tbuckley/cabot-search huggingface dataset:
Symptomatology and Diagnosis of Multiple Sclerosis-Reply
Authors: David G. Sherman
Journal: JAMA (1982)

<h3>In Reply.—</h3> Our review focused on the role of newer diagnostic investigations in the diagnosis of MS, many of which are unfamiliar to nonneurologists. It was not our purpose to discuss in detail the sensitivity and specificity of symptoms and signs. The symptoms and signs listed in Table 3 were chosen because, in our consulting experience, many clinicians fail to elicit them in MS suspects. Limb weakness, as noted by Dr Poser, is a quite common feature of MS, but is usually a prominent complaint, readily detected by clinicians. We wished to emphasize the<i>inob</i><i>vious</i>features, less familiar to many clinicians, which occasionally establish the multifocal nature of the illness. Multifocal signs, individually nonspecific, are a hallmark of MS. Thus, we have no real disagreement with Dr Poser's comments except as regards their relevance to our review. Furthermore, it is unclear from Dr Poser's Table if the prevalence of
Occupation and Coronary Disease: Schooling as a Confounder
Authors: J. Paul Leigh
Journal: JAMA (1988)

<h3>To the Editor.</h3> —Buring et al<sup>1</sup>recently reported an interesting correlation between occupational status and heart disease. White-collar workers were found to have a statistically significant 30% decreased risk of fatal coronary heart disease compared with blue-collar workers once the effects of other coronary risk factors were considered. The additional risk and controlling factors considered included age, gender, neighborhood, Jewish religion, relative weight, exercise level, and medical history variables. The evidence of Buring et al is potentially useful since it could be used to target groups for medical interventions as well as to point directions for future researchers who are interested in investigating the psychosocial and job-specific correlates of heart disease. One correlate that future researchers should investigate is years of schooling, which was unfortunately omitted by Buring et al. Schooling has been found to be strongly correlated with many diseases and measures of overall health as well as
STUDIES ON THE CIRCULATION IN MAN
Authors: G. N. Stewart
Journal: The Journal of Experimental Medicine (1913)

1. In the cases of fever investigated the flow in the feet never exceeded the normal flow and was usually much below the normal 2. In explanation of the relatively small foot flow in the fever cases it is suggested that the vasoconstrictor mechanism of the peripheral parts, especially of the skin, is abnormally excited, and some direct evidence that this is the case is brought forward. 3. The significance of this hypersensitiveness, or at least increased action, of the cutaneous vasoconstrictor mechanism is assumed to be that the peripheral vasoconstriction is a compensatory arrangement which secures for the organs mainly suffering from the infective process an increased flow of blood. 4. On this hypothesis the rise of temperature is, chiefly at least, secondary, inevitably following the vasoconstriction, provided that the metabolism is, upon the whole, not diminished. 5. Accordingly the rational treatment of hyperpyrexia, or of pyrexia if it is considered necessary to treat it, is to abstract heat by a process which will not diminish and may even increase the cutaneous vasoconstriction. This condition is exactly fulfilled by the cold bath, at least as regards its initial effect. Other so called tonic effects of the cold bath are not considered here. Antipyretic drugs which act by dilating the cutaneous vessels would seem to be inferior in this regard. They diminish the temperature, it is true, but at the cost of defeating the beneficial redistribution of the blood which it is the function of the peripheral vasoconstriction to insure. 6. It is obvious that for the elimination of a given quantity of heat from the skin by radiation and conduction in fever, a smaller cutaneous blood flow will suffice than with normal body temperature, since the elimination of heat per gram of blood passing through the surface must be greater in fever owing to the greater difference of temperature between the surface of the body and its surroundings. I am much indebted to the staff of the City Hospital for their coöperation which has rendered this investigation possible.
Treatment of a Case of Puerperal Fever by Antistreptococcus Serum
Authors: D. Arthur
Journal: BMJ (1899)

The prevalence of right ventricular hypertrophy was studied in necropsy material from 215 coalworkers, a group which consisted of 115 men with simple or no pneumoconiosis and 100 with progressive massive fibrosis. Right ventricular hypertrophy was considered to be present if the ratio of the weight of the left ventricle plus septum to that of the right ventricle was less than 2:1. The prevalence of right ventricular hypertrophy was low (15%) in the absence of progressive massive fibrosis and appeared to be related to emphysema or airways disease or both, and not to simple pneumoconiosis. It was evident only in subjects who had smoked. In subjects with progressive massive fibrosis the prevalence of right ventricular hypertrophy was higher (34%) and it was occasionally seen in non-smokers. The prevalence increased with increasing size of lesion, and for any given size of lesion subjects with right ventricular hypertrophy had more panacinar emphysema than those without right ventricular hypertrophy. There was no relationship, however, between the extent of massive lesions or amount and type of emphysema and the degree of right ventricular hypertrophy.
Secondary hyperparathyroidism. Conservative management in patients with renal insufficiency
Authors: M. M. Popovtzer
Journal: JAMA (1975)

In three patients with advanced renal disease (inulin clearance, 4.6 to 9.1 ml/min) and systemic manifestations of secondary hyperparathyroidism, concentrations of serum calcium and phosphorus were maintained within our normal limits (9 and 3.5 mg/100 ml, respectively) with phosphate-binding antacids and orally given calcium carbonate. The result was progressive disappearance of symptoms related to secondary hyperparathyroidism, healing of osteitis fibrosa, and normalization of serum concentrations of immunoreactive parathyroid hormone. (<i>JAMA</i>231:960-962, 1975)
Pulmonary Hypertension and Risk of Death in Cardiomyopathy
Authors: Thomas P. Cappola, G. Michael Felker, W.H. Linda Kao, Joshua M. Hare, Kenneth L. Baughman, Edward K. Kasper
Journal: Circulation (2002)

Pulmonary hypertension is a clinically useful predictor of death in patients with heart failure. Whether pulmonary hypertension has the same prognostic value among specific underlying causes of cardiomyopathy is unknown. Using a diverse cohort of cardiomyopathy patients, we tested the hypotheses that (1) elevated mean pulmonary arterial pressure is the most important hemodynamic predictor of death and (2) the prognostic value of mean pulmonary pressure varies among different cardiomyopathies.Patients (n=1134) with new cardiomyopathy were prospectively assigned a specific diagnosis on the basis of clinical evaluation and endomyocardial biopsy. All patients underwent right heart catheterization at baseline and were followed for an average of 4.4 years. In multivariate Cox models that allowed for nonlinear relations between hemodynamics and death, mean systemic pressure (mSP) and mean pulmonary arterial pressure (mPA) emerged as the most important hemodynamic predictors of death. Moreover, there was a statistically significant positive interaction between mPA and the diagnosis of myocarditis. For each 5-mm Hg increase in baseline mSP, mortality rates decreased with relative hazard (RH) of 0.89 (0.86 to 0.92). For a 5-mm Hg increase in baseline mPA, mortality rates increased in patients who did not carry the diagnosis of myocarditis with RH 1.23 (1.17 to 1.29); among patients with myocarditis, mortality rates increased substantially with RH of 1.85 (1.50 to 2.29; P<0.001 for interaction).Baseline mPA is particularly important for stratifying risk in myocarditis. These findings suggest that secondary pulmonary hypertension may have different biological features in myocarditis and that patients with pulmonary hypertension and myocarditis should be targeted for aggressive medical therapy.
Chronic Inflammatory Gingival and Periodontal Disease
Authors: Roy C. Page
Journal: JAMA (1978)

Gingivitis and periodontitis account for more than 95% of all inflammatory diseases of the tissues surrounding the teeth, comprising the principal cause of tooth loss in adults. Gingivitis is a relatively innocuous inflammation of the gums, with associated bleeding and exudation. Gingivitis may convert to periodontitis, a destructive aggressive disease with resorption of alveolar bone, destruction of collagen with fibrosis, and formation of deep pockets around the necks of the teeth. Gingivitis and periodontitis are caused by microorganisms populating the gingival sulcus and periodontal pocket. Treatment is directed toward arresting the progress of the disease through debridement and stabilization of the teeth. Toothbrushing and other measures by which the teeth are mechanically cleaned remain the most effective way to control plaque accumulation and periodontal disease.
398. Adeno-Associated Virus Serotype 8 Efficiently Crosses Blood Vessel Barrier in Muscle and Heart for Whole-Body - Delivery
Authors: Zhong Wang, Tong Zhu, Chunping Qiao, Liqiao Zhou, Bing Wang, Jian Zhang, Chunlian Chen, Juan Li, Xiao Xiao
Journal: Molecular Therapy (2005)

Top of pageAbstract
Previous efforts to deliver genes into multiple muscles relied on isolated vessel perfusion with pressure or pharmacological interventions to enforce vector spread. We have compared a number of AAV serotype vectors (AAV1, 2, 5, 6, 7 and 8) for their ability to deliver genes systemically into muscle and heart without additional interventions. Here we showed that, in neonatal mice, a single-dose of intraperitoneal or intravenous administration of AAV vectors, particularly the AAV8 vector, led to efficient, systemic, and prolonged transductions of skeletal and cardiac muscles into adulthood. Additionally, intravenous injection of AAV8 in adult mice also achieved systemic muscle gene delivery, although the efficiency was lower than that of the neonatal mice. Long term and highly efficient gene transfer was also observed in non-muscle tissues, such as the liver, pancreas and the interstitial tissues of testis. In addition to mice, we further showed effectiveness of the AAV8 vector in both adult and neonatal hamsters.

Compared to AAV8, AAV1 and AAV6, though robust in directly infecting skeletal muscle, were less effective in achieving systemic skeletal and cardiac muscle delivery after intravenous and intraperitoneal injection in both neonatal mice and adult mice. Finally, direct perfusion of isolated hind limb without high pressure via blood vessel in adult mice and hamsters suggested that AAV8 is more efficient in crossing the blood vessel barrier in muscle tissues than other vectors, suggesting potential mechanisms for the superiority of AAV8 vector in systemic gene delivery to striated muscles.
Clinical Crossroads: A 21-Year-Old Woman With Menstrual Irregularity
Authors: John T. Littell
Journal: JAMA (1997)

To the Editor.  —With regard to the case of the 21-year-old woman with menstrual irregularity, 1 I would like to point out that this patient's menstrual irregularities commenced within 6 months of discontinuing (what appeared to be) depomedroxyprogesterone acetate injections (after only 2 injections). Dr Davis correctly states that  of use [of depomedroxyprogesterone] does not correlate with the duration of ovulatory suppression.  In my practice of family medicine, I have seen many young women who have experienced dramatic changes in their menstrual pattern with depomedroxyprogesterone, often after receiving but a single injection. Yet none of these women (in my experience) was counseled beforehand about this relatively frequent adverse effect as well as many other unpleasant adverse effects of depomedroxyprogesterone, including depression, weight gain, and osteoporosis.  Hopefully, the objective presentation of case studies and clinical research dealing with the untoward effects of depomedroxyprogesterone will help those caring for patients seeking contraceptive advice to achieve
Dizziness, Hearing Loss, and Tinnitus
Authors: Douglas C. Bigelow
Journal: Annals of Internal Medicine (1999)

Medical Writings: Book Notes5 October 1999Dizziness, Hearing Loss, and TinnitusDouglas C. Bigelow, MDDouglas C. Bigelow, MDUniversity of Pennsylvania, Philadelphia, Pennsylvania. (Bigelow)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-7-199910050-00040 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Baloh RW. 224 pages. Philadelphia: FA Davis; 1998. $65.00. ISBN 0803603304. Order phone 800-323-3555.Field of medicine: Neurotology.Format: Hardcover book.Audience: Physicians and trainees in family practice, internal medicine, otolaryngology, neurology, audiology, and neurosurgery.Purpose: To present an organized approach to the evaluation of patients with dizziness, hearing loss, or tinnitus.Content: The first section offers a detailed but concise overview of the middle and inner ear and a review of the central connections of the vestibular and auditory systems. The second part of the book provides an excellent overview of important points in the patient history and the ... Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania, Philadelphia, Pennsylvania. (Bigelow) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 5 October 1999Volume 131, Issue 7Page: 556KeywordsAudiologyChartsHearingNeurologyNeurosurgerySoftware toolsTinnitus ePublished: 15 August 2000 Issue Published: 5 October 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The S1P-analog FTY720 differentially modulates T-cell homing via HEV: T-cell–expressed S1P1 amplifies integrin activation in peripheral lymph nodes but not in Peyer patches
Authors: Cornelia Halin, M. Lucila Scimone, Roberto Bonasio, Jean-Marc Gauguet, Thorsten R. Mempel, Elizabeth Quackenbush, Richard L. Proia, Suzanne Mandala, Ulrich H. von Andrian
Journal: Blood (2005)
It Takes Four Years
Authors: Ronald M. Greenberg
Journal: JAMA (1976)

<h3>To the Editor.—</h3> This letter is prompted by the article entitled "It Takes Four Years" (234:387, 1975). The author has correctly identified many problems inherent in the threeyear curriculum. The benefits are even fewer than he suggests. He states: "The three-year curriculum serves to increase the number of graduates by only one class each 12 years." It does not even do that. It only increases the number of physicians that the school produces by one class during the year that the fouryear to three-year transition is made, and two classes are graduated simultaneously. Thereafter, unless the class size is increased, there is no difference in the number of physicians produced. A significant strain is inevitably placed on clinical facilities during the year of double graduation. If at any time in the future a change is made back to a four-year curriculum, the entire gain is lost. A medical school that
The mitogenic effects of sera from psoriatic subjects on normal dermal fibroblasts: an absence of correlation with the clinical activity of psoriasis
Authors: T. A. LAUBSCHER, N. HARRIS, D. O. CHALTON
Journal: British Journal of Dermatology (1991)

Serum was obtained from 21 normal and 22 psoriatic subjects, and the severity of skin disease in the psoriatic patients was recorded using the PASI score. The scores ranged from 1.8 to 51.0. The growth stimulatory effect of the sera on normal dermal fibroblasts in cell culture was assessed by measuring [3H]‐thymidine uptake. Each serum was assessed at four concentrations (2, 5, 10, 20%). The psoriatic sera were more growth stimulatory than normal sera, but this difference was statistically significant (P>0.02) only at 20% serum concentration. Eleven of the 22 psoriatic serum samples had a mitogenic effect greater than the mean ± 2 SEM of all the normal sera: these sera were from patients with PASI scores of 4.5–51.0. Six of these psoriatic subjects were recalled after 5 months: their PASI scores were reassessed, and the mitogenic effect of new serum samples was compared with that of the initial samples. All of these patients displayed a change in serum mitogenic effect, but this was not consistent with the change in severity of skin disease over the corresponding time period. In one subject, the severity of the psoriasis had increased marginally over the 5 months, while the mitogenic effect of her serum decreased significantly (mean counts of 43808 vs. 32660; P= 0.0029).
The Behrhorst Foundation at 25 Years
Authors: Jonathan C. Horton
Journal: New England Journal of Medicine (1987)

IN 1962 Carroll Behrhorst, M.D., left family practice in Kansas and moved to Guatemala to open a small clinic offering medical services to the local Indian population. He settled in Chimaltenango, a bustling market town located in the heart of the rugged western highlands. Since then his single-bed examining room has evolved into a major Guatemalan institution, the Behrhorst Development Foundation, that provides health services to the country's neglected rural poor.1 During 1984 and 1985, I spent five months at the Behrhorst Foundation as an observer, trying to understand how it has grown, indeed flourished, despite difficult circumstances engendered by . . .
Organization and management II
Authors: J. M. Rodrígues Roldín, M. De La Fuente Sánohes, F. Del Nogal Saes, J. López Martínes, A. Algora Weber, J. Rebollo Ferreiro, R. Abizanda, B. Balerdi, F. X. Valle, R. Jorda, J. López, E. Lemonnier, P. Loirat, D. Kleinknecht, F. Brivet, P. Landais, M. Niskanen, A. Kari, M. Pääkkönen, E. Iisalo, L. Kaukinen, V. Rauhala, E. Saarela, P. Nikki, D. Holst, K. Reiche, K. Hörauf, M. Möllmann, P. Lawin, L. Garcia, J. Ruiz, Y. González, K. Gordon, M. Aaenjo
Journal: Intensive Care Medicine (1992)
Early detection of cardiovascular autonomic neuropathy in diabetic pigs using blood pressure and heart rate variability
Authors: D Mésangeau
Journal: Cardiovascular Research (2000)

Cardiac autonomic neuropathy is a common complication in insulin dependent diabetes mellitus. Nevertheless, little is known about when this impairment occurs during the time course of the disease. Analysis of blood pressure (BP) and heart rate (HR) variability could be used to detect early signs of autonomic alteration. To test this proposal, twelve sexually mature male Yucatan miniature pigs were equipped with an arterial catheter for telemetric BP analysis, and with a venous access. BP and HR were recorded together with respiratory movements while the animals were resting in a sling. After the first recording session performed when the pigs were 5 months old, streptozotocin (STZ) was used to induce diabetes in seven pigs, while the five others were controls. BP and HR were measured 3 and 6 months after the onset of diabetes and at a similar age in the controls. BP and HR oscillated at the respiratory range (0.19 Hz). Spectral analysis showed this respiratory component was the main determinant of the short-term variability of BP and HR. Atropine increased HR and BP and markedly diminished the respiratory sinus arrhythmia. Propranolol diminished HR and the respiratory peak of HR. A reduced respiratory oscillation of BP paralleled the diminution of the respiratory peak of HR. Baroreceptor-HR reflex was estimated using injections of phenylephrine and nitroprusside, and by cross-spectral analysis between BP and HR. Atropine shifted the curve to higher HR values, while propranolol reduced the level of the upper plateau. Atropine decreased both the coherence and gain of the cross-spectral analysis. STZ injection resulted in a type 1 diabetes. At 3 months, diabetic pigs exhibited low levels of BP and a reduced overall variability of HR and BP. Spectral analysis indicated the respiratory sinus arrhythmia was markedly reduced. In addition, the sensitivity of the baroreceptor-HR reflex was reduced. At a latter stage of diabetes these alterations were marked and the level of the resting HR was increased. These data demonstrate the dual (vagal and sympathetic) control of HR in pigs and the dominant role of respiration in the genesis of HR and BP fluctuations. The spectral and cross-spectral analysis of BP and HR were altered after 3 months of diabetes and could be proposed as early detectors of cardiac autonomic neuropathy.
False-Positive FTA-ABS in Hydralazine-Induced Lupus
Authors: Brian Anderson, M. Thomas Stillman
Journal: JAMA (1978)

<h3>To the Editor.—</h3> Although the FTAABS test is considered to be sensitive and specific for the diagnosis of syphilis, it may be falsely positive in several disease states, including systemic lupus erythematosus (SLE). The occurrence of a false-positive FTA-ABS in drug-induced lupus has previously been reported to occur only with procainamide.<sup>1</sup>We wish to report a case of hydralazine-induced lupus in which the FTA-ABS was falsely positive. A 68-year-old hypertensive woman had taken hydralazine hydrochloride, 50 mg four times daily, for two years. She gave a four-week history of fever, weight loss, severe muscle weakness, skin rash, arthralgias, and pleuritic chest pain. The fluorescent antinuclear antibody (FANA) test was positive at a titer of 1:1,280, homogeneous pattern, with negative determination for anti-DNA. The C<sub>3</sub>, C<sub>4</sub>, and total hemolytic complement levels were normal. Rheumatoid factor was negative. Creatine phosphokinase and aldolase levels were normal. A muscle biopsy specimen
Replication, establishment of latency, and induced reactivation of herpes simplex virus gamma 1 34.5 deletion mutants in rodent models.
Authors: R J Whitley, E R Kern, S Chatterjee, J Chou, B Roizman
Journal: Journal of Clinical Investigation (1993)

Previous studies have shown that a gene mapping in the inverted repeats of the L component of herpes simplex virus, type 1 DNA, designated as gamma (1) 34.5, was dispensable for growth in cells in culture but that the deletion mutant (R3616) and a mutant containing a stop codon (R4009) in each copy of the gene were incapable of replicating in the central nervous systems (CNS) of mice. Restoration of the deleted sequences restored the wild type virus phenotype. We report here that the gamma (1) 34.5 mutant viruses (R3616 and R4009) replicated in the vaginal tract of two different strains of mice and guinea pig, although both viruses were shed at lower titer and for fewer days than the wild type and restored viruses. Both R3616 and R4009 failed to replicate or cause significant pathology in the cornea of Balb/C mice or following intranasal inoculation of Swiss Webster mice. Analyses of sensory trigeminal and dorsal root ganglia innervating the site of inoculation indicated that the incidence of establishment of latency or reactivation from latency by R3616 and R4009 viruses was significantly lower than that determined for mice infected with wild type or restored virus. Thus, selective deletion of gamma (1) 34.5 gene abolished the capacity of the virus to spread from peripheral mucosal sites to the CNS or replicate in the CNS, and diminished the capacity of the virus to replicate at mucosal sites and, subsequently, establish latency, or be able to be reactivated ex vivo. The results of our studies may have direct implications for the development of genetically engineered herpes simplex virus vaccines.
SIV Replication in the Infected Rhesus Macaque Is Limited by the Size of the Preexisting T <sub>H</sub> 17 Cell Compartment
Authors: Dennis J. Hartigan-O’Connor, Kristina Abel, Koen K. A. Van Rompay, Bittoo Kanwar, Joseph M. McCune
Journal: Science Translational Medicine (2012)

Macaques with abundant T H 17 cells in blood and intestinal tissue before infection are resistant to SIV replication.