tbuckley/cabot-search huggingface dataset:
Chronic Administration of Levosulpiride and Glycemic Control in IDDM Patients With Gastroparesis
Authors: Pierluigi Melga, Carlo Mansi, Emanuela Ciuchi, Roberta Giusti, Luigi Sciabà, Romano Prando
Journal: Diabetes Care (1997)

OBJECTIVE We evaluated the effect of chronic administration of levosulpiride, a prokinetic drug that is a selective antagonist for D2 dopamine receptors, on the glycemic control of IDDM subjects. RESEARCH DESIGN AND METHODS The study was performed on 40 long-standing IDDM subjects with clinical signs of autonomic neuropathy and delayed gastric emptying. Gastric emptying time and glycemic parameters (diurnal glycemic profile and HbA1c) were checked under double-blind conditions before and after the administration of levosulpiride at the dosage of 25 mg t.i.d. orally for 6 months, or placebo. RESULTS No significant differences were noted in the glycemic and HbA1c values before and after 6 months of placebo administration. In contrast, after 6 months of levosulpiride, glycemic control had improved (HbA1c 6.7 ± 0.4 and 5.7 ± 0.3%, P &amp;lt; 0.01; mean daily glycemia 10.9 ± 0.8 and 8.8 ± 0.4 mmol/l, P &amp;lt; 0.05, at the start and at the end of the study), while the dosage of injected insulin (0.65 ± 0.02 IU · kg−1 · day−1) and the number of severe hypoglycemic episodes remained unchanged. After 6 months of levosulpiride therapy, the time of gastric emptying was significantly reduced from 321 ± 14 to 261 ± 9 min (P &amp;lt; 0.001) and dyspeptic symptoms had improved. CONCLUSIONS Our results show the importance of gastric emptying in the maintenance of glycemic control and the usefulness of chronic administration of levosulpiride in diabetic subjects with gastroparesis.
Diabetes Risk Among Overweight and Obese Metabolically Healthy Young Adults
Authors: Gilad Twig, Arnon Afek, Estela Derazne, Dorit Tzur, Tali Cukierman-Yaffe, Hertzel C. Gerstein, Amir Tirosh
Journal: Diabetes Care (2014)

OBJECTIVE To determine diabetes incidence over time among obese young adults without metabolic risk factors. RESEARCH DESIGN AND METHODS Incident diabetes during a median follow-up of 6.1 years was assessed among 33,939 young men (mean age 30.9 ± 5.2 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults cohort who were stratified for BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ≥30 kg/m2 in the presence of normoglycemia, normal blood pressure, and normal levels of fasting triglyceride and HDL-cholesterol levels (n = 631). RESULTS A total of 734 new cases of diabetes were diagnosed during 210,282 person-years of follow-up. The incidence rate of diabetes among participants with no metabolic risk factors was 1.15, 2.10, and 4.34 cases per 1,000 person-years among lean, overweight, and obese participants, respectively. In a multivariable model adjusted for age, region of origin, family history of diabetes, physical activity, fasting plasma glucose, triglyceride level, HDL-cholesterol, systolic blood pressure, and white blood cell count, a higher diabetes risk was observed among MH-overweight (hazard ratio [HR] 1.89 [95% CI 1.25–2.86]; P &amp;lt; 0.001) and MH-obese (HR 3.88 [95% CI 1.94–7.77]; P &amp;lt; 0.001) compared with MH-normal weight subjects. There was no interaction between BMI and the number of metabolic abnormalities at enrollment in predicting diabetes risk. CONCLUSIONS Healthy metabolic profile and the absence of diabetes risk factors do not protect young adults from incident diabetes associated with overweight and obesity.
Bone pain as the presenting manifestation of secondary syphilis.
Authors: S Middleton, C Rowntree, S Rudge
Journal: Annals of the Rheumatic Diseases (1990)

A 31 year old fireman presented with acute pain and tenderness in both shins and forearms. Radiographs were normal but bone scintigraphy showed widespread increased isotope uptake. Serology was consistent with a diagnosis of secondary syphilis, and the patient9s symptoms resolved completely six weeks after a course of penicillin.
The role of the QT interval in the sudden infant death syndrome.
Authors: D H Kelly, D C Shannon, R R Liberthson
Journal: Circulation (1977)

To evaluate the role of QT interval prolongation in the genesis of the sudden infant death syndrome (SIDS), the post-resuscitation electrocardiograms of 21 aborted SIDS infants were reviewed. The infants had been found apneic, cyanotic, limp and unresponsive during sleep and required vigorous physical stimulation and mouth-to-mouth resuscitation. Three subsequently experienced repeat similar episodes from which they could not be resuscitated. Extensive studies eliminated all "known" etiologies for death. The QT intervals of these infants were compared to age and sex matched normal infants as well as to established normal values in the literature; in both the aborted and the subsequent actual SIDS infants, the QT intervals were not significantly different from those of the normal population. Thus, we conclude that QT intervals prolongation does not play a major role in the genesis of the aborted SIDS.
Quality of Life Evolution after Pulmonary Metastasectomy: A Prospective Study Comparing Isolated Lung Perfusion with Standard Metastasectomy
Authors: Bram Balduyck, Jana Van Thielen, Anouschka Cogen, Willem Den Hengst, Jeroen Hendriks, Patrick Lauwers, Paul Van Schil
Journal: Journal of Thoracic Oncology (2012)

To prospectively evaluate quality of life (QoL) evolution after a classic pulmonary metastasectomy or after an isolated lung perfusion (ILuP) metastasectomy.QoL was prospectively recorded in 35 consecutive patients (27 classic metastasectomy; 8 ILuP) The European Organisation for Research and Treatment of Cancer C30 and lung cancer -13 QoL Questionnaires were administered before surgery and 1, 3, 6 and 12 months postoperatively (MPO).After a classic metastasectomy, a temporary increase in dyspnea (1 MPO p = 0.03 3 MPO p = 0.01), coughing (3 MPO p = 0.01), fatigue (1 MPO p = 0.01, 3 MPO p = 0.02), thoracic pain (1 MPO, p = 0.02), shoulder dysfunction (1 MPO p = 0.03, 3 MPO p = 0.02) as well as an impaired physical (1 MPO p = 0.01, 3 MPO p = 0.04) and role functioning (1 MPO p = 0.01, 3 MPO p = 0.01) was reported the first 3 months after surgery. Six months after surgery, all domains returned to baseline. After ILuP metastasectomy, all QoL functioning and symptom scores, except for coughing complaints (1 MPO p = 0.03, 3 MPO p = 0.04) and shoulder dysfunction (1 MPO p = 0.04, 6 MPO p = 0.04), returned to baseline at 1 month after surgery. No significant differences were seen when QoL evolution was compared between classic and ILuP metastasectomy with the exception of a higher burden of thoracic pain (6 MPO p = 0.04, 12 MPO p = 0.01), shoulder dysfunction (6 MPO p = 0.04, 12 MPO p = 0.02), and dysphagia (6 MPO p = 0.04, 12 MPO p = 0.02) 6 and12 months after ILuP.All QoL domains returned to baseline at 6 months after a classic metastasectomy. After ILuP, only increases in coughing and shoulder dysfunction were reported. In comparison classic metastasectomy patients, ILuP patients report more thoracic pain, shoulder dysfunction, and dysphagia.
The New Fertility Testing Tape-Reply
Authors: Joseph Bernard Doyle
Journal: JAMA (1961)

<h3>To the Editor:—</h3> In reply to Dr. Abarbanel, the new Fertility Tape's primary use is to aid the childless wife whose basal thermal shifts are often difficult to interpret. Ovulation may occur 3 days before and 3 days after the lowest day. Rhythm patients are instructed to avoid all coitus before and during the fertile phase as indicated by cervical glucose turning the tape from pink to blue, and for at least 3 negative (pink) days thereafter. We never state that all the women had to do was to avoid intercourse the nights the testing paper turned blue. The insemination date never proves that the sperm fertilized the ovum that same day. Sperm, especially from highly fertile donors, may fertilize 2 to 3 days later. Hence a negative test on insemination day does not mean that the patient may not have positive tests during the next few days. Diabetes, cervical
Efficient Neuronal Gene Transfer with AAV8 Leads to Neurotoxic Levels of Tau or Green Fluorescent Proteins
Authors: Ronald L. Klein, Robert D. Dayton, Nancy J. Leidenheimer, Karen Jansen, Todd E. Golde, Richard M. Zweig
Journal: Molecular Therapy (2005)

Adeno-associated virus (AAV) serotype 8 appears to be the strongest of the natural serotypes reported to date for gene transfer in liver and muscle. In this study, we evaluated AAV8 in the brain by several methods, including biophotonic imaging of green fluorescent protein (GFP). In the adult rat hippocampus, levels of GFP expressed were clearly greater with AAV8 than with AAV2 or AAV5 by Western blot and biophotonic imaging and slightly but significantly greater than AAV1 by Western blot. In the substantia nigra, the GFP expression conferred by AAV8 was toxic to dopamine neurons, although toxicity could be avoided with dose titration. At the low dose at which there was no GFP toxicity from the GFP vector, another AAV8 vector for a disease-related (P301L) form of the microtubule-associated protein tau caused a 78% loss of dopamine neurons and significant amphetamine-stimulated rotational behavior. The AAV8 tau vector-induced cell loss was greater than that from AAV2 or AAV5 tau vectors, demonstrating that the increased gene transfer was functional. While the toxicity observed with GFP expression warrants great caution, the efficient AAV8 is promising for animal models of neurodegenerative diseases and potentially as well for gene therapy of brain diseases.
ABO Blood Groups in Relation to Ischaemic Heart Disease
Authors: B. Bronte-Stewart, M. C. Botha, L. H. Krut
Journal: BMJ (1962)

THROMBO-ENDARTERECTOMYas much as they should.If it is right that when we give treatment and fail we should constantly review our methods and our skills, it is also true that when we avoid the responsibility of intervention we should be reminded of the results of our inactivity.We can be sure that there will be deaths from surgical treatment but that these will diminish when patients are given a chance earlier, before all the large coronary arteries are extensively involved.Coronary angiography is likely to play an important part in the selection of such patients.If the history of anticoagulant therapy forms any sort of a parallel it will be a very long time before there is conclusive statistical support for surgical treatment.In the meantime it is important that patients should be considered for one or other form of treatment on the basis of the fullest possible investigation so that as numbers do become available they can be useful in statistical surveys. Summary and ConclusionMechanical factors in arterial disease are discussed.The part played by local arterial obstruction in the production of peripheral emboli is emphasized.The application of thrombo-endarterectomy to the coronary vessels is described and case reports of six patients are given.Coronary angiography has an important part to play in the detailed investigation of coronary artery disease.The early demonstration of stenosis or complete obstruction may well be of vital importance in assessing prognosis and in the selection of patients for surgical treatment.The most logical surgical treatment is removal of the arterial obstruction where this is possible.The Population of the Cape Peninsula In a previous report (Bronte-Stewart et al., 1955) a description was given of the three main racial groups resident in the Cape Peninsula-namely, Bantu, Cape Coloured, and White (European)-which was felt to be pertinent to their differing prevalence of ischaemic heart disease.In that report the Whites were treated as a homogeneous group, but for the purposes of the present study it became necessary to divide the Whites into English-speaking, Afrikaans-speaking, Jewish, and other groups and define the measure whereby this separation was achieved.There are distinct differences between these groups.Apart from home language, there are differences in outlook, occupation, temperament, dietary customs, and religious faith, but the environmental differences are not as marked nor are they dictated
Genetic Diagnosis by DNA Analysis
Authors: Stuart H. Orkin
Journal: New England Journal of Medicine (1987)

Genetic disorders are most often diagnosed in affected persons on the basis of clinical and family histories, physical examination, and clinical laboratory tests. Diagnosis based on analysis of DNA samples from patients and their families is a more recent approach that presents distinct advantages. These include diagnosis of a disease before its clinical appearance, prenatal diagnosis, detection of carriers, and discrimination among phenotypically similar but genetically disparate conditions. The remarkable progress in molecular diagnosis of genetic diseases witnessed during the past decade is a direct consequence of the clinical application of recombinant-DNA techniques.Much is now known that is directly . . .
Acute Severe Aortic Regurgitation
Authors: JOEL MORGANROTH
Journal: Annals of Internal Medicine (1977)

Acute severe aortic regurgitation is a relatively unfamiliar, though life-threatening, disease. We review its diverse causes, anatomic faults, and hemodynamic sequelae and set the stage for an understanding of the clinical manifestations in light of their physiologic mechanisms. Clinical information includes the natural history, physical signs (physical appearance, systemic arterial pulse, jugular venous pulse, precordial palpation, auscultation), electrocardiogram, and chest roentgenogram. Echocardiographic features are especially emphasized and the need for prompt diagnosis and surgical intervention underscored, even in the setting of active infective endocarditis.
Angioplasty versus thrombolytics for patients presenting with congestive heart failure; GUSTO IIb substudy findings
Authors: J.S. Hochman, W.A. Jaber, E.R. Bates, D.A. Criger, J. Boland, C. Vassanelli, E.J. Topol, S.G. Ellis
Journal: Journal of the American College of Cardiology (1998)
Doctors' leader calls on Hunt to stop using GPs as scapegoats
Authors: G. Iacobucci
Journal: BMJ (2013)

The chairman of the BMA’s General Practitioners Committee has called on the government to end its attacks on the profession and to stop blaming GPs for the ongoing pressure on hospitals’ accident and emergency departments.

In a defiant keynote speech to GPs at the annual conference of local medical committees in London, Laurence Buckman accused the health secretary for England, Jeremy Hunt, of “spouting rubbish” and of using the NHS as a “political weapon” at a time when “the future of the health service is under real threat.”

In a fierce response to recent criticism from the health secretary, who has blamed recent pressure on emergency …
Vasopressor Response to Angiotensin II Infusion in Patients With Chronic Heart Failure Receiving β-Blockers
Authors: Timothy J. Vittorio, Chim C. Lang, Stuart D. Katz, Milton Packer, Donna M. Mancini, Ulrich P. Jorde
Journal: Circulation (2003)

Background— A synergistic interaction between the angiotensin II (Ang II) type 1 receptor and α 1 -adrenergic receptors has been described. We hypothesized that the nonselective β-antagonist carvedilol, through its α 1 -adrenergic blocking properties, may modulate vascular reactivity to Ang II in patients with chronic heart failure (CHF). Accordingly, we compared the vasopressor response to infused Ang II in patients treated with carvedilol and metoprolol, a selective β-antagonist. Methods and Results— All subjects were treated with carvedilol or metoprolol for at least 3 months. ACE inhibitor therapy was standardized to enalapril 40 mg/d or the maximally tolerated dose. Exogenous Ang II was administered as sequential intravenous bolus injections (2.5 to 30 ng/kg) titrated to a rise in radial artery systolic pressure of ≥20 mm Hg. The dose of Ang II required to elicit a change of 20 mm Hg in radial artery systolic pressure (PD20) defined the vasopressor response to Ang II. Twenty subjects with CHF (mean left ventricular ejection fraction 28±9%, New York Heart Association class II [n=13] and III [n=7]) were studied. There was no correlation between plasma Ang II levels and PD20. However, the PD20 was significantly higher in patients treated with carvedilol than in those treated with metoprolol (20 [range 2.5 to 30] versus 5 [range 2.5 to 10] ng/kg, P =0.019). Conclusions— The vasopressor response to Ang II infusion in patients treated with carvedilol was significantly lower than in patients treated with metoprolol. Whether this is due to the α 1 -adrenergic blocking or other ancillary properties of carvedilol warrants further investigation.
Benefits of metastasectomy for colorectal cancer
Authors: T. Cecil, F. Mohamed, B. Moran
Journal: BMJ (2014)

We commend Treasure and colleagues and The BMJ for their efforts in resurrecting and publishing data from unpublished trials. William Slack’s reported observation that “active cancer had to be detected earlier than was possible clinically if repeat surgery was to benefit patients” was wise and prophetic.1 It forms the basis for exciting developments in the use of second look laparotomy in the modern …
Development of pulmonary arteriovenous shunt after superior vena cava-right pulmonary artery (Glenn) anastomosis. Report of four cases.
Authors: R C McFaul, A J Tajik, D D Mair, G K Danielson, J B Seward
Journal: Circulation (1977)

Four patients with cyanotic congenital heart disease who had previously undergone superior vena cava-right pulmonary artery (Glenn) anastomosis developed pulmonary arteriovenous malformations that resulted in significant intrapulmonary right-to-left shunting. This abnormality was documented by selective angiography, oximetry, and contrast echocardiogrphy. It may be a major cause of late clinical deterioration in patients treated with the Glenn anastomosis.
MHC class II-expressing hepatocytes function as antigen-presenting cells and activate specific CD4 T lymphocyutes
Authors: Johannes Herkel, Bettina Jagemann, Christiane Wiegard, Jose Francisco Garcia Lazaro, Stefan Lueth, Stephan Kanzler, Manfred Blessing, Edgar Schmitt, Ansgar W. Lohse
Journal: Hepatology (2003)

The ability to activate CD4 T cells is restricted to antigen–presenting cells that express major histocompatibility complex (MHC) class II molecules. Parenchymal cells normally do not express MHC class II molecules; however, in clinical hepatitis, viral or autoimmune, hepatocytes often exhibit aberrant MHC class II expression. It is not known whether MHC class II–expressing hepatocytes can function as antigen–presenting cells, but it has been suggested that aberrant MHC class II expression by parenchymal cells may cause autoimmune disease. Therefore, we generated transgenic mice that specifically overexpress class II transactivator molecules in hepatocytes. Hepatocytes from these mice exhibited stable MHC class II expression and were used to stimulate CD4 T cells from T–cell receptor transgenic mice and CD4 T–cell lines. MHC II–expressing hepatocytes featured costimulatory CD80 molecules and could serve as antigen–presenting cells that were able to process protein antigen and to activate specific CD4 T cells. Nevertheless, the transgenic mice with aberrant hepatocellular MHC class II expression did not exhibit any symptoms of autoimmune disease. In conclusion, MHC II–expressing hepatocytes, as found in clinical hepatitis, can present antigen and activate CD4 T cells. The ability of hepatocytes to present antigen on MHC II molecules does not seem to be a sufficient cause for inflammatory autoimmunity and hepatitis. However, we still need to explore whether such antigen presentation is occurring in vivo . The transgenic mice described in this study may serve as a model to study the immune interaction of hepatocytes and CD4 T cells in both in vitro and in vivo .
Immediate plasma renin response to propranolol: differentiation between essential and renal hypertension.
Authors: F Skrabal, W Czaykowska, P Dittrich, H Braunsteiner
Journal: BMJ (1976)

The immediate short-term effect on plasma renin activity of intravenous injection of propranolol was studied in 31 normal subjects and 166 hypertensive patients. In patients with essential hypertension and normal subjects plasma renin activity fell considerably within 15 minutes; the fall was directly proportional to initial plasma renin levels. In contrast, in patients with renal hypertension the fall was much less pronounced or totally absent. These differences in response to propranolol provide, though presently only on a group basis, a biochemical means of differentiating between patients with renal hypertension and those with essential hypertension. The observations also indicate that, unlike normal subjects and patients with essential hypertension, in patients with renal hypertension sympathetic activity plays no part in the control of basal plasma renin levels.
A History of Immunology
Authors: Paul P. VanArsdel
Journal: JAMA (1990)

In January 1979, the journal<i>Cellular Immunology</i>published a centennial notice on the founding of immunology as a scientific discipline. To quote from that notice: In the autumn of 1879, following the chance observation that cultures of chicken cholera organisms had become attenuated over the summer vacation, Louis Pasteur and his assistants Chamberland and Roux performed the first set of rigorous and well-controlled experiments on immunity.... The decades that followed were exciting ones, dominated by such other giants as Koch, Metchnikoff, Ehrlich, von Behring, Bordet, Richet and the young Landsteiner and influenced by the discoveries of antibody, complement, serodiagnosis, anaphylaxis, and numerous other phenomena and techniques. The editors of the journal used this occasion to open its pages to occasional scholarly contributions on the history of immunology, and they directed inquiries about the new section to Dr Silverstein. Contributions came frequently— from Dr Silverstein—over most of the next decade. Eventually,
LOW TEMPERATURE, HIGH BAROMETER AND SUDDEN DEATH
Authors: HERMAN N. BUNDESEN
Journal: JAMA (1926)

In a recent note in the<i>British Medical Journal</i>, "A. O. W."<sup>1</sup>called attention to an apparent concurrence between the incidence of sudden deaths and high barometric pressures. The point thus raised by a casual observer was taken up by Dr. Percy Stocks<sup>2</sup>of the University of London, who undertook a short statistical investigation on the alleged association of deaths from "heart failure" with high barometric readings. He correlated the weekly deaths registered in London, taking deaths from diseases of the heart and circulatory system, with the mean corrected barometric pressures for the same weeks at Greenwich. He used the data for the last week of October and the four weeks of November in each of the years 1900 to 1914 and 1919 to 1925, and found a coefficient of correlation of + 0.23 ± 0.06. Dr. Stocks interpreted this correlation as indicatory of an appreciable relation between the
Decision Aids From Genetics to Treatment of Breast Cancer
Authors: Charis Eng, Dirk Iglehart
Journal: JAMA (2004)

EDICAL SCIENCE IS A VICTIM OF ITS OWN SUCcess. Clinical and translational investigation has resulted in a bounty of relevant and specialized knowledge that is adopted into routine clinical use. While this 21st-century science is hurtling quickly into the clinical arena, the relative growth of clinicians in some specialized areas, who are facile in using 21st-century scientific knowledge to practice 21st-century medicine, has not increased at a rate to keep pace with that of recent scientific advances. Compounded with the growing trend of viewing patients as partners in medical decision making, necessitating educating and helping patients withchoicesinafieldthatchangesweekly,themedicalcommunity is facing a crisis. Two articles published in this issue of JAMA try to address this problem by exploring the utility and limitations of patient decision aids in breast can