financially and in terms of the time invested by guideline development groups. The Scottish Intercollegiate Guidelines Network (SIGN) budget is £25 000 (excluding staffing costs, which are 70% of the total budget) for each new guideline, which takes around 29 months to complete (personal communication, SIGN programme lead). The healthcare professionals involved in writing …
Benefits of lipid-lowering therapy in men with elevated apolipoprotein B are not confined to those with very high low density lipoprotein cholesterol
Authors: B.Fendley Stewart, B.Greg Brown, Xue-Qiao Zhao, Lynn A. Hillger, Alan D. Sniderman, Alice Dowdy, Lloyd D. Fisher, John J. Albers
Journal: Journal of the American College of Cardiology (1994)
KÖHLER'S DISEASE OF THE TARSAL SCAPHOID OR OS NAVICULARE PEDIS RETARDATUM
Authors: F. C. KIDNER
Journal: JAMA (1924)

There are two distinct pathologic entities to which the name of Kohler's disease has been given. One of these occurs in the head of the second metatarsal, and the other in the scaphoid of the tarsus. A similar condition has been described by Kienbock as occurring in the carpus. In this paper, we shall deal only with the condition as seen in the tarsal scaphoid. We suggest as an accurate descriptive name the term os naviculare pedis retardatum. To correspond with this term, we suggest for the other two conditions the names metatarsus planus and os lunatum retardatum.  We are presenting this paper because we recently had an opportunity to study a typical case of os naviculare pedis retardatum from both the clinical and the pathologic points of view.  REPORT OF CASE  A. B., a boy, aged 8 years came to the hospital clinic complaining of pain in the left
Emergency planning and the acute toxic potency of inhaled ammonia.
Authors: R A Michaels
Journal: Environmental Health Perspectives (1999)

Ammonia is present in agriculture and commerce in many if not most communities. This report evaluates the toxic potency of ammonia, based on three types of data: anecdotal data, in some cases predating World War 1, reconstructions of contemporary industrial accidents, and animal bioassays. Standards and guidelines for human exposure have been driven largely by the anecdotal data, suggesting that ammonia at 5,000-10,000 parts per million, volume/volume (ppm-v), might be lethal within 5-10 min. However, contemporary accident reconstructions suggest that ammonia lethality requires higher concentrations. For example, 33,737 ppm-v was a 5-min zero-mortality value in a major ammonia release in 1973 in South Africa. Comparisons of secondary reports of ammonia lethality with original sources revealed discrepancies in contemporary sources, apparently resulting from failure to examine old documents or accurately translate foreign documents. The present investigation revealed that contemporary accident reconstructions yield ammonia lethality levels comparable to those in dozens of reports of animal bioassays, after adjustment of concentrations to human equivalent concentrations via U.S. Environmental Protection Agency (EPA) procedures. Ammonia levels potentially causing irreversible injury or impairing the ability of exposed people to escape from further exposure or from coincident perils similarly have been biased downwardly in contemporary sources. The EPA has identified ammonia as one of 366 extremely hazardous substances subject to community right-to-know provisions of the Superfund Act and emergency planning provisions of the Clean Air Act. The Clean Air Act defines emergency planning zones (EPZs) around industrial facilities exceeding a threshold quantity of ammonia on-site. This study suggests that EPZ areas around ammonia facilities can be reduced, thereby also reducing emergency planning costs, which will vary roughly with the EPZ radius squared.
Improved cardiac assistance with an aortic arch balloon
Authors: W. BLEIFELD, W. D. BUSSMANN, J. MEYER, S. EFFERT
Journal: Cardiovascular Research (1973)

The haemodynamic effects of intra-aortic counterpulsation with normally used cylindrical and newly designed aortic arch balloons on the coronary blood flow and the performance of the normal dog heart were compared. Both balloon types resulted in a decrease of left ventricular systolic and end-diastolic pressure, systolic arterial and end-diastolic arterial pressure. The amplitude of diastolic augmentation was significantly larger with the aortic arch balloon. The carotid artery flow increased significantly more with the aortic arch balloon (36%) than with the cylindrical balloon. Pulsation in the aortic arch effected a significant decrease in left ventricular impedance (33%), which was inversely correlated with a marked increment of the stroke volume (36%). In addition, mean coronary blood flow increased during aortic arch balloon pulsation (37%). From these data, it is concluded that optimal intra-aortic balloon pulsation should be performed with large balloons close to the aortic valve. The newly designed aortic arch balloon fulfils this condition.
Working Capacity of Women Doctors
Authors: F. M. Ulyatt
Journal: BMJ (1966)

Evidence suggests that the phytocannabinoids Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) differentially regulate salience attribution and psychiatric risk. The ventral hippocampus (vHipp) relays emotional salience via control of dopamine (DA) neuronal activity states, which are dysregulated in psychosis and schizophrenia. Using <i>in-vivo</i> electrophysiology in male Sprague Dawley rats, we demonstrate that intra-vHipp THC strongly increases ventral tegmental area (VTA) DA neuronal frequency and bursting rates, decreases GABA frequency, and amplifies VTA beta, gamma and epsilon oscillatory magnitudes via modulation of local extracellular signal-regulated kinase phosphorylation (pERK1-2). Remarkably, whereas intra-vHipp THC also potentiates salience attribution in morphine place-preference and fear conditioning assays, CBD co-administration reverses these changes by down-regulating pERK1-2 signaling, as pharmacological re-activation of pERK1-2 blocked the inhibitory properties of CBD. These results identify vHipp pERK1-2 signaling as a critical neural nexus point mediating THC-induced affective disturbances and suggest a potential mechanism by which CBD may counteract the psychotomimetic and psychotropic side-effects of THC. <b>SIGNIFICANCE STATEMENT</b> Strains of marijuana with high levels of delta-9-tetrahydrocannabinol (THC) and low levels of cannabidiol (CBD) have been shown to underlie neuropsychiatric risks associated with high potency cannabis use. However, the mechanisms by which CBD mitigates the side effects of THC have not been identified. We demonstrate that THC induces cognitive and affective abnormalities resembling neuropsychiatric symptoms directly in the hippocampus, while dysregulating dopamine activity states and amplifying oscillatory frequencies in the ventral tegmental area via modulation of the extracellular signal-regulated kinase (ERK) signaling pathway. In contrast, CBD co-administration blocked THC-induced ERK phosphorylation, and prevented THC-induced behavioural and neural abnormalities. These findings identify a novel molecular mechanism that may account for how CBD functionally mitigates the neuropsychiatric side-effects of THC.
Annual or biennial FOBT screening reduced colorectal cancer mortality, but not all-cause mortality, at 30 years
Authors: Robert H. Fletcher
Journal: Annals of Internal Medicine (2014)

ACP Journal Club21 January 2014Annual or biennial FOBT screening reduced colorectal cancer mortality, but not all-cause mortality, at 30 yearsRobert H. Fletcher, MD, MScRobert H. Fletcher, MD, MScHarvard Medical School, Boston, Massachusetts, USA (R.H.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-160-2-201401210-02002 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationShaukat A, Mongin SJ, Geisser MS, et al. Long-term mortality after screening for colorectal cancer. N Engl J Med. 2013;369:1106-14. https://pubmed.ncbi.nlm.nih.gov/24047060Clinical Impact RatingsGIM/FP/GP: Gastroenterology: References1 Brenner H, Tao S. Superior diagnostic performance of faecal immunochemical tests for haemoglobin in a head-to-head comparison with guaiac based faecal occult blood test among 2235 participants of screening colonoscopy. Eur J Cancer. 2013;49:3049-54. [PMID: 23706981] Google Scholar2 Klabunde CN, Djenaba JA, King JB, White A, Plescia M; Centers for Disease Control and Prevention. Vital signs: colorectal cancer screening test use–United States, 2012. MMWR Morb Mortal Wkly Rep. 2013;62:881-8. [PMID: 24196665] Google Scholar3 Atkin WS, Edwards R, Kralj-Hans I, et al; UK Flexible Sigmoidoscopy Trial Investigators. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624-33. [PMID: 20430429] Google Scholar Author, Article, and Disclosure InformationAuthors: Robert H. Fletcher, MD, MScAffiliations: Harvard Medical School, Boston, Massachusetts, USA (R.H.F.)This article was published at Annals.org on 7 January 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 January 2014Volume 160, Issue 2Page: JC2KeywordsCancer screeningColonoscopyColorectal cancerColorectal cancer screeningHematologic testsMortalityRandomized trialsRelative riskSurgeryVeteran care ePublished: 21 January 2014 Issue Published: 21 January 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...