tbuckley/cabot-search huggingface dataset:
Renin, Sodium, and Vasodepressor Response to Saralasin in Renovascular and Essential Hypertension
Authors: LEONARD S. MARKS
Journal: Annals of Internal Medicine (1977)

Saralasin (1-sar-8-ala-angiotensin II), a competitive inhibitor of angiotensin II, was administered to 32 patients with renovascular or essential hypertension before (Day 1) and after (Day 2) they were mildly sodium depleted by furosemide (1 mg/kg body weight). A blood pressure lowering effect of saralasin was observed in 16 of 17 patients with renovascular hypertension on Day 2, but in only 10 of the 17 on Day 1. Of the 15 patients with essential hypertension, only the four with high renin levels exhibited a vasodepressor response on Day 2; three responded similarly on Day 1. The average net sodium loss between the 2 days was greater for patients who responded to the drug on Day 2 (170 meq) than those who did not (129 meq) (P < 0.05); however, there was no correlation between blood pressure response and either net sodium loss or urinary sodium excretion at the time of testing. Plasma renin activity correlated with saralasin responses (r = -0.74, P < 0.01). Saralasin testing during a state of modest sodium depletion compares favorably with renin measurements in the detection of renin-mediated hypertension.
Leadership in Internal Medicine; APM Responds
Authors: Gerald S. Levey
Journal: Annals of Internal Medicine (1991)

Letters1 June 1991Leadership in Internal Medicine; APM RespondsGerald S. Levey, MDGerald S. Levey, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-11-995_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: The members of the Association of Professors of Medicine (APM) have read with great interest the article by Dr. Reitemeier (1) on the leadership crisis in internal medicine. We agree with Dr. Reitemeier that the APM is the only organization within internal medicine with the authority, responsibility, and accountability to serve as an effective agent of change.It should be noted that the APM has begun to work towards positive change on several fronts. The APM has undertaken the major project for examining the curriculum for internal medicine residency training by appointing a curriculum committee that is...Reference1. Reitemeier R. The leadership crisis in internal medicine: what can be done? Ann Intern Med. 1991;114:69-75. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Association of Professors of Medicine Washington, DC 20036 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1991Volume 114, Issue 11Page: 995-995KeywordsResidency Issue Published: 1 June 1991 PDF DownloadLoading ...
Mental illness is often not recognised among black people
Authors: Z. Kmietowicz
Journal: BMJ (1997)

People with mental health problems are missing out on treatment because they are not being diagnosed in primary care or referred to specialist services appropriately.

White people who are mentally ill stand the best chance of being given a diagnosis and treatment, while mental illness in black people is more likely to go unrecognised, according to the first comprehensive survey of psychiatric morbidity and service use in …
Erasmus Wilson (1809–1884): The Dermatologist and the Obelisk
Authors: Robert K. Moxon
Journal: New England Journal of Medicine (1976)

The oldest public monument in London today is an Egyptian obelisk, "Cleopatra's Needle," dating from 1500 B.C. Standing on the Embankment since 1878 (Fig. 1), it commemorates two Pharaohs, British naval and military victories over Napoleon in 1798–1802, and the beneficence of England's first dermatologist, Erasmus Wilson.The obelisk was one of a pair standing originally in front of the Temple of Neptune at Heliopolis, erected by Thothmes III, with additional inscriptions made two centuries later by Rameses the Great. During the Greek Dynasty it was moved to Alexandria, the royal city of Cleopatra, and re-erected in 12 B.C. during . . .
Failure of papaverine to reduce pruritus in atopic dermatitis: a double-blind, placebo-controlled cross-over study
Authors: J. BERTH-JONES, R.A.C. GRAHAM-BROWN
Journal: British Journal of Dermatology (1990)

Papaverine has been reported, largely on the basis of clinical experience, to reduce the severity of pruritus associated with atopic dermatitis. A double-blind, placebo-controlled, cross-over study was performed to assess the degree of improvement. Fifty subjects with atopic dermatitis each received papaverine 100 mg q.d.s. orally for 4 weeks and another 4 weeks of matching placebo in randomized order. The parameters used to measure response were pruritus as assessed on visual analogue scales by the subjects, clinical scoring of extent and severity of the dermatitis and rate of usage of topical steroid preparations. Forty-five subjects completed the protocol and no improvement in any parameter was demonstrated.
Meta-analysis and Meta-Regression Analysis of Outcomes of Carotid Endarterectomy and Stenting in the Elderly
Authors: George A. Antoniou, George S. Georgiadis, Efstratios I. Georgakarakos, Stavros A. Antoniou, Nikos Bessias, John Vincent Smyth, David Murray, Miltos K. Lazarides
Journal: JAMA Surgery (2013)

Uncertainty exists about the influence of advanced age on the outcomes of carotid revascularization.To undertake a comprehensive review of the literature and conduct an analysis of the outcomes of carotid interventions in the elderly.A systematic literature review was conducted to identify articles comparing early outcomes of carotid endarterectomy (CEA) or carotid stenting (CAS) in elderly and young patients.Combined overall effect sizes were calculated using fixed or random effects models. Meta-regression models were formed to explore potential heterogeneity as a result of changes in practice over time. RESULTS Our analysis comprised 44 studies reporting data on 512,685 CEA and 75,201 CAS procedures. Carotid stenting was associated with increased incidence of stroke in elderly patients compared with their young counterparts (odds ratio [OR], 1.56; 95% CI, 1.40-1.75), whereas CEA had equivalent cerebrovascular outcomes in old and young age groups (OR, 0.94; 95% CI, 0.88-0.99). Carotid stenting had similar peri-interventional mortality risks in old and young patients (OR, 0.86; 95% CI, 0.72-1.03), whereas CEA was associated with heightened mortality in elderly patients (OR, 1.62; 95% CI, 1.47-1.77). The incidence of myocardial infarction was increased in patients of advanced age in both CEA and CAS (OR, 1.64; 95% CI, 1.57-1.72 and OR, 1.30; 95% CI, 1.16-1.45, respectively). Meta-regression analyses revealed a significant effect of publication date on peri-interventional stroke (P = .003) and mortality (P < .001) in CAS.Age should be considered when planning a carotid intervention. Carotid stenting has an increased risk of adverse cerebrovascular events in elderly patients but mortality equivalent to younger patients. Carotid endarterectomy is associated with similar neurologic outcomes in elderly and young patients, at the expense of increased mortality.
ADRENAL CORTEX INSUFFICIENCY
Authors: ROBERT F. LOEB
Journal: JAMA (1941)

CLINICAL PICTURE OF ADRENAL CORTEX INSUFFICIENCY  The syndrome of adrenal cortex insufficiency was first described by Thomas Addison, in his classic treatise, published in 1855. This symptom complex as observed in Addison's disease is characterized by an insidious onset and progressive development of fatigability and asthenia to the point of utter exhaustion, associated with varying degrees of anorexia, nausea and vomiting. Very occasionally diarrhea and abdominal pain are present. The symptoms may appear in the course of weeks, months or even years. At times, however, the tempo of the disease may be greatly accelerated. This may occur either spontaneously or in response to a withdrawal of sodium salts from the diet, or in association with an acute infection, and may, in the course of a few days, terminate fatally. These abrupt episodes of adrenal insufficiency are termed crises. In a few instances the symptoms and signs of hypoglycemia may dominate
Abstract P244: Comorbidities and Physical and Cognitive Impairments in Elderly Heart Failure Patients: Impact on Total Mortality: The Cardiovascular Health Study (CHS)
Authors: Khalil Murad, David C Goff, Timothy M Morgan, Gregory L Burke, Dalane W Kitzman
Journal: Circulation (2012)

Background: Comorbidities and physical and cognitive impairments are common in patients with heart failure (HF) and often associated with greater mortality. However, the prevalence of these conditions and their associated mortality risk in elderly patients with incident HF is unknown. Method: We examined the prevalence of 9 comorbidities and 4 measures of physical and cognitive impairments in 558 participants from CHS (age 79.2 ± 6.3, 52% men) with incident HF diagnosed between 1990 and 2002. Participants were followed prospectively until mid 2008 (an average follow up time of 4.7 years) to determine the associated mortality risk. Results: The burden of comorbidities was high; 60% of participants had ≥ 3 comorbidities, and only 2.5% had none. Impairment in ≥ 1 activity of daily living (ADL) and ≥ 1 instrumental activity of daily living (IADL) was present in 22.5% and 43.7% of participants, respectively. Significant cognitive impairment (modified mini-mental state exam (3MSE) score &lt; 80) was present in 17% of participants. During follow up, 504 participants died, with 1-year and 5-year survival rates of 0.81 and 0.44 respectively. In a multivariable-adjusted model, the following were significantly associated with greater total mortality (hazard ratio: 95% confidence interval): comorbidities including diabetes mellitus (1.64: 1.33–2.03), chronic kidney disease (moderate (1.32: 1.07–1.62); severe (3.00: 1.82–4.95)), cerebrovascular disease (1.53: 1.22–1.92), and depression (1.44: 1.09–1.90); Physical impairment (1 ADL impaired (1.30: 1.04–1.63); ≥ 2 IADL impaired (1.49: 1.07–2.04)); and cognitive impairment (3MSE score &lt; 80 (1.33: 1.02–1.73)). Conclusion: Elderly patients with incident HF have high burdens of comorbidities and physical and cognitive impairments that significantly contribute to their high mortality rates.
Probucol Protects Against Adriamycin Cardiomyopathy Without Interfering With Its Antitumor Effect
Authors: N. Siveski-Iliskovic, M. Hill, D.A. Chow, P.K. Singal
Journal: Circulation (1995)

Background The usefulness of adriamycin (ADR), a potent antitumor antibiotic, is limited by the development of life-threatening cardiomyopathy and congestive heart failure. Subcellular changes leading to heart failure are suggested to be mediated by a drug-induced increase in free radicals and lipid peroxidation. In an earlier study, concurrent treatment with probucol (PROB), a lipid-lowering drug with strong antioxidant properties, was shown to offer only partial protection against ADR cardiomyopathy. The present study had two aims: to determine whether this protective effect can be improved further by extended treatment with PROB, and to determine whether PROB affects the antitumor properties of ADR. Methods and Results ADR (cumulative dose, 15 mg/kg body wt) was administered in rats in six equal injections (IP) over a period of 2 weeks. Three weeks after the end of treatment, cardiomyopathy and congestive heart failure were characterized by ascites, congested liver, depressed cardiac function, elevated left ventricular end-diastolic pressure, and myocardial cell damage. Myocardial glutathione peroxidase (GSHPx) activity was decreased and lipid peroxidation was increased. Administration of PROB (cumulative dose, 120 mg/kg body wt) in 12 equal injections (IP), before and concurrent with ADR, completely prevented these cardiomyopathic changes, normalized left ventricular function, lowered mortality, and eliminated ascites. Treatment with PROB was also accompanied by an increase in myocardial GSHPx and superoxide dismutase activities with a concomitant decrease in lipid peroxidation. Tumor regression in syngeneic DBA/2 mice inoculated with L5178Y-F9 lymphoma cells in the ADR+PROB group was significant and comparable to the ADR group. Conclusions These data show for the first time that PROB can provide complete protection against ADR cardiomyopathy without interfering with antitumor properties of the drug. This protective effect of PROB may be related to the maintenance of the antioxidant status of the heart.
Glycemic Control with Closed-Loop Intraperitoneal Insulin in Type I Diabetes
Authors: Hervé LeBlanc, Dominique Chauvet, Pierre Lombrail, Jean Jacques Robert
Journal: Diabetes Care (1986)

Blood glucose levels were compared in eight type I diabetic subjects who were given closed-loop infusions of insulin by intraperitoneal (i.p.) and intravenous (i.v.) routes, in a cross-over randomized study. After a test meal, plasma glucose peaks were significantly higher with i.p. than with i.v. infusion (174 ± 22 versus 129 ± 29 mg/dl) and marked hypoglycemia occurred after 180 min in five of eight subjects. These observations appear to be the consequence of a 60-min lag in insulin rise with i.p. administration. Because of this difference in plasma glucose rise, twice as much insulin was administered i.p. than with i.v. Plasma insulin rose to similar values in both cases. Therefore, with present closed-loop systems, i.p. insulin infusion does not lead to better control of glucose levels than i.v. infusion and does not prevent hyperinsulinism. Adjustments of the artificial B-cell algorithms and the injection of a bolus dose must be tested so that the potential advantages of the i.p. route may be achieved.
Abstract 412: Isolation and analysis of metastasis-related genes in an oral cancer cells with autocrine stromal cell-derived factor −1/CXCR4 system
Authors: Daisuke Uchida, Tomitaro Onoue, Nobuyuki Kuribayashi, Tetsuya Tamatani, Hirokazu Nagai, Youji Miyamoto
Journal: Cancer Research (2010)

Abstract We have previously demonstrated that distant metastasis might require the autocrine stromal cell-derived factor-1 (SDF-1; CXCL12)/CXCR4 system in cases of oral squamous cell carcinoma (SCC). In this study, we examined the expression of metastasis-related genes in B88-SDF-1 cells, which have an autocrine SDF-1/CXCR4 system and distant metastatic potentials in vivo. Microarray analysis revealed that 418 genes were upregulated in B88-SDF-1 cells. To confirm the specificity of the microarray analysis, 3 highly upregulated genes, metabotropic glutamate receptor 5 (mGluR5), plasticity related gene 1 (PRG1), and unknown gene were reanalyzed by RT-PCR. These 3 genes were upregulated in B88-SDF-1 cells in comparison with those in mock cells, but AMD3100, a specific antagonist of CXCR4, abrogated the upregulation of 2 (mGluR5 and PRG1) out of 3 genes in B88-SDF-1 cells. Thus, we analyzed the expression of metabotropic glutamate receptor 5 (mGluR5), one of the genes that were upregulated in B88-SDF-1 cells. A specific mGluR5 antagonist, MPEP did not affect the growth of B88-SDF-1 cells, but did inhibit the enhanced-migration of B88-SDF-1 cells. When the B88-SDF-1 cells were transplanted into the vein, numerous metastatic foci were detected. Under the present conditions, MPEP significantly inhibited the lung metastasis of the B88-SDF-1 cells, ameliorated body weight loss, and improved the survival rate of tumor-bearing nude mice. These results suggested that mGluR5 might be one of a possible metastasis-related gene induced by an autocrine SDF-1/CXCR4 system in oral SCC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 412.
Polymeric carrier of proline analogue with antifibrotic effect in pulmonary vascular remodeling.
Authors: G J Poiani, J E Kemnitzer, J D Fox, C A Tozzi, J Kohn, D J Riley
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

The proline analogue cis-4-hydroxy-L-proline (cHyp) inhibits collagen accumulation but diffuses out of tissues. To prolong the antifibrotic effect, we used a copolymer of cHyp attached to a backbone of poly(ethylene glycol) (PEG) and lysine. The copolymer was encapsulated in liposomes conjugated with PEG or in liposomes coated with the polysaccharide amylopectin to improve uptake by lungs after intravenous infusion. Amylopectin-liposomes had approximately 3-fold greater uptake in cultured endothelial cells compared with PEG-liposomes and greater lung retention 1 wk after infusion (5.2 +/- 0.8% versus 2.7 +/- 0.2%, p < 0.05). Sustained antifibrotic activity, assayed by growth inhibition of smooth muscle cells and fibroblasts over 4 d, was greater for amylopectin-liposomes/copolymer than PEG-liposomes/copolymer. Inhibition of collagen accumulation in pulmonary arteries of hypoxic (10% O2) rats was used to assess antifibrotic activity. Amylopectin-liposomes/copolymer attenuated increased right ventricular pressure by approximately 50% and completely prevented excess vascular collagen 1 wk after a single intravenous injection. The copolymer in liposomes was > 1,000-fold more effective by weight than unencapsulated monomeric cHyp. Thus, the copolymer, a potent, long-acting antifibrotic agent, totally prevented collagen accumulation for 1 wk in pulmonary arteries undergoing vascular remodeling when delivered in amylopectin-liposomes.
A Comprehensive Karyotypic Study on Human Hepatocellular Carcinoma by Spectral Karyotyping
Authors: Nathalie Wong, Paul Lai, Elizabeth Pang, Thomas Wai-Tong Leung, Joseph Wan-Yee Lau, Philip James Johnson
Journal: Hepatology (2000)

The current paucity of cytogenetic information on hepatocellular carcinoma (HCC) reflects the difficulties in culturing hepatocytes in vitro . Here, we report on the successful culture of 15 HCC cases. Chromosome aneuploidy ranging from a near–diploid to hyperhexaploid karyotype was found, but their complete karyotypic interpretations were hampered by the presence of many unidentifiable rearrangements. Spectral karyotyping (SKY) was used to elucidate structural changes in these HCC samples and 3 liver cancer cell lines (PLC/PRF/5, Hep3B, and HepG2). Frequent structural abnormalities were found on chromosomes 1 (13 of 15 cases; 3 of 3 cell lines), 8 (10 of 15 cases; 2 of 3 cell lines), 17 (9 of 15 cases; 3 of 3 cell lines), and 19 (9 of 15 cases; 1 of 3 cell lines). In particular, the chromosome regions 1p13–q21, 8p12–q21, 17p11–q12, 17q22, and 19p10–q13.1 were involved in multiple rearrangements. SKY analysis also suggested several previously undescribed breakpoints in HCC. These breakpoints, predominantly pericentromeric, clustered around the chromosome bands 2q33–q34, 3p13–q12, 4p14–q12, 5p10–q11, 7p12–q11, 10q10–q11, 11q10, 11q13–q21, 12q10–q13, 12q22–q23, 13q10–q14, 15q10, 16q10–q13, 18p11–q11, 20p11–q13.1, 21q10, and 22q10. When tumor sizes were compared, a significantly higher number of structural abnormalities was found in tumors larger than 4 cm ( P = .007). Rearrangements such as t(1;8), t(1;11), t(1;19), and t(17;21) that were identified in both primary tumors and cell lines might represent markers that reflect proliferative advantages. Although SKY analysis did not indicate consistent translocations, it suggested nonrandom breakpoints, predominantly in the pericentromeric region, on a number of chromosomes. These breakpoint clusters may thus prove to be more important in the liver carcinogenesis and targets for further molecular investigations.
Therapeutic effects of the Chinese herbal formula, MSSM-003d, on persistent airway hyperreactivity and airway remodeling*1
Authors: P.J. Busse, M.C. Wen, C.K. Huang, K.D. Srivastava, T.F. Zhang, B. Schofield, H.A. Sampson, X.M. Li
Journal: Journal of Allergy and Clinical Immunology (2004)
Delta-9-Tetrahydrocannabinol as an Antiemetic in Cancer Patients Receiving High-Dose Methotrexate
Authors: Alfred E. Chang, David J. Shiling, Richard C. Stillman, Nelson H. Goldberg, Claudia A. Seipp, Ivan Barofsky, Richard M. Simon, Steven A. Rosenberg
Journal: Annals of Internal Medicine (1979)

Fifteen patients with osteogenic sarcoma receiving high-dose methotrexate chemotherapy were studied in a randomized, double-blind, placebo-controlled trial of oral and smoked delta-9-tetrahydrocannabinol (THC) as an antiemetic. Each patient served as his or her own control. Fourteen of 15 patients had a reduction in nausea and vomiting on THC as compared to placebo. Delta-9-tetrahydrocannabinol was significantly more effective than placebo in reducing the number of vomiting and retching episodes, degree of nausea, duration of nausea, and volume of emesis (P < 0.001). There was a 72% incidence of nausea and vomiting on placebo. When plasma THC concentrations measured < 5.0 ng/mL, 5.0 to 10.0 ng/mL, and > 10.0 ng/mL, the incidences of nausea and vomiting were 44%, 21%, and 6%, respectively. Delta-9-tetrahydrocannabinol appears to have significant antiemetic properties when compared with placebo in patients receiving high-dose methotrexate.
Morning Hypercoagulability and Hypofibrinolysis
Authors: Stylianos Kapiotis, Bernd Jilma, Peter Quehenberger, Katharina Ruzicka, Sylvia Handler, Wolfgang Speiser
Journal: Circulation (1997)

Diurnal fluctuations of blood coagulation and fibrinolysis activity are thought to play a role in the observed circadian variation in the frequency of onset of acute cardiovascular events. In the present study, the diurnal variations in blood coagulation and fibrinolysis activity were investigated in 10 young, healthy control subjects by use of specific molecular activation markers.The plasma levels of activated factor FVII (FVIIa), the active portion of the main coagulation activator, decreased during the day (8 AM: 2.03 ng/mL, CI 1.16 to 2.88 ng/mL; 8 PM: 1.16 ng/mL, CI 0.81 to 1.5 ng/mL; P = .005), whereas FVII antigen did not change significantly. In parallel with the diurnal variations of FVIIa, we found a decrease of prothrombin fragment F1+2 (8 AM: 0.97 nmol/L, CI 0.79 to 1.15 nmol/L; 8 PM: 0.78 nmol/L, CI 0.64 to 0.93 nmol/L; P = .005), a molecular marker of intravasal thrombin generation. Evidence for a possible functional relevance of circulating FVIIa was found because this parameter was significantly correlated with prothrombin fragment F1+2 in 72 fasting healthy individuals (r = .29, P = .011). Plasminogen activator inhibitor-1 levels decreased (8 AM: 9.9 ng/mL, CI 7.7 to 12.1 ng/mL; 8 PM: 5.4 ng/mL, CI 3.8 to 6.9 ng/mL; P < .005), whereas plasmin-plasmin inhibitor complex levels, representing the degree of intravascular plasmin generation, concomitantly increased (8 AM: 235 micrograms/L, CI 198 to 272 micrograms/L; 8 PM: 449 micrograms/L, CI 391 to 507 micrograms/L; P = .008).Our data suggest that the diurnal changes in the plasma levels of activators and inhibitors of coagulation and fibrinolysis lead to corresponding changes in the activity state of these systems, leading to morning hypercoagulability and hypofibrinolysis.
Severe Vinblastine-Induced Leukopenia During Late Pregnancy with Delivery of a Normal Infant
Authors: JAMES J. NORDLUND
Journal: Annals of Internal Medicine (1968)

A pregnant woman was treated with vinblastine for Hodgkin's disease. Despite the mother's severe bone marrow suppression from vinblastine at delivery, the fetus demonstrated no significant toxicity. Pharmacologic doses of steroids were unable to protect against an anaphylactic reaction.