tbuckley/cabot-search huggingface dataset:
Diagnosing and managing acute heart failure in adults: summary of NICE guidance
Authors: K. Dworzynski, E. Roberts, A. Ludman, J. Mant
Journal: BMJ (2014)

Acute heart failure may present de novo in people without known cardiac dysfunction, or as an acute decompensation of known chronic heart failure. Acute heart failure is a common cause of admission to hospital (more than 67 000 admissions in England and Wales each year) and is the leading cause of hospital admission in people aged 65 years or more in the United Kingdom.1 European registry data show that nearly 50% of people admitted to hospital with acute heart failure are re-admitted within 12 months,2 and a third of people with acute heart failure die within a year of their first hospital admission.1 The diagnosis of heart failure can be challenging because of non-specific symptoms and clinical signs, and there is evidence of wide variation in the way people with acute heart failure are managed.1 This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on acute heart failure.3 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations can be based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Organisation of care
IgM Antibodies Specific for Epstein-Barr Virus in Infectious Mononucleosis without Heterophil Antibodies
Authors: J. Nikoskelainen, J. Leikola, E. Klemola
Journal: BMJ (1974)

IgM antibodies specific for Epstein-Barr (E.B.) virus were demonstrable in all but one out of 46 patients diagnosed as having infectious mononucleosis wihout heterophil antibodies; cytomegalovirus aetiology was excluded. In all but two cases the highest titre was found in the first sample. In 21 patients a significant decrease was seen within a few weeks. IgG antibodies to E.B. virus, mostly remaining at a constant level, were demonstrable in all cases. IgM antibodies to E.B. virus were found in only five out of 300 controls.The results suggest that in a disease similar to infectious mononucleosis without heterophil antibodies testing of transient E.B. virus-specific IgM antibodies makes a rapid aetiological diagnosis possible and that in clinically well-defined cases viruses other than E.B. virus and cytomegalovirus are unlikely to be causal agents.
Asthma, Ephedrine, and Olympic Eligibility
Authors: Claude A. Frazier
Journal: JAMA (1976)

<h3>To the Editor.—</h3> In 1972, a young American swimmer, Rick DeMont, was forced to give up the gold medal he won in an Olympic swimming event when ephedrine traces were found in an analysis of his urine. DeMont had asthma and he used an ephedrine compound (Marax) to control his asthma during the athletic events. Even though the Executive Committee of the American Academy of Allergy drew up the following resolution, that gold medal has not been restored to Mr DeMont: WHEREAS, individuals with asthma should be encouraged to lead as normal a life as possible, and, in particular should be encouraged to participate in athletics and not consider themselves different from other individuals, and WHEREAS, ephedrine and ephedrine-containing compounds are standard universally accepted drugs for treatment of asthma, and WHEREAS, there is no evidence that athletic performance can be enhanced beyond the normal by therapeutic doses of ephedrine, and
Assessment of regional left ventricular relaxation in patients with coronary artery disease: importance of geometric factors and changes in wall thickness.
Authors: H Pouleur, M F Rousseau, C van Eyll, A A Charlier
Journal: Circulation (1984)

To assess local myocardial relaxation abnormalities in patients with coronary artery disease, local myocardial left ventricular wall stress was computed in nine normal subjects and in 22 patients with coronary artery disease. In normal left ventricles, the rate of decrease in isovolumic local stress was not significantly different from the rate of decrease in isovolumic pressure, and the residual wall stress at the end of isovolumic relaxation was uniformly low. In patients with coronary artery disease, the residual wall stress was increased both in infarcted areas and in non-infarcted areas perfused by stenosed arteries (43 +/- 31 and 30 +/- 19 kdyne/cm2, respectively, vs 9 +/- 5 kdyne/cm2 in normal areas; p less than .001). The rate of decrease in local stress in infarcted areas paralleled the rate of decrease in pressure (48 vs 49 msec; NS), but in ischemic areas the rate of decrease in stress was significantly slower than the rate of decrease in pressure (69 +/- 35 vs 48 +/- 15 msec; p less than .05). It is concluded that in patients with coronary artery disease, indexes based only on the analysis of decreases in isovolumic pressure underestimate the severity of local impairments in relaxation rate and cannot be used to predict the level of residual diastolic wall stress.
Latest clue to exercise-induced amenorrhea
Authors: Terra Ziporyn
Journal: JAMA (1984)

Exercise-induced amenorrhea, as well as shortened luteal phase and delayed menarche, have been attributed to a complex interplay of physical, hormonal, nutritional, psychological, and environmental factors that include stress of competition, decreased protein consumption, and altered lean-fat ratio (<i>JAMA</i>1983; 249:354,<i>JAMA</i>1981;246:1590,<i>JAMA</i>1981;246:1559-1563,<i>JAMA</i>[MEDICAL NEWS] 1980;243:1699). And although it is known that circulating levels of gonadotropins—necessary to induce ovulation—fall with exercise, the exact link between regular strenuous exercise and menstrual irregularities continues to puzzle investigators. At the Seventh International Congress of Endocrinology in Quebec City, however, Lesley Rees, MD, who is chair of the British Society for Endocrinology, offered a new clue: Serum levels of β-endorphins increase with exercise, and these, in turn, appear to inhibit pituitary release of gonadotropins (luteinizing hormone, or LH, and follicle-stimulating hormone, or FSH). β-Endorphins are a kind of endogenous opioid peptide, released from the anterior pituitary in response to stress (including
CATHETER ABLATION OF ATRIAL FLUTTER: ACUTE AND LONG-TERM RESULTS
Authors: Etienne Luciani, Marliese Nagy, Johannes Brachmann, Karl-Heinz Kuck, Dietrich Andresen, Stephan Willems, Ellen Hoffmann, Burghard Schumacher, Thorsten Lewalter, Stefan Spitzer, Jürgen Tebbenjohanns, Rüdiger Becker, Jochen Senges, Bernd-Dieter Gonska
Journal: Journal of the American College of Cardiology (2011)
An Update on Radionuclide Imaging in Hepatobiliary Disease
Authors: Leonard Rosenthall
Journal: JAMA (1981)

THE RECENT introduction of technetium Tc 99m-labeled acetanilide iminodiacetic acid (<sup>99m</sup>Tc-IDA) analogues has facilitated the clinical study of the bile flow pathways. This was done with difficulty in previous years using rose bengal sodium I 131 (Robengatope I-131). Images were of poor quality because of the restriction placed on the administered dose to reduce radiation exposure. This has been overcome with the<sup>99m</sup>Tc label. A variety of<sup>99m</sup>Tc-IDA derivatives are under investigation. Basically all are metabolized by the hepatocyte and immediately thereafter excreted unconjugated into the biliary tract. The analogues differ in the amount of hepatocyte uptake, renal excretion, and rate of transport from the liver cell to the biliary tract. Although they all perform well in normal to mild jaundice, some are more desirable in moderate to severe jaundice because of lesser renal elimination and greater hepatocyte uptake in liver failure. Of the various derivatives tested,
The Stripe Sign
Authors: C. DAVID TEATES, JAMES R. BROOKEMAN, THOMAS M. DANIEL, JONATHON D. TRUWIT, JAYASHREE S. PAREKH, JOHN P. MUGLER, EDUARD E. DE LANGE
Journal: Clinical Nuclear Medicine (1999)

PURPOSE: The aim of this study was to correlate regional ventilation and perfusion images and perfusion SPECT with images made using a newly developed magnetic resonance ventilation (MRV) method. MATERIALS AND METHODS: The investigation included a single patient with chronic obstructive pulmonary disease and a healthy control participant. Ventilation and perfusion images using Xe-133 and Tc-99m MAA, including perfusion SPECT, were compared with single-breath MRV with hyperpolarized He-3. RESULTS: Ventilation and perfusion defects correspond to areas of poor ventilation on MRV. High-resolution MRV images show preservation of bronchi and acinus units in areas of the "stripe sign" on the V/Q study. CONCLUSIONS: MRV imaging confirms that the stripe sign seen on nuclear perfusion imaging correlates with subsegmental preserved lung. MRV imaging has the potential for high-resolution innovative studies of subsegmental lung function, using either He-3 or Xe-129 hyperpolarized gases.
Abrogation of Protein Uptake through Megalin-Deficient Proximal Tubules Does Not Safeguard against Tubulointerstitial Injury
Authors: Franziska Theilig, Wilhelm Kriz, Timo Jerichow, Petra Schrade, Brunhilde Hähnel, Thomas Willnow, Michel Le Hir, Sebastian Bachmann
Journal: Journal of the American Society of Nephrology (2007)

Sustained proteinuria and tubulointerstitial damage have been closely linked with progressive renal failure. Upon excess protein endocytosis, tubular epithelial cells are thought to produce mediators that promote inflammation, tubular degeneration, and fibrosis. This concept was tested in a transgenic mouse model with megalin deficiency. Application of an anti–glomerular basement membrane serum to transgenic megalin-deficient mice [Cre(+)/GN] and megalin-positive littermates [Cre(−)/GN] produced the typical glomerulonephritis (GN) with heavy proteinuria in both groups. Tubulointerstitial damages correlated closely with glomerular damages in pooled Cre(+)/GN and Cre(−)/GN mice. Owing to a mosaic pattern of megalin expression in the mutant mice, Cre(+)/GN kidneys permitted side-by-side analysis of megalin-deficient and megalin-positive tubules in the same kidney. Protein endocytosis was found only in megalin-positive cells. TGF-β, intercellular adhesion molecule, vascular cellular adhesion molecule, endothelin-1, and cell proliferation were high in megalin-positive cells, whereas apoptosis, heat-shock protein 25, and osteopontin were enhanced in megalin-deficient cells. No fibrotic changes were associated with either phenotype. Tubular degeneration with interstitial inflammation was found only in nephrons with extensive crescentic lesions at the glomerulotubular junction. In sum, enhanced protein endocytosis indeed led to an upregulation of profibrotic mediators in a megalin-dependent way; however, there was no evidence that endocytosis played a pathogenetic role in the development of the tubulointerstitial disease.
Induction of matrix metalloproteinases-14 and -2 by cyclical mechanical stretch is mediated by tumor necrosis factor-? in cultured human umbilical vein endothelial cells
Authors: B WANG, H CHANG, S LIN, P KUAN, K SHYU
Journal: Cardiovascular Research (2003)

Mechanical forces have profound effects on endothelial cells. This study was undertaken to examine the hypothesis that tumor necrosis factor-alpha (TNF-alpha) is a potential mediator of stretch-induced effects on matrix metalloproteinase (MMP).Human umbilical vein endothelial cells (HUVECs) grown on a flexible membrane base were stretched by vacuum to 20% of maximum elongation, at 60 cycles/min. We used the TNF-alpha monoclonal antibody and c-Jun N-terminal kinase (JNK) inhibitor, SP600125, to investigate the cyclical stretch-induced expression of MMP-14 and -2 in cultured HUVECs.Cyclical mechanical stretch significantly increased protein synthesis and mRNA expression for MMP-14 and -2 from 2 to 24 h. The increased MMP-14 and-2 proteins after stretch were completely blocked after the addition of TNF-alpha monoclonal antibody (5 microg/ml) or SP600125 (20 microM) 30 min before stretch. By zymography, MMP-2 expression was induced by cyclical stretch and was attenuated by TNF-alpha monoclonal antibody and SP600125. Cyclical stretch increased the immunohistochemical labeling of MMP-14 and -2 and significantly increased release of TNF-alpha into the culture media from 120+/-2 to 331+/-2 pg/ml (P<0.001) after stretch for 12 h. Cyclical stretch increased and SP600125 decreased the phosphorylated JNK. Gel-shifting assay showed that DNA-protein binding activity of AP-1 increased after cyclical stretch and TNF-alpha monoclonal antibody and SP600125 abolished the binding activity induced by cyclical stretch.These findings indicate that cyclical stretch augments TNF-alpha production and MMP genes expression in HUVECs. TNF-alpha mediates the stretch-induced MMP genes expression, at least in part, through the JNK pathway.
Recombinant tissue plasminogen activator (rt‐PA) for veno‐occlusive liver disease in pediatric autologous bone marrow transplant patients
Authors: Lolie C. Yu, Indrani Malkani, Oswaldo Regueira, David L. Ode, Raj P. Warrier
Journal: American Journal of Hematology (1994)

Abstract The pathogenesis of veno‐occlusive disease (VOD) of the liver appears to be secondary to endothelial damage of terminal hepatic venules, which leads to activation of the coagulation cascade, fibrin deposition, and eventual fibrous obliteration of the hepatic venules. Patients with VOD usually present with jaundice, hepatomegaly, weight gain, and ascites. This complication is usually associated with a high mortality rate. We report here the frequency and treatment of VOD in our autologous bone marrow transplant (BMT) patient population. Three of 15 (20%) children (median age 9 years) developed VOD and were treated with recombinant tissue plasminogen activator (rt‐PA). Two of these three patients were prepared for BMT with busulfan (16 mg/kg) and cyclophosphamide (Cytoxan, 200 mg/kg), while the other child received cytosine arabinoside (ARA‐C 18 g/m 2 ), Cytoxan (3,600 mg/m 2 ) and total body irradiation (TBI, 1,400 r). VOD developed between days 7–24 posttransplant. Clotting studies obtained pretransplant and during VOD included prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, fibrin‐degradation product (FDP), proteins C and S, and platelet count. There was no correlation between the incidence of VOD and coagulation status. All patients had normal pretransplant clotting studies. However, protein C levels were noted to be consistently low for those patients at the time of VOD. All three patients received rt‐PA at a dose of 0.25–0.5 mg/kg for 4 days. This dose produced increased levels of FDP but did not significantly prolong PT nor PTT. Two of the patients had dramatic responses and had complete resolution of VOD within 6–12 days from the start of therapy. The other patient died of fulminant hepatic failure. It seems that rt‐PA is effective in VOD of the liver, which may be associated with low protein C level. © 1994 Wiley‐Liss, Inc.
Acupuncture for Chronic Pain
Authors: Andrew J. Vickers, Klaus Linde
Journal: JAMA (2014)

Is acupuncture associated with reduced pain outcomes for patients with chronic pain compared with sham-acupuncture (placebo) or no-acupuncture control?Acupuncture is associated with improved pain outcomes compared with sham-acupuncture and no-acupuncture control, with response rates of approximately 30% for no acupuncture, 42.5% for sham acupuncture, and 50% for acupuncture.
Mechanism and Location of Atrial Flutter in Transplanted Hearts: Observations During Transient Entrainment From Distant Sites
Authors: Angel Arenal, Jesus Almendral, Roberto Muñoz, Julian Villacastín, Jose Luis Merino, Jesus Palomo, José Antonio García Robles, Rafael Peinado, Juan Luis Delcán
Journal: Journal of the American College of Cardiology (1997)
"Restless Legs" Syndrome in Acute Intermittent Porphyria
Authors: EMANUEL S. HELLMAN
Journal: Annals of Internal Medicine (1962)

Case Reports1 March 1962"Restless Legs" Syndrome in Acute Intermittent PorphyriaEMANUEL S. HELLMAN, M.D., DONALD P. TSCHUDY, M.D.EMANUEL S. HELLMAN, M.D.Search for more papers by this author, DONALD P. TSCHUDY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-3-487 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA syndrome of unpleasant paresthesias, predominantly in the lower extremities, and the resultant voluntary, restless, twitching motions on the part of the sufferer to obtain relief, was probably first noted by Willis in 1685 (1). Attention was redirected to this sympton complex by Ekbom in 1944 and in his subsequent publications (2-4) where he applied the term "restless legs" to this syndrome. "Restless legs" developing in a patient with acute intermittent porphyria is presented and documented as yet another symptom in a disease of protean manifestations.CASE REPORTThe patient was a 58-year-old white male former machinist. Hypertension, apparently labile...References1. WILLIS T: The London Practice of Physick, 1st ed., Thomas Basset and William Crooke, London, 1685, p. 404. Google Scholar2. EKBOM KA: Asthenia crurum paraesthetica (irritable legs). Acta Med. Scand. 118: 197, 1944. CrossrefGoogle Scholar3. EKBOM KA: Restless legs. Acta Med. Scand. (Supp.) 158: 1, 1945. Google Scholar4. EKBOM KA: Restless legs syndrome. Neurology 10: 868, 1960. CrossrefMedlineGoogle Scholar5. JOLIVET B: Paresthesies agitantes nocturnes des members inferieurs, impatiences. These de Paris, 1953. Google Scholar6. ASK-UPMARK E: Contribution to the pathogenesis of the syndrome of restless legs. Acta Med. Scand. 164: 231, 1959. CrossrefMedlineGoogle Scholar7. BRENNING R: Restless legs; forsok till patogenetisk forklaring. Svensk. Lakartidn. 54: 2293, 1957. MedlineGoogle Scholar8. SIMONS AJ: On paresthesia. Thesis, Utrecht, 1951. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, MarylandFrom the Metabolism Service, National Cancer Institute, National Institutes of Health.Requests for reprints should be addressed to Donald P. Tschudy, M.D., National Cancer Institute, National Institutes of Health, Bethesda, Maryland. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIh contributes to increased motoneuron excitability in restless legs syndromeAcute-onset Restless legs syndrome in acute neurological conditions-a prospective study on patients with the Guillain-Barre syndrome and acute strokePERIODIC LIMB MOVEMENTS AND RESTLESS LEGS SYNDROMESPONTANEOUS LEG CRAMPS AND “RESTLESS LEGS” DUE TO DIABETOGENIC HYPERINSULINISM: OBSERVATIONS ON 131 PATIENTS* 1 March 1962Volume 56, Issue 3Page: 487-489KeywordsHypertensionLesionsPorphyriaRestless legs syndromeTachycardia Issue Published: 1 March 1962 PDF downloadLoading ...
Glucocorticoid-induced glucocorticoid-receptor expression and promoter usage is not linked to glucocorticoid resistance in childhood ALL
Authors: Wim J. E. Tissing, Jules P. P. Meijerink, Bas Brinkhof, Mathilde J. C. Broekhuis, Renee X. Menezes, Monique L. den Boer, Rob Pieters
Journal: Blood (2006)
Pharmacokinetics, chemical interactions, and toxicological risk assessment in perspective.
Authors: J N Blancato
Journal: Environmental Health Perspectives (1994)

Chemical mixtures and multiple routes of exposure are frequently difficult problems for exposure and risk assessors. Chemicals can interact synergistically or antagonistically at a variety of physiologic and biochemical loci within target cells. Many of these interactions can be accounted for with a thorough understanding of the pharmacokinetics of the compounds in the mixture. Many pharmacokinetic processes such as metabolism and absorption can be impacted by the presence of other chemicals in the environment and diet and as a result of medication. In addition, variations between responses as a result of different exposure scenarios (route of exposure, frequency, magnitude) can sometimes result from the impacts upon the pharmacokinetics. Pharmacokinetic models, when properly formulated and tested, can be useful tools to describe and predict the magnitude of the impact of multichemical and multiroute exposures. Several examples will be used to demonstrate this potentially powerful tool and how it can impact the risk assessment process.
Aquarius: Age of Change
Authors: Alfred B. Mason
Journal: JAMA (1970)

To the Editor.—  Aquarius: Age of Change ( 212 :1517, 1970) ruefully recognizes the pace of modern science and politics, proposes that we oldsters adjust as best we can.  One of the earliest intelligent evaluations of Aquarius appeared on the last pages of Henry Adams' The Education of Henry  written about the turn of the century. For most historical changes, said Adams, the pace has been a geometrical progression (the modern terminology would be exponential, with a positive exponent).  Adams correctly foresaw the 20th-century explosion of progress, science, and power; he also foresaw the grave social problems that would result. To the children of that century, he said, their grandparents would seem infantile; how could they, the grandparents, have accomplished so much in such dense ignorance? Yet the disturbances would eventually dominate the picture, and total dissolution would probably take place late in the century.  Adams' exponential rule has proved
On Joining the Lynch Mob
Authors: Steven H. Miles
Journal: The American Journal of Bioethics (2008)

Click to increase image sizeClick to decrease image size This Open Peer Commentary addresses Michael Keane's Target Article The Ethical “Elephant” in the Death Penalty “Room” from The American Journal of Bioethics 8(10): 45–50 and the Open Peer Commentaries that follow on pp. 51–61.
How It All Began
Authors: J. H. Chloropos
Journal: JAMA (1967)

<h3>Act I</h3> A room in a house in the Greek town of Modik long ago. Five nobles are lounging on couches. Philolaus: Fellow nobles, this dull, inactive life is deplorable. No war. No excitement. Empedocles: You're right! Since the advent of Greek fire it looks like war is a thing of the past. Heraclitus: And we haven't had a good public scandal since the furor over Isosceles' triangle died down. Patroclus: Maybe we'll regain political favor. Empedocles: Fat chance with Lysanias Boeotia Junius in power. Heraclitus: Right! With LBJ ruling the roost we might as well look for something else to do. Philolaus: Well, whatever we do, it should be worthy of us as nobles. Empedocles: Something that shapes man's destiny. Democritus: There's that fellow named Asclepios who goes around treating the sick. Calls himself a doctor. He shapes men's destinies. Heraclitus: You mean that nut with the snake on
Housing the Chronically Homeless
Authors: Stefan G. Kertesz, Saul J. Weiner
Journal: JAMA (2009)

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