tbuckley/cabot-search huggingface dataset:
Gout Without Hyperuricemia
Authors: Daniel J. McCarty
Journal: JAMA (1994)

ACUTE GOUTY arthritis can rarely present with persistently normal serum urate levels. The following case illustrates the diagnostic and therapeutic misadventures that can occur when acute gout is not considered because of normal uric acid levels. The pathophysiologic characteristics underlying urate crystal deposition can be readily explained by the physicochemical properties of sodium urate. <h3>Report of a Case</h3> An 88-year-old man presented in a wheelchair to a rheumatology consultation clinic on July 15,1992. He had noted onset of pain and swelling in his right foot in early April 1992, 48 hours after his toenails had been trimmed by a podiatrist. His entire foot was swollen and so painful that it could not bear weight. He was taking codeine every 4 hours for pain control. A presumptive diagnosis of gout had been made by an internist on July 15, 1980, because of acute podagra responsive to therapy with a nonsteroidal anti-inflammatory
Attitudes about Guidelines
Authors: Sean R. Tunis
Journal: Annals of Internal Medicine (1994)

Letters1 November 1994Attitudes about GuidelinesSean R. Tunis, MD, MSc, Robert S.A. Hayward, MD, MPH, and Mark C. Wilson, MD, MPHSean R. Tunis, MD, MScSearch for more papers by this author, Robert S.A. Hayward, MD, MPHSearch for more papers by this author, and Mark C. Wilson, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-9-199411010-00038 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Hongsermeier's letter shows the ambivalence of many physicians toward clinical practice guidelines. She presents two contrasting visions of the future: One anticipates that insurers' algorithms will be enforced through pocket computers, and the other envisions clinician-developed practice guidelines being used to improve decisions, reduce paperwork, and enhance patient-provider interactions. These contrasts are also prominent in our survey, in which physicians perceived guidelines as potentially educational and coercive, quality-driven and economically motivated, and convenient and disciplinary [1].The “Brave New World” envisioned by Dr. Hongsermeier assumes that health insurers will control the development and enforcement of clinical guidelines. ...REFERENCE1. Tunis SR, Wilson MC, Hayward RSa, Rubin HR, Bass EB, Johnston M, et al. Internists' attitudes about clinical practice guidelines. Ann Intern Med. 1994; 120:956-63. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1994Volume 121, Issue 9Page: 725-726KeywordsAlgorithmsComputersDecision makingForecastingTreatment guidelinesVision ePublished: 15 August 2000 Issue Published: 1 November 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Ageism in services for transient ischaemic attack and stroke: Author's reply
Authors: Peter Rothwell
Journal: BMJ (2006)

EDITOR—Heath seems to have misunderstood the aims and methods of our study.

Because we were indeed aware that the low rates of treatment of older patients documented in many previous studies might sometimes have been due to patients' choice (as we stated in the introduction), we adopted the new method of comparing a nested, population based cohort, which was investigated exactly as per current clinical guidelines and patient choice, with …
Book: Limits to Medicine. Medical Nemesis: The Expropriation of Health
Authors: R. Smith
Journal: BMJ (2002)

Rating: ![Graphic][1]</img> The closest I ever came to a religious experience was listening to Ivan Illich. A charismatic and passionate man surrounded by the fossils of the academic hierarchy in Edinburgh, he argued that “the major threat to health in the world is modern medicine.” This was 1974. He convinced me, not least because I felt that what I saw on the wards of the Royal Infirmary of Edinburgh was more for the benefit of doctors than patients. I dropped out of medical school that day. Three days later I dropped back in again, unsure what else to do. Now I'm the editor of the BMJ , which is ironic. Having deserted medicine, I've become a pillar of the … [1]: /embed/inline-graphic-1.gif
PERINEAL OR "COCCYGEAL" HERNIA
Authors: Leigh F. Watson
Journal: JAMA (1931)

To the Editor:  —InThe Journal, Nov. 22, 1930, page 1588, G. A. Pagenstecher reports a case of  hernia. The anatomic boundaries he gives this hernia are those of posterior perineal hernia.  He also states that no case of coccygeal hernia is on record in the present literature. This statement is incorrect, and if allowed to stand may lead bibliographers into serious error. Though rare, there are several cases of posterior perineal hernia recorded in the literature, probably the earliest being Papen's case, described in a letter to Haller, in 1750 (Haller: Disputationes chirurgicae selectae, Laussannae 3 : 313-316, 1755). Scarpa described the anatomy of posterior perineal hernia in his monograph Sull' ernia del perineo, Pavia, 1821.  In 1924 I collected a number of these cases from the literature and made a special study of the anatomy of posterior perineal hernia, all of which is described and fully illustrated in
Doctors Change Breast Cancer Treatment Practices
Authors: K. Smigel
Journal: JNCI Journal of the National Cancer Institute (1992)

Journal Article Doctors Change Breast Cancer Treatment Practices Get access Kara Smigel Kara Smigel Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 84, Issue 12, 17 June 1992, Pages 924–925, https://doi.org/10.1093/jnci/84.12.924 Published: 17 June 1992
Nuclear Factor-κB Activation in Neonatal Mouse Lung Protects against Lipopolysaccharide-induced Inflammation
Authors: Cristina M. Alvira, Aida Abate, Guang Yang, Phyllis A. Dennery, Marlene Rabinovitch
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Injurious agents often cause less severe injury in neonates as compared with adults.We hypothesized that maturational differences in lung inflammation induced by lipopolysaccharide (LPS) may be related to the nature of the nuclear factor (NF)-kappaB complex activated, and the profile of target genes expressed.Neonatal and adult mice were injected with intraperitoneal LPS. Lung inflammation was assessed by histology, and apoptosis was determined by TUNEL (terminal deoxynucleotidyl transferase UTP nick-end labeling). The expression of candidate inflammatory and apoptotic mediators was evaluated by quantitative real-time polymerase chain reaction and Western immunoblot.Neonates demonstrated reduced inflammation and apoptosis, 24 hours after LPS exposure, as compared with adults. This difference was associated with persistent activation of NF-kappaB p65p50 heterodimers in the neonates in contrast to early, transient activation of p65p50 followed by sustained activation of p50p50 in the adults. Adults had increased expression of a panel of inflammatory and proapoptotic genes, and repression of antiapoptotic targets, whereas no significant changes in these mediators were observed in the neonates. Inhibition of NF-kappaB activity in the neonates decreased apoptosis, but heightened inflammation, with increased expression of the same inflammatory genes elevated in the adults. In contrast, inhibition of NF-kappaB in the adults resulted in partial suppression of the inflammatory response.NF-kappaB activation in the neonatal lung is antiinflammatory, protecting against LPS-mediated lung inflammation by repressing similar inflammatory genes induced in the adult.
Distribution of Atrial and Nodal Cells Within the Rabbit Sinoatrial Node
Authors: E. Etienne Verheijck, Andy Wessels, Antoni C. G. van Ginneken, Jan Bourier, Marry W. M. Markman, Jacqueline L. M. Vermeulen, Jacques M. T. de Bakker, Wouter H. Lamers, Tobias Opthof, Lennart N. Bouman
Journal: Circulation (1998)

In the sinoatrial node (SAN) the course of the action potential gradually changes from the primary pacemaker region toward the atrium. It is not known whether this gradient results from different intrinsic characteristics of the nodal cells, from an increasing electrotonic interaction with the atrium, or from both. Therefore we have characterized the immunohistochemical, morphological, and electrophysiological correlates of this functional gradient.The distribution of rabbit nodal myocytes in the SAN has been studied by immunohistochemistry. After cell isolation, the electrophysiological characteristics of different nodal cell types were measured. (1) The staining pattern of a neurofilament protein coincides with the electrophysiologically mapped pacemaker region in the SAN. (2) Enzymatic digestion of the SAN reveals three morphologically different nodal cell types and one atrial type. Of each nodal cell type, neurofilament-positive as well as neurofilament-negative myocytes are found. Atrial cells are all neurofilament-negative. (3) In contrast to previous findings, we observed atrial cells in the very center of the SAN. The relative number of atrial cells gradually increases from the central pacemaker area toward the atrium. (4) Differences in electrophysiological characteristics between individual nodal cells are not associated with differences in cell type.(1) The expression of neurofilaments can be used to delineate the nodal area in the intact SAN but is not sufficiently sensitive for characterizing all individual isolated nodal cells. (2) A fundamentally different organization of the SAN is presented: The gradual increase in density of atrial cells from the dominant area toward the crista terminalis in the SAN causes a gradual increase of atrial electrotonic influence that may be an important cause of the gradual transition of the nodal to the atrial type of action potential.
Do non—insulin-dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM) share genetic susceptibility loci? An analysis of putative IDDM susceptibility regions in familial NIDDM
Authors: Steven C. Elbein, Michael D. Hoffman, Rachel A. Mayorga, Kelli L. Barrett, Mark Leppert, Sandra Hasstedt
Journal: Metabolism (1997)
THE ELECTROLYTE THERAPY OF PREMENSTRUAL DISTRESS
Authors: J. P. GREENHILL
Journal: JAMA (1941)

Premenstrual tension is the term which Frank has designated for a not uncommon syndrome which occurs in the premenstrual phase and disappears with the onset of menstruation. It usually consists of several of the following symptoms and signs: headache, emotional instability, irritability, abdominal distention, nausea and vomiting, increased sex desire, pruritus and swelling of the vulva. Many women, however, suffer from moderate degrees of such disturbances but these are usually accepted without question as a normal feature of the menstrual cycle. For the sake of convenience we have termed the latter condition "premenstrual distress." It is our belief that both premenstrual distress and premenstrual tension have a common etiology, the difference between the two being a quantitative one. We have postulated that both are the result of changes in the electrolyte and water balance of the various tissues of the body which are probably the result of cyclic ovarian activity.
Access to Medical Care in the US: Who Has It, Who Doesn't
Authors: Bruce Stuart
Journal: JAMA (1985)

Did the recession of 1981-1982 reduce Americans' access to medical care? This study, based on a Lou Harris survey of 4,800 families taken in 1982, provides encouraging news. It seems that the steady progress toward improved equity evident during the 1960s and 1970s continues today. The poor and minorities, the unemployed and uninsured still have more difficulty in obtaining needed care than do other population groups, but for the most part the differentials are declining. That these findings relate to a period of severe economic stress is particularly telling: either our health care system has become recession-proof or the access picture now is even brighter than that painted by Aday and colleagues. This volume is the latest product in a research program spanning ten years. The conceptual framework for analyzing access issues was developed by the authors in 1975 and served as the basis for several national and community surveys
OUTCOMES FOLLOWING MULTIVESSEL OR CULPRIT VESSEL REVASCULARIZATIONS AT THE TIME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS WITH CARDIOGENIC SHOCK AND MULTIVESSEL DISEASE
Authors: Jin Sup Park, Kwang Soo Cha, Hye Won Lee, Bo Won Kim, Jong Hyeon Choi, Jun-Hyok Oh, Jung Hyun Choi, Jeong Cheon Choi, Han Cheol Lee, Taek Jong Hong, Myung Ho Jeong, Youngkeun Ahn
Journal: Journal of the American College of Cardiology (2015)
Cytochrome P450 2C9 is involved in flow‐dependent vasodilation of peripheral conduit arteries in healthy subjects and in patients with chronic heart failure
Authors: Dieter Fischer, Ulf Landmesser, Stephan Spiekermann, Denise Hilfiker‐Kleiner, Marian Hospely, Maja Müller, Rudi Busse, Ingrid Fleming, Helmut Drexler
Journal: European Journal of Heart Failure (2007)
Lipid and protein metabolism in asthma. Effects of diet and corticosteroid therapy
Authors: C Picado, R Deulofeu, E Casals, R Lleonart, M Agustí, L Quintó, J Mullol
Journal: Allergy (1999)

Background: Because little is known about the effects of asthma and asthma therapy on lipid and protein metabolism, we have investigated the characteristics of diet and plasma/serum levels of fat and protein in a group of asthma patients with various degrees of severity. Methods: A case‐control study was carried out on 118 asthma patients recruited from an outpatient clinic and 121 healthy subjects. Asthma severity was characterized in four groups according to clinical symptoms, lung‐function tests, and therapy. Normal dietary intake was estimated from a food frequency questionnaire. Serum protein, albumin, and fatty acids were determined by standard methods. Results: The dietary energy intake of the asthmatics was significantly lower than that of the controls. However, no differences in the body mass index were found between asthma patients and healthy subjects. There were no differences in serum/plasma levels in any of the measured biochemical parameters between healthy subjects and asthmatics. Plasma levels of protein and albumin were significantly lower in severely corticosteroid‐dependent patients. There was a significant negative correlation between plasma protein ( r =0.36, P &lt;0.05) and plasma albumin levels ( r =0.43, P &lt;0.01) and the daily dose of oral corticosteroids. We did not find any differences in plasma levels of cholesterol, HDL‐cholesterol, LDL‐cholesterol, and fatty acids between cortico‐dependent patients and those not receiving this therapy. No correlation was found between any biochemical parameters and the daily dose of inhaled corticosteroids. Conclusions: Our results suggest that asthma induces a decrease in energy intake that does not result in a decreased body weight. Inhaled corticosteroids do not exert any metabolic effect, whereas severe asthma with regular oral corticosteroid therapy is associated with reduced plasma protein and albumin levels.
Guns of Tedium
Authors: Morton L. Podolsky
Journal: JAMA (1965)

<h3>To the Editor:—</h3> Your editorial was neither humorous nor critically constructive. It was unfair to compare the style and context of a highly technical work to that of a popular narrative. AsThe Journaleditorial writer would say it: You should see the wet streets of London. As Charles Dickens said it: "But the streets of London, to be beheld in the very height of their glory, should be seen on a dark, dull, murky winter's night, when there is just enough damp gently stealing down to make the pavement greasy, without cleansing it of any of its impurities; and when the heavy lazy mist, which hangs over every object, makes the gas-lamps look brighter, and the brilliantly-lighted
TCT-316 Radiation Dose Surveillance Using Automated, Remote-site Dose Monitoring In Cardiac Catheterization Laboratories Across Asia Pacific
Authors: Punitha Arasaratnam, Wilson Low, Ho Hee Hwa, Cecilia Felix, Nandita Beri, Aung Than Htike, David Foo, Paul Ong
Journal: Journal of the American College of Cardiology (2012)
A More Modest Proposal: Putting the Heart Before the Course
Authors: William H. Brunie
Journal: JAMA (1992)

<h3>To the Editor.</h3> —There are at least two alternatives to Dr Chan's<sup>1</sup>exquisite "modest proposal": (1) some of Chan's "women with no health problems" may renounce "their status as potential patients," thus creating a vow of a different kind; or (2) a physician may get married "before initiating a genuine dating or romantic relationship"! An optimist is one who believes the future is uncertain. Ethical dilemmas, of course, remain, but they are transformed into those resolvable by individuals rather than by the "conclusions" of councils.
Update from EIC 2013
Authors: Emad El-Omar
Journal: Gut (2013)

It gives me great pleasure to provide you with a quick update on our journal. In June this year the 2012 impact factors were announced and ours increased to 10.732 (2011 IF 10.111), the highest ever achieved for Gut. We retained third position among the 74 gastrointestinal (GI) journals. This is a very healthy position and reflects the hard work and commitment of my associate editors and our journal staff. This success would not have been achieved without the full support and loyalty of our reviewers and the editorial board. Most of all, however, I am very grateful to the authors who put …
Environmental and familial clues sought to MS
Authors: William Check
Journal: JAMA (1978)

Although the multiple sclerosis (MS) clinic at the University of Arizona in Tucson was set up primarily for comprehensive patient care, its epidemiologic approach is doing double duty. According to Colin R. Bamford, MD, assistant professor of neurology and director of the clinic, approximately 125 patients with MS are being followed as well as about 80 people without neurological diseases who serve as controls. Both patients and controls are interviewed monthly with a "symptom scoring form" and an epidemiologic questionnaire. Every three months (or whenever the disease course appears to alter) the patients' neurological status is determined. In addition, coded serum samples are periodically obtained and stored. By these procedures the center is generating a description of the natural history of this highly variable disease. Further, it is testing possible associations between environmental and familial factors on the one hand and onset of disease, relapses, and remissions on the other.
Acute Septic Arthritis Complicating Chronic Rheumatoid Arthritis
Authors: David L. Rimoin
Journal: JAMA (1966)

During a recent two-year period, five patients with chronic rheumatoid arthritis who had developed acute suppurative arthritis were encountered. Elderly patients with chronic debilitating arthritis and minor skin infections are most susceptible. Hemolytic Staphylococcus aureus is by far the most common microorganism involved. This often fatal complication may be easily overlooked as the clinical features simulate those of an acute, uncomplicated rheumatoid exacerbation.
Experts Agree To Disagree on Adjuvant Therapy For Breast Cancer
Authors: K. Smigel
Journal: JNCI Journal of the National Cancer Institute (1990)

Experts Agree To Disagree on Adjuvant Therapy For Breast Cancer Get access Kara Smigel Kara Smigel Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 8, 18 April 1990, Pages 640–641, https://doi.org/10.1093/jnci/82.8.640 Published: 18 April 1990
Acute metabolic acidosis enhances circulating parathyroid hormone, which contributes to the renal response against acidosis in the rat.
Authors: M Bichara, O Mercier, P Borensztein, M Paillard
Journal: Journal of Clinical Investigation (1990)

Acute PTH administration enhances final urine acidification in the rat. HCl was infused during 3 h in rats to determine the parathyroid and renal responses to acute metabolic acidosis. Serum immunoreactive PTH (iPTH) concentration significantly increased and nephrogenous adenosine 3H,5H-cyclic monophosphate tended to increase during HCl loading in intact and adrenalectomized (ADX) rats despite significant increments in plasma ionized calcium. Strong linear relationships existed between serum iPTH concentration and arterial bicarbonate or proton concentration (P less than 0.0001). Serum iPth concentration and NcAMP remained stable in intact time-control rats and decreased in CaCl2-infused, nonacidotic animals. Urinary acidification was markedly reduced in parathyroidectomized (PTX) as compared with intact rats during both basal and acidosis states; human PTH-(1-34) infusion in PTX rats restored in a dose-dependent manner the ability of the kidney to acidify the urine and excrete net acid. Acidosis-induced increase in urinary net acid excretion was observed in intact, PTX, and ADX, but not in ADX-thyroparathyroidectomized rats. We conclude that (a) acute metabolic acidosis enhances circulating PTH activity, and (b) PTH markedly contributes to the renal response against acute metabolic acidosis by enhancing urinary acidification.
Benzalkonium Chloride—Source of Hospital Infection with Gram-Negative Bacteria
Authors: John C. Lee
Journal: JAMA (1961)

QUATERNARY ammonium compounds (QAC) have been in common use for more than a decade because of their wetting and antibacterial properties. As disinfectants they have many useful attributes and have been recommended for cold sterilization of instruments which cannot be autoclaved.<sup>1</sup>However, since 1957 several reports have stressed the risks of using QAC for skin disinfection.<sup>2-5</sup>It has been shown that aqueous solutions of these compounds lose most of their antibacterial properties if stored with cotton fibers or protein. After accidental contamination of QAC solutions, some organisms, particularly gram-negative bacteria, may survive and even multiply and may then be applied with cotton to the patient's skin prior to needle puncture.<sup>5</sup>Despite this published experience, cotton pledgets stored in QAC continue to be used for skin cleansing. This report is presented to emphasize the dangers inherent in the use of these compounds in hospital wards and to
Nonsense mutation R1162X of the cystic fibrosis transmembrane conductance regulator gene does not reduce messenger RNA expression in nasal epithelial tissue.
Authors: R Rolfini, G Cabrini
Journal: Journal of Clinical Investigation (1993)

Cystic fibrosis (CF) patients bearing the premature translation termination mutation (nonsense mutation) W1282X present severe pulmonary and pancreatic disease, whereas patients carrying other nonsense mutations such as G542X, R553X, S1255X, R1162X, and W1316X show a severe pancreatic but mild pulmonary illness. CF gene expression was found absent in respiratory tissues with mutations R553X and W1316X, which led to the hypothesis that the absence of the gene product in the lung is more favorable than the presence of an altered one. We asked whether or not all the nonsense mutations characterized by mild pulmonary disease phenotypes do present the absence of CF gene expression. We therefore investigated gene expression at the mRNA level in respiratory cells obtained from nasal polyps from a patient homozygous for the R1162X mutation. Gene expression was studied by amplification with polymerase chain reaction of segments of the CF transmembrane conductance regulator cDNA that was obtained by reverse transcription of RNA. Semiquantitative analysis was performed by Northern analysis. By comparing the data obtained from polyps deriving from non-CF subjects and a CF patient homozygous for dF508 mutation, it is shown that no reduction of CF gene expression is evident in R1162X respiratory tissue. We conclude that CF nonsense mutations have heterogeneous mechanisms of gene expression.