tbuckley/cabot-search huggingface dataset:
Evoked Potential Testing: Clinical Applications
Authors: Charles M. Poser
Journal: JAMA (1986)

Evoked potential tests have assumed an increasing importance in the practice of a number of specialties, but mostly in neurology. The surprisingly rapid growth in popularity of these procedures seems to have outstripped the care and circumspection that should be exercised when accepting a relatively new diagnostic test into the investigative armamentarium. Obviously, one major reason for their popularity is that they are noninvasive, totally harmless, painless (except for the somatosensory evoked potential test, which may be uncomfortable), and can be carried out by a technician who requires little additional training beyond what has already been learned as an electroencephalographic technician. Perhaps these are all reasons why these tests have become overused and, unfortunately, often misinterpreted. This book, regrettably, does little to address this important problem. It is an excellent manual for the technically inclined and should be indispensable to the physician or scientist setting up a laboratory for the
Health and Physiological Effects of an Emotional Disclosure Intervention Adapted for Application at Home: A Randomized Clinical Trial in Rheumatoid Arthritis
Authors: Henriët van Middendorp, Rinie Geenen, Marjolijn J. Sorbi, Lorenz J.P. van Doornen, Johannes W.J. Bijlsma
Journal: Psychotherapy and Psychosomatics (2009)

&lt;i&gt;Background:&lt;/i&gt; The efficacy of emotional disclosure in alleviating psychological and physical stress has been well documented in controlled laboratory studies. A next step is to evaluate its clinical utility in ‘real world’ settings. We adapted the emotional disclosure intervention for use in home-based settings by stimulating the suggested effective ingredients of cognitive-emotional processing, and evaluated its psychological and clinical effectiveness. Reviews indicated the need to examine the physiological changes brought about by emotional disclosure, which may be particularly relevant in immune-mediated diseases. This study was the first to examine neuroendocrine and immune changes after emotional disclosure in patients with rheumatoid arthritis. &lt;i&gt;Methods:&lt;/i&gt; Sixty-eight patients were randomly assigned to four weekly oral emotional disclosure or time management sessions. At baseline and 1 week and 3 months after the sessions, depressed and cheerful mood, joint scores, erythrocyte sedimentation rate, cortisol, noradrenaline, interleukin-6 (IL-6), interferon-γ (IFN-γ), and IL-10 were evaluated. Repeated measures analyses of variance were performed. &lt;i&gt;Results:&lt;/i&gt; No effect on psychological well-being and clinical outcome was found (p ≥ 0.10). Cortisol (p = 0.01) and the serum level of the pro-inflammatory cytokine IFN-γ (p = 0.05) were differentially affected by the two conditions. The change of IL-6 nearly reached significance (p = 0.07). &lt;i&gt;Conclusions:&lt;/i&gt; The physiological changes are in agreement with theories on the mechanisms underlying emotional disclosure benefits and are suggestive of better disease control after emotional disclosure. General and study-specific reasons for the absence of psychological and clinical effects are discussed. The findings warn against widespread implementation of this home-based emotional disclosure intervention in unselected rheumatoid arthritis samples.
Hypothalamic Insufficiency: The Cause of Hypopituitarism in Sarcoidosis
Authors: CHARLES A. STUART
Journal: Annals of Internal Medicine (1978)

Ten patients with generalized sarcoidosis and hypopituitarism were studied. Six of these 10 patients presented with sarcoid involvement of the optic nerves resulting in asymmetric visual field defects. All patients had deficiencies of two or more anterior pituitary hormones and seven had abnormalities of water metabolism. Despite hypopituitarism, nine patients had a pituitary responsive to the synthetic hypothalamic releasing factors, thyrotropin releasing hormone and gonadotropin releasing hormone, and the tenth patient had a partially responsive pituitary. The demonstration of pituitary responsiveness allows us to infer hypothalamic insufficiency as the major cause for hypopituitarism in these patients. The combination of visual field defects and hypopituitarism in sarcoidosis is a medically treatable condition that simulates the clinical presentation of a pituitary tumor.
Urinary Reflux From Ileal Neobladder into a Non-Functioning Kidney
Authors: Lankanath Alwis, Frances Hampson, Davina Pawaroo, Kottekkattu Balan
Journal: Clinical Nuclear Medicine (2009)

The importance of monitoring renal function in patients undergoing cystectomy and urinary diversion is well established. Dynamic renography using Tc-99m MAG3 in combination with furosemide challenge has been widely used to determine the differential function of the kidneys, occurrence of reflux as well as the patency of the outflow tract in this context. The authors have described here a patient in whom significant urinary reflux from the neo-bladder into the nonfunctioning kidney was demonstrated during MAG3 diuretic renography.
EFFECT OF THYROID THERAPY ON THE CONDITIONAL REFLEX FUNCTION IN HYPOTHYROIDISM
Authors: W. HORSLEY GANTT, WALTER FLEISCHMANN
Journal: American Journal of Psychiatry (1948)

A complete clinical study of a hypothyroid boy, age 13, was made for a period of 2 years. An examination of the higher nervous activity by the conditional reflex method showed that the ability to form and differentiate conditional reflexes ran parallel to the metabolic records (BMR, serum cholesterol) and to the EEG, showed a marked improvement within several weeks after thyroid therapy, the improvement in these items reaching a level in 2 months, without further change after 2 years of therapy. The IQ (depending largely upon an accumulation of learning) showed a marked stability over the same 2-year period. The conditional reflex, on the contrary, is a delicate measure of higher nervous function practically independent of education, related specifically to the status praesens of the patient and in this hypothyroid patient to basic metabolic changes.
Preventing Anticoagulant-Related Bleeding
Authors: C. Seth Landefeld
Journal: Annals of Internal Medicine (1993)

Letters15 January 1993Preventing Anticoagulant-Related BleedingC. Seth Landefeld, MD and Philip A. Anderson, MDC. Seth Landefeld, MDSearch for more papers by this author and Philip A. Anderson, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-2-199301150-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Davidson asks: What is the optimal range of the APT for an individual patient treated by continuous infusion of heparin? The question is important because low APT have been associated with bleeding [1, 2]. Unfortunately, available data do not provide a definitive answer.Hirsh and colleagues [4] reported that 1) heparin levels of 0.2 to 0.4 U/mL by protamine titration achieved a full antithrombotic effect, as indicated by inhibition of fibrinogen accretion; 2) the APT value associated with a given heparin concentration varies directly with the patient's baseline APT; and 3) a heparin level of 0.3 U/mL ...References1. Hirsh J. Drug therapy: heparin. N Engl J Med. 1991; 324:1565-74. Google Scholar2. Landefeld CS, McGuire E 3d, Rosenblatt MW. A bleeding risk index for estimating the probability of major bleeding in hospitalized patients starting anticoagulant therapy. Am J Med. 1990; 89:569-78. Google Scholar3. Hull RD, Raskob GE, Hirsh J, Jay RM, Ledera JR, Geerts WH, et al. Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. N Engl J Med. 1986; 315:1109-14. Google Scholar4. Hirsh J, Genton E, Hull R. Heparin. In: Venous Thromboembolism. New York: Grune and Stratton; 1981:166-7. Google Scholar5. Landefeld CS, Anderson PA. Guideline-based consultation to prevent anticoagulant-related bleeding. Ann Intern Med. 1992; 116:829-37. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1993Volume 118, Issue 2Page: 158-159KeywordsAttentionBloodClinical laboratoriesFibrinogenHemorrhageHeparinProtaminesResearch laboratories ePublished: 15 August 2000 Issue Published: 15 January 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Epinephrine supports the postabsorptive plasma glucose concentration and prevents hypoglycemia when glucagon secretion is deficient in man.
Authors: S G Rosen, W E Clutter, M A Berk, S D Shah, P E Cryer
Journal: Journal of Clinical Investigation (1984)

We hypothesized that adrenergic mechanisms support the postabsorptive plasma glucose concentration, and prevent hypoglycemia when glucagon secretion is deficient. Accordingly, we assessed the impact of glucagon deficiency, produced by infusion of somatostatin with insulin, without and with pharmacologic alpha- and beta-adrenergic blockade on the postabsorptive plasma glucose concentration and glucose kinetics in normal human subjects. During somatostatin with insulin alone mean glucose production fell from 1.5 +/- 0.05 to 0.7 +/- 0.2 mg/kg per min and mean plasma glucose declined from 93 +/- 3 to 67 +/- 4 mg/dl over 1 h; glucose production then increased to base-line rates and plasma glucose plateaued at 64-67 mg/dl over 2 h. This plateau was associated with, and is best attributed to, an eightfold increase in mean plasma epinephrine. It did not occur when adrenergic blockade was added; glucose production remained low and mean plasma glucose declined progressively to a hypoglycemic level of 45 +/- 4 mg/dl, significantly (P less than 0.001) lower than the final value during somatostatin with insulin alone. These data provide further support for the concept that maintenance of the postabsorptive plasma glucose concentration is a function of insulin and glucagon, not of insulin alone, and that adrenergic mechanisms do not normally play a critical role. They indicate, however, that an endogenous adrenergic agonist, likely adrenomedullary epinephrine, compensates for deficient glucagon secretion and prevents hypoglycemia in the postabsorptive state in humans. Thus, postabsorptive hypoglycemia occurs when both glucagon and epinephrine are deficient, but not when either glucagon or epinephrine alone is deficient, and insulin is present.
Clinical trial with inactivated hepatitis A vaccine and recommendations for its use.
Authors: A. J. Tilzey, S. J. Palmer, S. Barrow, K. R. Perry, H. Tyrrell, A. Safary, J. E. Banatvala
Journal: BMJ (1992)

OBJECTIVE--To compare the reactogenicity and immunogenicity of an inactivated hepatitis A vaccine in two different immunisation schedules. DESIGN--Randomised trial. SETTING--One London teaching hospital. SUBJECTS--104 healthy adult volunteers (71 men, 33 women aged 19-60). INTERVENTIONS--Hepatitis A vaccine to group 1 (54 volunteers) at 0, 1, and 2 months and to group 2 (50) at 0, 1, and 6 months. MAIN OUTCOME MEASURES--Symptoms at and after each dose; liver function, hepatitis A virus specific serum immune response; and responses in saliva and parotid fluid in immunised volunteers and subjects with natural immunity. RESULTS--The vaccine was well tolerated; 97% (96/99) and 100% of those immunised developed serum antibody after one and two doses of vaccine respectively. Geometric mean titres increased progressively after each dose and were significantly higher in men but not women in group 2 after the third dose (ratio between geometric mean titres 0.265, 95% confidence interval 0.18 to 0.39; p less than 0.001). At one year this group-sex interaction was absent; geometric mean titres for both sexes were significantly higher in group 2 (ratio 0.330, 0.227 to 0.478; p less than 0.0001). Antibody responses were not significantly different between the groups at two years. Compared with naturally infected subjects immunised volunteers developed poor or undetectable virus specific IgG and IgA responses in saliva and parotid fluid. CONCLUSIONS--The vaccine was safe and highly immunogenic, and the differences in the immune responses in saliva and parotid fluid are unlikely to affect its efficacy.
Common variants near MBNL1 and NKX2-5 are associated with infantile hypertrophic pyloric stenosis
Authors: Bjarke Feenstra, Frank Geller, Camilla Krogh, Mads V Hollegaard, Sanne Gørtz, Heather A Boyd, Jeffrey C Murray, David M Hougaard, Mads Melbye
Journal: Nature Genetics (2012)
Intra-articular corticosteroids are effective in osteoarthritis but there are no clinical predictors of response.
Authors: A Jones, M Doherty
Journal: Annals of the Rheumatic Diseases (1996)

To show whether intra-articular steroid injections are effective in osteoarthritis; to determine factors that predict response; and to determine whether injection has a beneficial effect on muscle strength.Double blind, placebo controlled, crossover study in 59 patients with symptomatic osteoarthritis of the knee. Outcome measure-Primary outcome measure: change in visual analogue score for pain at three weeks. Predictors of response analysed using logistic regression with a 15% decrease in pain score at three weeks defining response.Intra-articular methyl prednisolone acetate produced a significant reduction in visual analogue pain score at three weeks compared to both baseline (median change -2.0 mm, interquartile range -16.25 to 4.0) and placebo (median 0.0 mm, interquartile range -9.0 to 6.25). No clinical predictors of response could be identified. Muscle strength was not significantly improved in the short term by intra-articular injection.Intra-articular corticosteroids are effective for short term relief of pain in osteoarthritis but predicting responders is not possible. There may be a place for their more widespread use.
Roentgen Diagnosis, vol 5, Abdomen
Authors: Richard E. Buenger
Journal: JAMA (1967)

ABSTRACT The well-known masterpiece Roentgen Diagnosis is now in its sixth German edition (1965). The fifth German edition (1952) was translated into English in 1954. The present edition is now being translated in parts, and the previous four-volume work has been expanded into five. The present volume 5 is the first to be published.The selection of Dr. Leo G. Rigler to arrange and edit the American edition was most appropriate. Throughout the book he has provided frequent and pertinent footnotes, which moderate controversial opinions, relate the text to the prevailing American radiological and surgical concepts and nomenclature, and supply critical additions from the latest American literature and a vast personal experience. The translation is free, smooth, and in the American scientific idiom.The new volume 5, Abdomen, justifiably supersedes the previous volume 4, Gastrointestinal Tract, Gynecology, Urology, in every aspect. The double-columned text allows easier reading and facilitates the placement
Do children think of the self as the soul?
Authors: Shaun Nichols
Journal: Behavioral and Brain Sciences (2006)

Bering's work provides new insight into the child's concept of the self. For his results indicate that children don't regard bodily identity as required for identity of self across time. Bering's methodology for investigating afterlife beliefs might also be exploited to explore the extent to which children think that psychological similarity is required for sameness of self.
Calibration of color Doppler flow mapping during extreme hemodynamic conditions in vitro: a foundation for a reliable quantitative grading system for aortic incompetence.
Authors: D F Switzer, A P Yoganathan, N C Nanda, Y R Woo, A J Ridgway
Journal: Circulation (1987)

If color Doppler imaging is to continue to evolve into a reliable clinical method to noninvasively evaluate regurgitant lesions, then its grading methods must be quantitated and calibrated under extreme hemodynamic conditions. A left heart pulse duplicator was used to provide a completely controllable system to study aortic incompetence jet morphologies as a function of hemodynamic extremes. The system was first used to calibrate the limits of resolution of color Doppler imaging. Next, to define which jet features reliably predict the defect size or the regurgitant fraction and which are primarily influenced by instantaneous hemodynamic variables, we measured the jets' maximal length, width, proximal width, and temporal pattern of color variance during independent variations in the heart rate, cardiac output, and pressure gradient across the incompetent valve. The proximal jet width (immediately below the valve plane) was the only reliable independent predictor of both the defect size and the regurgitant fraction. Jet depth accurately predicted peak velocity (quantitated by laser Doppler velocimetry); it reliably predicted the severity of incompetence only at a known pressure gradient across the valve. Large defects (5 mm) produced jets with maximal color variance in early diastole, whereas small defects produced pandiastolic variance.
Scrotal Cellulitis Simulating Testicular Infarction by Tc-99m Pertechnetate Imaging
Authors: ALAN APPELBAUM
Journal: Clinical Nuclear Medicine (1997)

A 37-year-old man with an extensive psychiatric history attempted self-castration by tightening a coat hanger around his scrotum. This action resulted in scrotal cellulitis. Scrotal imaging with Tc-99m pertechnetate was requested to assess testicular viability. The study shows increased activity surrounding the region of the coat hanger and extending inferiorly; activity was greater on the right side. An ovoid area of relatively decreased activity on the left was interpreted initially as left testicular infarction. Subsequent surgical exploration showed that both testicles were perfused normally. The relatively decreased activity on the left presumably represents an area of less severe cellulitus.
Case 30-1982
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, Edwin O. Wheeler, Thomas H. Aretz
Journal: New England Journal of Medicine (1982)

Presentation of CaseA 49-year-old man was admitted to the hospital because of dyspnea and syncope.He was well until three months earlier, when dyspnea developed abruptly while he was walking up a short hill, and he lost consciousness briefly. He entered another hospital, where an electrocardiogram demonstrated a normal rhythm with a PR interval of 0.26 second and left-axis deviation. A 24-hour Holter-monitor recording showed rare premature atrial contractions and single premature ventricular contractions. An exercise-tolerance test disclosed no ectopic activity and provoked no chest pain. One month before admission exertional dyspnea recurred and progressed, and he returned to . . .
Tissue remodelling in upper airways: where is the link with lower airway remodelling?
Authors: J.‐B. Watelet, T. Van Zele, M. Gjomarkaj, G. W. Canonica, S.‐E. Dahlen, W. Fokkens, V. J. Lund, G. K. Scadding, J. Mullol, N. Papadopoulos, S. Bonini, M. L. Kowalski, P. Van Cauwenberge, J. Bousquet
Journal: Allergy (2006)

Tissue remodelling reported in upper airways include epithelial hyperplasia, increased matrix deposition in the nasal or paranasal lining, matrix degradation and accumulation of plasma proteins. Genetic influences, foetal exposures and early life events may contribute to structural changes such as subepithelial fibrosis from an early age. Other structural alterations are related to duration of the disease and long-term uncontrolled inflammation. Structural changes may increase alteration of the protective functions of the upper airways namely by affecting mucociliary clearance and conditioning of inspired air. The sequences of tissue changes during wound repair of upper airway mucosa after surgery are illustrative of the complexicity of tissue modelling and remodelling and could be considered as an important source of information for a better understanding of the complex relationship between inflammatory reaction, of the subsequent tissue damages and fibroblast metabolism of upper airways.
The Willowbrook Wars
Authors: Peter L. Putnam
Journal: JAMA (1985)

Large public institutions, including city general hospitals as well as institutions for the mentally ill, the aged, and the mentally retarded, have frequently been the subject of investigative journalism. Willowbrook, on Staten Island, was such an institution, with over 5,000 beds for the retarded. In the early 1970s, a coalition of groups, including the New York Mental Health Law Project, brought suit against Willowbrook. After a lengthy court battle, the judgment ordered community placement of most of the residents. Even before this project, both authors were committed to the concept of deinstitutionalization or normalization. Sheila Rothman had trained and worked in the Boston area. In her master's thesis she noted that patients refused admission to the hospital because of lack of beds were able to continue to live at home "not because they were any less handicapped than those in the institution." She believed that there might be programs that
"Monarthritis" in a young man
Authors: A P Cairns
Journal: Annals of the Rheumatic Diseases (2003)

A 20 year old male university student presented with a one year history of a stiff painful swollen left ankle. He described morning stiffness of one hour and also night pain which occasionally kept him awake. He was unable to take part in sporting activities. There was no history of trauma. No other joints were painful. There was no history of back or heel pain, psoriasis, iritis, urethritis, or inflammatory bowel disease. There was no history of preceding gastrointestinal or genitourinary infection. He had had an episode of Stevens-Johnson syndrome at the age of 12 (but no recent skin or mouth lesions) and occasional migraine headaches. His health was otherwise good. There was no history of weight loss. Non-steroidal anti-inflammatory drugs provided more symptomatic relief than simple analgesics. His grandmother had rheumatoid arthritis. There was no other significant family history. Clinical examination demonstrated a large warm ankle effusion with generalised tenderness, stress pain, and significantly decreased ankle movement. No abnormality was found on examination of the remainder of the locomotor system. There was no evidence of psoriasis or other rash or nail lesion. The remainder of the clinical examination was …
Magnifying Endoscopic Observation of the Gastric Mucosa, Particularly in Patients with Atrophic Gastritis
Authors: N. Sakaki, Y. Iida, Y. Okazaki, S. Kawamura, T. Takemoto
Journal: Endoscopy (1978)

The gastric mucosal surface was observed using the magnifying fibergastroscope (FGS-ML), and the fine gastric mucosal patterns, which were even smaller than one unit of gastric area, were examined at a magnification of about 30. For simplicification, we classified these patterns by magnifying endoscopy in the following ways; FP, FIP, FSP, SP and MP, modifying Yoshii's classification under the dissecting microscope. The FIP, which was found to have round and long elliptical gastric pits, is a new addition to our endoscopic classification. The relationship between the FIP and the intermediate zone was evaluated by superficial and histological studies of surgical and biopsy specimens. The width of the band of FIP seems to be related to the severity of atrophic gastritis. Also, the transformation of FP to FIP was assessed by comparing specimens taken from the resected and residual parts of the stomach, respectively. Moreover, it appears that severe gastritis occurs in the gastric mucosa which shows a FIP. Therefore, we consider that the FIP indicates the position of the atrophic border.