tbuckley/cabot-search huggingface dataset:
INSPECTION OF THE PATIENT AND CELL BIOLOGY
Authors: Dorothy B. Windhorst
Journal: JAMA (1968)

The clinician readily notes pigmentary deficiencies such as vitiligo, piebaldism, and albinism. Less overt defects, such as those seen in phenylketonuria, require careful and thoughtful patient evaluation. Recent studies indicate that some variations in pigmentation, particularly those which are on a genetically determined basis, may offer insights into basic biologic mechanisms and inject new sig`nificance into inspection of the patient.  A relatively new disease in this category is the autosomal-recessive Chediak-Higashi (CH) syndrome. CH syndrome develops in a child who is normal at birth except for diminished pigmentation, which leaves residual color based on the color of the parents; eg, children of Japanese parents will have blue-gray hair and be pigmented irregularly and lightly, whereas white children will appear almost as classical albinos. After some months or years, these children manifest susceptibility to infection, possibly more so to viral infection, and eventually die with hepatosplenomegaly and bone marrow failure. 1
Effect of loxiglumide and atropine on erythromycin-induced reduction in gallbladder volume in human subjects
Authors: Max C.W. Jebbink, Ad A.M. Masclee, Frank G.H. van der Kleij, Jaap Schipper, Lucio C. Rovati, Jan B.M.J. Jansen, Cornelis B.H.W. Lamers
Journal: Hepatology (1992)

This study was undertaken to investigate the effect of erythromycin, a motilin agonist with prokinetic activity, on fasting gallbladder volume. To evaluate the mechanism of action of erythromycin on gallbladder motility, erythromycin (3.5 mg/kg.20 min, intravenously) was infused on three separate occasions: during cholinergic blockage with atropine (0.005 mg/kg.hr), during cholecystokinin receptor blockade with loxiglumide (10 mg/kg.hr) and during saline solution infusion (control). Atropine, loxiglumide and saline solution infusions were started 3 hr before administration of erythromycin and were continued for 3 hr thereafter. Gallbladder volumes (measured by ultrasonography), plasma cholecystokinin levels (radioimmunoassay) and plasma pancreatic polypeptide levels (radioimmunoassay) were determined at regular intervals for 6 hr in six healthy volunteers. During the 3-hr infusion before administration of erythromycin, both loxiglumide and atropine significantly increased gallbladder volumes--from 18 +/- 2 to 37 +/- 3 cm3 (p less than 0.05) and from 17 +/- 3 to 24 +/- 2 cm3 (p less than 0.05), respectively--whereas saline solution did not significantly affect gallbladder volume. During control saline solution infusion, erythromycin induced prolonged gallbladder contraction that was significant (p less than 0.05) between 60 and 180 min and reached a maximum of 45% +/- 8% at 150 min. Plasma cholecystokinin levels were not affected by erythromycin. Erythromycin induced a significant (p less than 0.05) increase in plasma pancreatic polypeptide levels, from 12 +/- 1 pmol/L to 34 +/- 3 pmol/L. Loxiglumide did not prevent the erythromycin-induced reduction in gallbladder volume. Atropine markedly reduced the effect of erythromycin, causing slight but significant (p less than 0.05) gallbladder volume reductions (18% +/- 4%) between 150 and 180 min.(ABSTRACT TRUNCATED AT 250 WORDS)
Real-time monitoring of mesangial cell-macrophage cross-talk using SEAP in vitro and ex vivo
Authors: Yiman Meng, Ayumi Kasai, Nobuhiko Hiramatsu, Kunihiro Hayakawa, Masayuki Takeda, Fujio Shimizu, Hiroshi Kawachi, Jian Yao, Masanori Kitamura
Journal: Kidney International (2005)
Examination Fees for Diplomas
Authors: T. F. Mackintosh
Journal: BMJ (1972)

isotopes could ethically be given.All three patients were able to form 25-hydroxycholecalciferol to the same extent as non- Pakistani control patients with a similar de- gree of vitamin D deficiency.The two Pakistani patients were also shown to form the potent biologically active metabolite 1,25 dihydroxycholecalciferol.Details relating to one of these patients have been published.2We feel therefore that inability to produce the appropriate metabolites of vitamin D is not the explanation for the phenomena re- ported in both surveys.-We are, etc.,
Ring-like Uptake Pattern of a Skeletal Imaging Agent in a Huge Renal Cell Carcinoma
Authors: WEI-JEN SHIH, FRANK H. DELAND, PEGGY A. DOMSTAD, MARGUERITE PURCELL
Journal: Clinical Nuclear Medicine (1986)

A case of huge renal cell carcinoma with localization of a skeletal imaging agent is presented. Two unusual scintigraphic findings of bone agent localization in the tumor were observed: 1) a ring-like configuration, and 2) low-intensity uptake. The large ring-like appearance of the extraosseous radioactivity may reflect a bulky tumor with central necrosis and a less active calcification process.
Maingot's Abdominal Operations
Authors: Edwin A. Deitch
Journal: JAMA (1997)

The 10th edition of this classical surgical text has much to commend it. As in previous editions, this excellent text is dedicated to providing general surgeons and surgical trainees a concise but detailed overview of the operative and nonoperative components of abdominal surgery. SinceMaingot's Abdominal Operationshas a wide readership and has enjoyed considerable success in the past, and there is a tendency not to tamper with success, I expected the 10th edition to largely resemble the previous edition, which was published in 1990.  Nothing could be further from the truth. The new edition is more than a major revision of a classical text; in many ways it is a de novo text, with new chapters and new authors. In comparing the 10th to the ninth edition, I found that only 18 of the 81 chapters had the same contributors, while 20 chapters were new, and the remaining 43
Death After Withdrawal of Meprobamate-Reply
Authors: Leonard A. Swanson
Journal: JAMA (1963)

We thank Dr. Nordstrom for his excellent comments. We feel we can exclude water intoxication in this patient for the following reasons: The patient, who weighed 209 lb (94.8 kg), lost considerable fluid through perspiring. The hemoglobin of 20.0 gm/100 cc and the packed red blood cell volume of 57%, obtained approximately 36 hours prior to death, suggest hemoconcentration. A serum sodium sample submitted at the same time was reported as 145 mEq/liter. Clinically, the patient did not vomit or have diarrhea such as is often seen in dilutional hyponatremia. Lastly, in our own experience and that of many others consulted, hyperthermia to the degree observed in this patient is not associated with water intoxication.
Editorial on CFS was biased, inaccurate, and misleading
Authors: C. Shepherd
Journal: BMJ (2002)

EDITOR—As a member of the chief medical officer's working group on chronic fatigue syndrome, I consider that Straus has failed to appreciate the difficulties of deciding what constitutes evidence in an illness as uncertain and heterogeneous as this.1 He also misunderstood, or took out of context, some of the key conclusions and recommendations in the chief medical officer's report.

Although it was agreed that evidence should not just be limited to the results …
THE STEM PESSARY FOR AMENORRHEA AND DYSMENORRHEA.SOME FURTHER OBSERVATIONS.
Authors: J. H. CARSTENS
Journal: JAMA (1906)

Many inquiries by physicians in different parts of the country in reference to the use of the stem pessary have prompted me to write another short article on the question. There is no doubt that the bane of the general practitioner, and even of the gynecologist, is the treatment of stubborn cases of amenorrhea and dysmenorrhea, as they last for months and years and often persist after all the known modes of treatment have been tried. <h3>AMENORRHEA.</h3> If this occurs at the age of puberty, time and hygienic management will generally bring about a normal condition. There are certain types of this disease that are very troublesome, as, for example, when menstruation occurs only at long intervals and then is scanty, or when the function has been thoroughly established for some years and then becomes irregular and slight, often accompanied by pain. This generally causes a great deal of mental
Are the Health of the Nation's targets attainable? Postal survey of general practitioners' views
Authors: P. Cheung, A P. S Hungin, J. Verrill, A. J Russell, H. Smith
Journal: BMJ (1997)

Objective: To describe the impact, direct costs of, and participants' attitudes to the first two years and eight months of locality commissioning in Avon.Design: Retrospective description of programme.Setting: Thirteen localities in Avon Health Authority area, covering 982 000 population and 147 general practices.Methods: Postal questionnaire survey of 147 general practitioners (one per practice); interviews with and questionnaire survey of 13 lead general practitioners and 13 so called link staff from the health authority.Main outcome measures: Locality initiatives, perceived influence, general practitioners' attitudes, management costs.Results: Twenty initiatives were identified that had changed services to patients, and another nine were planned.The commonest initiatives concerned primary mental health care (seven), nurse specialists for primary care of chronic diseases (three), referral and clinical practice guidelines (seven), and access to hospital outpatient departments (one, with two others planned).Localities were more likely to have influenced the authority, trust managers, and consultants than social services, community health councils, and voluntary organisations.Activity varied between localities, lead general practitioners estimating that 120/147 (82%) of practices had been involved in locality meetings (range 44-100% in different localities).The authority had spent 6 p per capita on running the scheme, and the total time used by general practitioners for locality commissioning was estimated at 1.5 whole time equivalents.Conclusion: Locality commissioning has selectively changed services with limited extra funding and without delegation of hospital and community health service budgets.General practitioners wanted more policy and financial support.Further development should be based on evidence of costs, benefits, and limitations of locality commissioning schemes.
Internal Ureteral Stents for Conservative Management of Ureteral Calculi during Pregnancy
Authors: Kevin R. Loughlin, Robert B. Bailey
Journal: New England Journal of Medicine (1986)

DURING pregnancy, acute problems of the urinary tract, especially urinary calculi, are the most common cause of abdominal pain severe enough to require hospitalization. The incidence of urinary calculi during pregnancy varies from 1 in 715 to 1 in 2247 pregnancies, according to reported series.1 2 3 4 5 6 In the light of increasing concern about the risks of anesthestics or x-rays to mother and fetus during pregnancy, cystoscopic placement of internal ureteral tubes, or stents, between the kidney and bladder may be useful in the management of urinary calculi in pregnant women. Such a hollow stent retains its position because it has a . . .
Selective activation of the calcium signaling pathway by altered peptide ligands.
Authors: J Sloan-Lancaster, T H Steinberg, P M Allen
Journal: The Journal of Experimental Medicine (1996)

We previously demonstrated that altered peptide ligands (APL) can partially activate T cells, resulting in multiple distinct functional phenotypes, including the induction of anergy. Such APL stimulate a unique pattern of T cell receptor (TCR) phospho-zeta species, and lack associated ZAP-70 kinase activity. While these data suggested that selective signaling pathways downstream of the TCR/CD3 molecules are activated upon APL stimulation, they did not directly demonstrate this. Thus, we pursued intracellular signaling events successfully stimulated by APL. Because our previous studies showed that cyclosporin A (CsA) completely inhibited anergy induction, we assessed whether TCR ligation by APL cause a rise in cytosolic calcium (Ca+2). Our results show that these ligands can induce Ca+2 transients, in contrast to data generated using analogue peptides in other antigen systems. These opposing results may reflect differences in the intracellular signaling pathways utilized by different APL, or may be due to the exquisite sensitivity of the assay used here. Importantly, the APL-stimulated Ca+2 induction is both initiated and sustained at lower levels than that stimulated by a strong agonist signal, but resembles that stimulated by a weaker agonist stimulus. Alone, the less than optimal Ca+2 induction does not cause anergy, because ionomycin treatment together with the APL does not result in a proliferative signal. Instead, we propose that a combination of this and other signaling pathways induces T cell anergy. Overall, these data support the concept of differential signaling in T cells, as a direct consequence of the phosphotyrosine status of the TCR/CD3 molecules.
Treosulfan/fludarabine as an allogeneic hematopoietic stem cell transplant conditioning regimen for high‐risk patients
Authors: Donatella Baronciani, Alessandro Rambaldi, Anna Paola Iori, Paolo Di Bartolomeo, Federica Pilo, Martina Pettinau, Cristina Depau, Caterina Mico, Stella Santarone, Emanuele Angelucci
Journal: American Journal of Hematology (2008)

Abstract In recent years, new conditioning regimens have been explored in patients not eligible for conventional transplant with the aim to reduce transplant‐related mortality. In a phase II multicentric prospective trial, we investigated the safety and feasibility of the treosulfan–fludarabine combination prior to allogeneic hematopoietic stem cell transplant in patients with various hematological malignancies not eligible for conventional regimens because of previous intensive treatment, older age, and comorbidities. Forty‐six consecutive patients, median age 48 years (range 17–69), were enrolled. Sixteen of them were in complete remission, and 20 had a HSCT comorbidity index ≥ 1. Forty‐four patients had regular and sustained engraftment, and 39 out of 40 evaluable patients developed complete chimerism. Nonhematological toxicity was limited. Risk of transplant‐related mortality was 9% (95% CI, 2–17%) at day +100 and plotted at 15% (95% CI, 7–22%) after 7 months. The estimated overall survival and progression‐free survival with a median follow‐up of 20 months were 51% and 38%, respectively. The estimated 30 months progression‐free survival for patients transplanted in remission was 56%. The treosulfan–fludarabine combination is a reduced‐toxicity but myeloablative regimen that can be proposed to patients not fitting criteria for conventional transplant regimens. Longer follow‐up and further prospective studies are necessary to evaluate this regimen. © 2008 Wiley‐Liss, Inc. Am. J. Hematol., 2008.
Effective Postponement of Diabetic Nephropathy With Enalapril in Normotensive Type 2 Diabetic Patients With Microalbuminuria
Authors: Jamal Ahmad, Mohammad A Siddiqui, Habib Ahmad
Journal: Diabetes Care (1997)

OBJECTIVE This study determines the long-term efficacy of the ACE inhibitor, enalapril, in reducing the progression of microalbuminuria to clinical albuminuria in normotensive patients with type 2 diabetes. RESEARCH DESIGN AND METHODS There were 103 normotensive type 2 diabetic patients with persistent albumin excretion rate (AER) 20–200 micrograms/min and normal renal function followed for 5 years in a prospective randomized single-blind placebo-controlled trial. AER, blood pressure, fasting plasma glucose, and HbA1 were measured every 3–4 months and glomerular filtration rate (GFR), renal plasma flow (RPF), and urinary urea every 12 months. RESULTS In the patients treated with enalapril, AER decreased from 55 ± 33 to 20 ± 59 micrograms/min (geometric mean ± SD), whereas in the placebo group, AER increased from 53 ± 31 to 85 ± 90 micrograms/min after 5 years. Within 5 years, 7.7% (4/52) of enalapril-treated subjects and 23.5% (12/51) of placebo-treated subjects progressed to clinical albuminuria defined as AER &amp;gt; 200 micrograms/min and at least 34% above baseline (risk reduction = 66.7%, P &amp;lt; 0.001). AER increased at an annual rate of 12.3% (95% CI 9.8–14.9) in the placebo group, while it declined by 16.7% (95% CI −18.3 to −15.2) in the enalapril group (P &amp;lt; 0.001). In addition, 8 of the 12 placebo-treated patients had evidence of coronary artery disease. The rest of the parameters remained practically unchanged in the two groups. CONCLUSIONS After 5 years of therapy with enalapril, compared with placebo, normotensive subjects with type 2 diabetes experienced significantly less progression of microalbuminuria to clinical albuminuria, reduced AER, and preserved GFR.
Identification of Gene Markers for Formaldehyde Exposure in Humans
Authors: Guang-Yong Li, Hye-Young Lee, Ho-Sang Shin, Hyeon-Young Kim, Cheol-Hong Lim, Byung-Hoon Lee
Journal: Environmental Health Perspectives (2007)

BackgroundFormaldehyde (FA) is classified as a human carcinogen and has been linked to increased leukemia rates in some epidemiologic studies. Inhalation of FA induces sensory irritation at relatively low concentrations. However, little is known concerning the cellular alterations observed after FA exposure in humans.ObjectivesOur aim was to profile global gene expression in Hs 680.Tr human tracheal fibroblasts exposed to FA and to develop biomarkers for the evaluation of FA exposure in humans.Methods and ResultsWe used gene expression analysis, and identified 54 genes designated as FA responsive. On the basis of these data, we conducted an exploratory analysis of the expression of these genes in human subjects exposed to high or low levels of FA. We monitored FA exposure by measuring the urinary concentration of thiazolidine-4-carboxylate (TZCA), a stable and quantitative cysteinyl adduct of FA. Nine genes were selected for real-time PCR analysis; of these, BHLHB2, CCNL1, SE20-4, C8FW, PLK2, and SGK showed elevated expression in subjects with high concentrations of TZCA.ConclusionThe identification of gene marker candidates in vitro using microarray analysis and their validation using human samples obtained from exposed subjects is a good tool for discovering genes of potential mechanistic interest and biomarkers of exposure. Thus, these genes are differentially expressed in response to FA and are potential effect biomarkers of FA exposure.
Vitamin A deficiency in Crohn's disease.
Authors: A N Main, P R Mills, R I Russell, J Bronte-Stewart, L M Nelson, A McLelland, A Shenkin
Journal: Gut (1983)

Fifty two patients with Crohn9s disease (31 outpatients and 21 inpatients) were investigated for evidence of vitamin A deficiency. Eleven (21%) had low plasma retinol concentrations (less than 1.2 mumol/l (34.3 micrograms %)). Five of these were outpatients and plasma retinol was only slightly reduced (greater than 1.0 mumol/l (28.6%)). All outpatients weighed 80% or more of ideal, and were considered at low risk of developing vitamin A deficiency. In contrast, of the six inpatients with low plasma retinol concentration, five had a level of less than 1.0 mumol/l (28.6 micrograms %) and weighed less than 80% ideal. Three of these had impaired dark adaptation and a plasma retinol concentration of less than 0.8 mumol/l (less than 22.9 micrograms %). As a group, the inpatients were more protein depleted than the outpatients, with respect to serum albumin (p less than 0.01), transferrin (p less than 0.001), and prealbumin (p less than 0.001) but retinol binding protein levels were not significantly lower. It is suggested that patients with extensive small bowel Crohn9s disease, who weigh less than 80% of ideal weight, merit measurement of plasma retinol concentration. Those with plasma retinol less than 0.8 mumol/l (less than 22.9 micrograms %) run a high risk of night blindness. Vitamin supplements should be given and protein depletion corrected.
Medicine's Position Is Both Pivotal and Precarious in Assisted-Suicide Debate
Authors: Paul Cotton
Journal: JAMA (1995)

PHYSICIAN-ASSISTED suicide may become as contentious an issue as abortion. The escalating battle pits those who say they are protecting a right to life against those who are demanding a right to choose. Opposing camps are virtually identical to those that war over abortion with one notable exception: organized medicine. "They are two different issues," says American Medical Association (AMA) board of trustees secretary Thomas R. Reardon, MD, an internist in Portland, Ore. "Not even experts agree when life begins," so the AMA maintains that abortion is a medical matter best left between patient and physician. Assisted suicide involves "actively participating in the killing of a living, breathing, functioning, cognitive human being who has a terminal illness," says Reardon. "For myself and for the AMA this is not a religious issue, it is an ethical issue. Our purpose as physicians is to heal." The option of assisted suicide would tarnish
Postoperative Hyponatremia in Menstruant Women
Authors: Richard H. Sterns
Journal: Annals of Internal Medicine (1993)

Letters15 June 1993Postoperative Hyponatremia in Menstruant WomenRichard H. Sterns, MDRichard H. Sterns, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-12-199306150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Ayus and colleagues [1] correctly emphasize the potential dangers of acute postoperative hyponatremia. No one should dispute that neurologic symptoms warrant a set of electrolyte studies, that symptomatic hyponatremia deserves urgent treatment, or that hypotonic fluids are best avoided in the postoperative period. Future editions of surgical textbooks should stress these important points. Unfortunately, the authors also leave the impression that hyponatremia in young women is associated with a high mortality rate. This conclusion is not supported by their findings.The only valid mortality statistics are found in the authors' survey of 674 consecutive patients with postoperative ...References1. Ayus JC, Wheeler JM, Arieff AI. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med. 1992; 117: 891-7. Google Scholar2. Arieff AI. Hyponatremia, convulsions, respiratory arrest, and permanent brain damage after elective surgery in healthy women. N Engl J Med. 1986; 314:1529-35. Google Scholar3. Fraser CL, Arieff AI. Fatal central diabetes mellitus and insipidus resulting from untreated hyponatremia: a new syndrome. Ann Intern Med. 1990; 112:113-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1993Volume 118, Issue 12Page: 984-985KeywordsAttentionBrain damageBrain diseasesDeath ratesForecastingHyponatremiaMorbidityMortalitySodium Issue Published: 15 June 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...