tbuckley/cabot-search huggingface dataset:
Fasting Versus Postload Glucose Levels
Authors: Hertzel C. Gerstein
Journal: Diabetes Care (2001)

In 1997, the American Diabetes Association (ADA) published updated criteria for the diagnosis of diabetes and states of glucose tolerance (1). Its recommendation that the oral glucose tolerance test (OGTT) not be routinely used to identify people with either diabetes or impaired glucose tolerance (IGT) has fueled considerable controversy regarding the importance of such testing in either a clinical or epidemiological context (2,3,4,5,6,7,8,9). Generally, these reports have pointed out that a fasting plasma glucose (FPG) level alone will underestimate the prevalence of diabetes and/or underestimate the prevalence of IGT. Moreover, they have also pointed out that postload hyperglycemia is an early risk factor for cardiovascular (CV) events and that it may be a stronger predictor of CV events than fasting hyperglycemia (4). These observations have been cited to support a re-evaluation of the ADA recommendation and retention of the OGTT for routine use. However, a careful examination of the ADA recommendation suggests that this may in part be based on a misinterpretation of its underlying rationale. A brief review of some relevant data and of the significance of a diagnosis of diabetes and IGT may help to inform ongoing discussions regarding this issue.

In the ADA report of the expert committee, epidemiological data regarding the clinical significance of an OGTT were reviewed. In at least three different populations, a 2-h plasma glucose level ≥11.1 mmol/l (200 mg/dl) (measured after a 75-g oral glucose load) was a strong predictor of subsequent eye and kidney disease. Therefore, these data 1 ) confirmed that this 2-h glucose level was an appropriate cutoff in which to base a diagnosis of diabetes, 2 ) highlighted the fact that the …
Echocardiographic detection of coronary artery disease during dobutamine infusion.
Authors: S G Sawada, D S Segar, T Ryan, S E Brown, A M Dohan, R Williams, N S Fineberg, W F Armstrong, H Feigenbaum
Journal: Circulation (1991)

BACKGROUND Two-dimensional echocardiography performed during dobutamine infusion has been proposed as a potentially useful method for detecting coronary artery disease. However, the safety and diagnostic value of dobutamine stress echocardiography has not been established. METHODS AND RESULTS In this study, echocardiograms were recorded during step-wise infusion of dobutamine to a maximum dose of 30 micrograms/kg/min in 103 patients who also underwent quantitative coronary angiography. The echocardiograms were digitally stored and displayed in a format that allowed simultaneous analysis of rest and stress images. Development of a new abnormality in regional function was used as an early end point for the dobutamine infusion. No patient had a symptomatic arrhythmia or complications from stress-induced ischemia. Significant coronary artery disease (greater than or equal to 50% diameter stenosis) was present in 35 of 55 patients who had normal echocardiograms at rest. The sensitivity and specificity of dobutamine-induced wall motion abnormalities for coronary artery disease was 89% (31 of 35) and 85% (17 of 20), respectively. The sensitivity was 81% (17 of 21) in those with one-vessel disease and 100% (14 of 14) in those with multivessel or left main disease. Forty-one of 48 patients with abnormal echocardiograms at baseline had localized rest wall motion abnormalities. Fifteen had coronary artery disease confined to regions that had abnormal rest wall motion, and 26 had disease remote from these regions. Thirteen of 15 patients (87%) without remote disease did not develop remote stress-induced abnormalities, and 21 of 26 (81%) who had remote disease developed corresponding abnormalities. CONCLUSIONS Echocardiography combined with dobutamine infusion is a safe and accurate method for detecting coronary artery disease and for predicting the extent of disease in those who have localized rest wall motion abnormalities.
Radionuclide imaging of infarcted heart gives best estimate of damage
Authors: William A. Check
Journal: JAMA (1980)

Sophisticated radionuclide imaging techniques are providing greatly improved estimates of the extent of cardiac damage and coronary artery involvement in persons who have suffered their first myocardial infarction. In a presentation to the recent meeting of the American Federation for Clinical Research in Washington, DC, cardiologist Randolph E. Patterson, MD, of the Mount Sinai School of Medicine in New York, reported that imaging with thallium 201 identified three-vessel and left main coronary artery disease more accurately during exercise than did electrocardiography or the occurrence of angina. Patients with these forms of ischemic heart disease are most likely to benefit from coronary artery bypass operations, he pointed out. In a separate presentation, Edward Geltman, MD, assistant medical director of the Cardiac Diagnostic Laboratory at Washington University School of Medicine in St Louis, showed that tomographic scanning using positron-emitting isotopes accurately identified the location and size of infarct zones in affected
Prostaglandin (PG) E2 generation by cultured canine synovial fibroblasts exposed to microcrystals containing calcium.
Authors: D J McCarty, H S Cheung
Journal: Annals of the Rheumatic Diseases (1985)

Immunoreactive prostaglandin (PG) E2 was released into the ambient medium in a dose dependent fashion when either hydroxyapatite (HA) or calcium pyrophosphate dihydrate (CPPD) crystals were added to canine synovial fibroblasts in tissue culture. PGE2 release peaked 6 to 9 hours after HA or CPPD crystals were added in the presence of serum but at 24 hours if they were added in the presence of lactalbumin hydrolysate. PGE2 release correlated with crystal endocytosis estimated qualitatively by serial phase contrast microscopy and time lapse photography. As postulated previously by others for monosodium urate crystals, prostaglandin production by synovial cells may also be related to the pathogenesis of the destructive arthropathies associated with HA or CPPD crystals.
Development of Matrix Metalloproteinase Inhibitors in Cancer Therapy
Authors: M. Hidalgo, S. G. Eckhardt
Journal: JNCI Journal of the National Cancer Institute (2001)

The matrix metalloproteinases (MMPs) are a family of zinc-dependent proteinases involved in the degradation of the extracellular matrix. The MMPs have been implicated in the processes of tumor growth, invasion, and metastasis; are frequently overexpressed in malignant tumors; and have been associated with an aggressive malignant phenotype and adverse prognosis in patients with cancer. A number of MMP inhibitors are being developed for the treatment of cancer. The most extensively studied class of MMP inhibitors includes collagen peptidomimetics and nonpeptidomimetic inhibitors of the MMP active site, tetracycline derivatives, and bisphosphonates. The hydroxamate peptidomimetic inhibitor batimastat and its orally bioavailable analogue marimastat, which bind covalently to the zinc atom at the MMP-active site, were the first MMP inhibitors to be studied in detail. Marimastat is currently being studied in randomized clinical trials. The nonpeptidic MMP inhibitors were synthesized in an attempt to improve the oral bioavailability and pharmaceutical properties of the peptidic inhibitors. Several members of this class of compounds are undergoing evaluation in phase III clinical trials. The tetracyclines and, particularly, the nonantibiotic chemically modified tetracyclines, interfere with several aspects of MMP expression and activation and inhibit tumor growth and metastases in preclinical models. A representative agent of this class, Col-3, is currently undergoing phase I clinical trials. The development of the MMP inhibitors, like that of other targeted and predominantly antiproliferative compounds, poses a challenge because the paradigms that have governed the design of clinical oncology trials may not be relevant to this new class of agents. The anticipated need for long-term administration of these drugs, together with their cytostatic mechanism of action, will require novel clinical trial design strategies.
Pulmonary Vascular Effects of Inhaled Nitric Oxide and Oxygen Tension in Bronchopulmonary Dysplasia
Authors: Peter M. Mourani, D. Dunbar Ivy, Dexiang Gao, Steven H. Abman
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Pulmonary hypertension contributes significantly to morbidity and mortality in bronchopulmonary dysplasia (BPD), but little is known about the relative contribution of arterial tone, structural remodeling, and vessel density to pulmonary hypertension, especially in older patients. To determine the role of high pulmonary vascular tone in pulmonary hypertension, we studied the acute effects of oxygen tension, inhaled nitric oxide (iNO), and calcium channel blockers (CCB) in 10 patients with BPD who underwent cardiac catheterization for evaluation of pulmonary hypertension. During normoxic conditions, mean pulmonary arterial pressure (PAP) and pulmonary to systemic vascular resistance ratio (PVR/SVR) were 34 ± 3 mm Hg and 0.42 ± 0.07, respectively. In response to hypoxia, PAP and PVR/SVR increased by 50 ± 8% and 82 ± 14%, respectively (p < 0.01). Hyperoxia decreased PVR/SVR by 28 ± 9% (p = 0.05). The addition of iNO treatment (20–40 ppm) to hyperoxia decreased PAP and PVR/SVR by 29 ± 5% (p < 0.01) and 45 ± 6% (p < 0.05) from baseline values, respectively, achieving near normal values. CCB did not alter PAP or PVR/SVR from baseline values. We conclude that hyperoxia plus iNO causes marked pulmonary vasodilatation in older patients with BPD, suggesting that heightened pulmonary vascular tone contributes to pulmonary vascular disease in BPD.
Radiation Therapy and Chemotherapy Combination
Authors: Simon Kramer
Journal: JAMA (1971)

Advanced cancer of the upper air and food passages presents a particular challenge to the radiation therapist. When tumors in these areas become advanced, the patient dies from disease that has extended locally, usually without distant metastases. These tumors are too extensive for surgical cure; however, the whole region can be encompassed by radiation therapy. Unlike the small oral and oropharyngeal lesions, which are eminently curable by aggressive radiation therapy, massive lesions are rarely cured. One reason for this difference in response is the local problem. The large tumor mass is more poorly vascularized, there is a greater number of hypoxic, and therefore, radioresistant tumor cells, and the very large number of tumor cells decreases the statistical chance of damaging all or most of these cells by irradiation. Another reason, however, is the often appallingly poor general condition of such patients. Many of them are malnourished derelicts or chronic alcoholics.
Imaging of Lower Extremity Artery Atherosclerosis in Diabetic Foot
Authors: Sandip Basu, Hongming Zhuang, Abass Alavi
Journal: Clinical Nuclear Medicine (2007)

In this communication, we present the FDG-PET findings in 2 patients with Type II diabetes mellitus with foot complications. The first case was a 47-year-old female patient, diagnosed case of a diabetic foot with ischemic complications and the second was a 60-year-old female patient diagnosed to have a neuropathic Charcot foot. Although the first case demonstrated prominent diffuse uptake in the lower extremity arteries, including popliteal and tibial arteries, the other did not. Histopathological correlation was available in both cases: the case showing diffuse FDG uptake in the arteries revealed features of atherosclerosis along with evidence of a gangrenous right toe; the other case without any uptake in the arteries had no evidence of atherosclerosis in the pathologic examination. However, increased tracer uptake was noted in the distal left tibia just above the ankle, midshaft of the tibia as well as in the soft tissue of lateral and plantar aspect of the left foot which was suggestive of osteomyelitis and cellulites, respectively, consequent to the neuropathy. FDG-PET is being actively investigated for its potential to image atherosclerosis. The present report describes its application for assessing inflammation related to atherosclerosis in a diabetic foot with ischemic complications and has important implications for clinical management because making a distinction between diabetic neuropathy and angiopathy is critical for therapeutic intervention in these patients. It is worthwhile to consider a larger prospective trial on the role of FDG-PET in this setting.
Leukotriene B4 stimulates polymorphonuclear leukocyte adhesion to cultured vascular endothelial cells.
Authors: M A Gimbrone, A F Brock, A I Schafer
Journal: Journal of Clinical Investigation (1984)

Adhesion of polymorphonuclear leukocytes (PMN) to the endothelial lining of blood vessels is an essential component of the inflammatory response. We have examined the effects of various lipoxygenase metabolites of arachidonic acid on PMN adhesion to cultured vascular endothelial cells, using a quantitative monolayer adhesion assay. Our results indicated that leukotriene B4 (LTB4) could effectively stimulate PMN adhesion to endothelial cell surfaces, in contrast to the sulfidopeptide leukotrienes C4, D4, and E4, and the monohydroxyacid lipoxygenase products of leukocytes and platelets, 5S-hydroxy-6-trans-8,11,14-cis-eicosatetraenoic acid and 12S-hydroxy-5,8-cis,10-trans,14-cis-eicosatetraenoic acid, respectively. LTB4-stimulation of PMN-endothelial adhesion did not appear to be dependent upon the generation of cyclooxygenase metabolites, nor was it inhibited by exogenous prostacyclin. Enhanced PMN adhesion was observed with endothelial cells that were cultured from different types of large vessels (arteries and veins) in several species. These findings suggest an important pathophysiologic role for LTB4 in regulating leukocyte-vessel wall interactions.
PERSISTENCE OF MECHANICAL DYSSYNCHRONY AFTER CARDIAC RESYNCHRONIZATION THERAPY IS ASSOCIATED WITH ADVERSE LONG TERM OUTCOME IN EJECTION FRACTION RESPONDERS
Authors: Josef Marek, Mohamed Ahmed, Tetsuari Onishi, Toshinari Onishi, Samir Saba, Evan Adelstein, John Gorcsan
Journal: Journal of the American College of Cardiology (2012)
The Acquired Immunodeficiency Syndrome and Lupus Anticoagulant
Authors: WILLIAM D. HAIRE
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 August 1986The Acquired Immunodeficiency Syndrome and Lupus AnticoagulantWILLIAM D. HAIRE, M.D.WILLIAM D. HAIRE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-2-301_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Cohen and colleagues (1) have recently reported the presence of the lupus anticoagulant in ten homosexual men with the acquired immunodeficiency syndrome (AIDS). Gold and colleagues (2) have extended these observations to include intravenous drug abusers with AIDS, particularly those with Pneumocystis carinii pneumonia. In both series the avidity of the lupus anticoagulant varied with the presence or absence of an opportunistic infection. I have recently cared for a patient with hemophilia A who developed a lupus anticoagulant associated with disseminated histoplasmosis.A 51-year-old white man with known mild hemophilia A was hospitalized for evaluation of fever...References1. COHENPHILLIPSKESSLER ATC. Circulating coagulation inhibitors in the acquired immunodeficiency syndrome. Ann Intern Med. 1986;104:175-80. LinkGoogle Scholar2. GOLDHAUBENSTOCKZALUSKY JAR. Lupus anticoagulant and AIDS [Letter]. N Engl J Med. 1986;314:1252. CrossrefMedlineGoogle Scholar3. SCHLEIDERNACHMANJAFFECOLEMAN MREM. A clinical study of the lupus anticoagulant. Blood. 1976;48:499-509. CrossrefMedlineGoogle Scholar4. . Revision of the case definition of acquired immunodeficiency syndrome for national reporting—United States. MMWR. 1985;34:373-5. MedlineGoogle Scholar5. LUSHERHILLMAN JC. Effects of inhibitors on coagulation factor assays [Abstract]. Blood. 1985;66(suppl 1):323. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 908 Main Street; Halstead, KS 67056 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySilica clotting time (SCT) as a screening and confirmatory test for detection of the lupus anticoagulantsRheumatologic Manifestations of Infection with Human Immunodeficiency Virus (HIV)Brian R. Kaye, MD 1 August 1986Volume 105, Issue 2Page: 301-302KeywordsAIDSAddictsAnticoagulantsFeversHemophilia AHistoplasmosisHomosexualsOpportunistic infectionsPneumocystis carinii pneumonia Issue Published: 1 August 1986 PDF DownloadLoading ...
Diseases of the Colon and Anorectum
Authors: Joel W. Baker
Journal: JAMA (1970)

Robert Turell's two-volume second edition covering diseases of the colon and anorectum has achieved a distinctive quality well above most texts with which I am familiar. He and his 92 contributing authorities have succeeded in covering every conceivable topic bearing on this portion of the gastrointestinal tract. In fact this might be considered one of the few flaws the reviewer finds with the volumes. The chapters dealing with endocrine factors and immunologic mechanisms could have been profitably condensed, and those covering pre- and postoperative care could have been more specific. The minor shortcomings of the early chapters which prompt this modest criticism are well compensated for by the chapters which follow, particularly those added to cover new developments relating to anorectocolonic disease. Controversial topics such as adenomas of the colon and rectum, written by Dr. Turell, are encyclopedic in their presentation and present all sides. The sections concerning rectal carcinoma
Regional Enteritis Presenting as Hypoproteinemia Without Intestinal Symptoms
Authors: Tyson C. Cobb
Journal: JAMA (1969)

A 24-year-old white man had regional enteritis presenting as pedal edema eight months prior to the onset of gastrointestinal complaints. Protein-losing enteropathy was demonstrated by a 15% excretion of chromated Cr 51 serum albumin in the stool. Regional enteritis as the cause of this enteropathy was revealed by roentgenography, exploratory laparotomy, and subsequent clinical course.
Arsenic-stimulated liver sinusoidal capillarization in mice requires NADPH oxidase–generated superoxide
Authors: Adam C. Straub, Katherine A. Clark, Mark A. Ross, Ashwin G. Chandra, Song Li, Xiang Gao, Patrick J. Pagano, Donna B. Stolz, Aaron Barchowsky
Journal: Journal of Clinical Investigation (2008)

Environmental arsenic exposure, through drinking contaminated water, is a significant risk factor for developing vascular diseases and is associated with liver portal hypertension, vascular shunting, and portal fibrosis through unknown mechanisms. We found that the addition of low doses of arsenite to the drinking water of mice resulted in marked pathologic remodeling in liver sinusoidal endothelial cells (SECs), including SEC defenestration, capillarization, increased junctional PECAM-1 expression, protein nitration, and decreased liver clearance of modified albumin. Furthermore, the pathologic changes observed after in vivo exposure were recapitulated in isolated mouse SECs exposed to arsenic in culture. To investigate the role of NADPH oxidase-generated ROS in this remodeling, we examined the effect of arsenite in the drinking water of mice deficient for the p47 subunit of the NADPH oxidase and found that knockout mice were protected from arsenite-induced capillarization and protein nitration. Furthermore, ex vivo arsenic exposure increased SEC superoxide generation, and this effect was inhibited by addition of a Nox2 inhibitor and quenched by the cell-permeant superoxide scavenger. In addition, inhibiting either oxidant generation or Rac1-GTPase blocked ex vivo arsenic-stimulated SEC differentiation and dysfunction. Our data indicate that a Nox2-based oxidase is required for SEC capillarization and that it may play a central role in vessel remodeling following environmentally relevant arsenic exposures.
Water Intoxication in Man After Cyclophosphamide Therapy
Authors: RALPH A. DeFRONZO
Journal: Annals of Internal Medicine (1973)

Cyclophosphamide therapy in doses greater than 50 mg/kg body weight has resulted in frank impairment of water excretion in 17 of 19 normally hydrated patients with cancer. Clinically, these patients developed hyponatremia, weight gain, and inappropriately concentrated urine during cyclophosphamide infusion, but without cyclophosphamide they excreted water loads normally. The decrease in serum osmolarity (range, 5 to 41 milliosmols/litre) and rise in urine osmolarity (range, 309 to 798 milliosmols/litre) occurred 4 to 12 hours after cyclophosphamide infusion, lasted up to 20 hours, and was related temporally with the urinary excretion of active alkylating metabolite(s) of the drug. Treatment of four cancer patients with cytosine arabinoside failed to provoke water intoxication. The mechanism of cyclophosphamide-induced impairment of water excretion is unclear. Tumor release of antidiuretic hormone after cyclophosphamide administration seems unlikely since the study group included patients with leukemia and aplastic anemia without tumor. The likelihood and self-limited time course of impaired water excretion during high-dose cyclophosphamide treatment should be recognized because such patients are invariably waterloaded to prevent uric acid lithiasis and drug-related cystitis.
Junior Hospital Doctors' Contract
Authors: P. Baylis
Journal: BMJ (1975)

If one contract is to be the rule for all consultants in all parts of Britain, then it must be generally and freely agreed as the best obtainable.At a meeting of consultants in this city on 8 January 73 voted to retain the present form of w,holeor part-time contract, provided it is suitably priced, and five voted for a fixed-time 10-session type of contract.If this feeling is widespread in Scotland (or, maybe, over the United Kingdom as a whole) serious consideration must be given by our negotiators to this body of opinion.The time has come to stand back and re-examine the wisdom of this headlong rush for a fixed-time contract.When the full implications of any fixed-time contract have been critically examined then many, even of those initially in favour of such oDntracts,
Surgical Closure of an Aortic Septal Defect
Authors: ROBERT E. GROSS
Journal: Circulation (1952)

Occurring just above the aortic and pulmonic valves, an aortic-pulmonary artery communication gives a left-right shunt which may be indistinguishable by clinical findings from a patent ductus arteriosus. Under some circumstances it is possible to identify the lesion by retrograde aortography. Because of increase in cardiac work, the shunt can produce cardiac strain. Whether or not the communication can be closed surgically depends upon the size of the opening and its distance above the coronary arteries. A case is here reported in which an aortic-pulmonary artery communication has been closed surgically.