tbuckley/cabot-search huggingface dataset:
Patient Education Re: Nuclear War
Authors: Deborah A. Cohen
Journal: JAMA (1985)

To the Editor.—  The threat of nuclear war is the greatest public health hazard today. 1,2 Accordingly, multiple articles on the medical consequences of nuclear war and commentaries advocating greater physician involvement in educating the public have been published. 1-3 At least one recent poll 4 shows that most Americans consider the possibility of nuclear war as their number 1 concern and 79% of Americans are in a favor of a nuclear freeze. 5 I would like to relate my personal experience in educating my own patients about the medical hazards of nuclear war and nuclear winter.  I developed a short brochure that describes the effects of a single nuclear explosion, the concepts of nuclear winter, the effect of the nuclear age on children, and the inability of physicians to deal with the medical effects of radiation and nuclear war. In addition, a section was included on what people could do
Halo naevus--a frustrated malignant maelanoma.
Authors: M G Lewis, P W Copeman
Journal: BMJ (1972)

47improvement as demonstrated by reduction or in some cases disappearance of spon- taneous pain in walking (so much so that after many years two patients were able to go upstairs without pause).The rheographic tracing was not modified in one case; in six others it showed an im- provement both in baseline conditions and after trinitrin.More prolonged and extended trial is needed to confirm the preliminary observations.
Inhibition of Prolyl Hydroxylase Domain Proteins Promotes Therapeutic Revascularization
Authors: Céline Loinard, Amandine Ginouvès, José Vilar, Clément Cochain, Yasmine Zouggari, Alice Recalde, Micheline Duriez, Bernard I. Lévy, Jacques Pouysségur, Edurne Berra, Jean-Sébastien Silvestre
Journal: Circulation (2009)

Background— The hypoxia-inducible transcription factor (HIF) subunits are destabilized via the O 2 -dependent prolyl hydroxylase domain proteins (PHD1, PHD2, and PHD3). We investigated whether inhibition of PHDs via upregulating HIF might promote postischemic neovascularization. Methods and Results— Mice with right femoral artery ligation were treated, by in vivo electrotransfer, with plasmids encoding for an irrelevant short hairpin RNA (shRNA) (shCON [control]) or specific shRNAs directed against HIF-1α (shHIF-1α), PHD1 (shPHD1), PHD2 (shPHD2), and PHD3 (shPHD3). The silencing of PHDs induced a specific and transient downregulation of their respective mRNA and protein levels at day 2 after ischemia and, as expected, upregulated HIF-1α. As a consequence, 2 key hypoxia-inducible proangiogenic actors, vascular endothelial growth factor-A and endothelial nitric oxide synthase, were upregulated at the mRNA and protein levels. In addition, monocyte chemotactic protein-1 mRNA levels and infiltration of Mac-3-positive macrophages were enhanced in ischemic leg of mice treated with shPHD2 and shPHD3. Furthermore, activation of HIF-1α-related pathways was associated with changes in postischemic neovascularization. At day 14, silencing of PHD2 and PHD3 increased vessel density by 2.2- and 2.6-fold, capillary density by 1.8- and 2.1-fold, and foot perfusion by 1.2- and 1.4-fold, respectively, compared with shCON ( P &lt;0.001). shPHD1 displayed a lower proangiogenic effect. Of interest, coadministration of shHIF-1α with shPHD3 abrogated shPHD3-related effects, suggesting that activation of endogenous HIF-1-dependent pathways mediated the proangiogenic effects of PHD silencing. Conclusions— We demonstrated that a direct inhibition of PHDs, and more particularly PHD3, promoted therapeutic revascularization. Furthermore, we showed that activation of the HIF-1 signaling pathway is required to promote this revascularization.
Measurement of red blood cell‐vitamin B12: A study of the correlation between intracellular B12 content and concentrations of plasma holotranscobalamin II
Authors: G. Tisman, T. Vu, J. Amin, G. Luszko, M. Brenner, M. Ramos, V. Flener, V. Cordts, R. Bateman, S. Malkin, T. Browder
Journal: American Journal of Hematology (1993)

We have recently reported a new and rapid assay to measure plasma holotranscobalamin II (holo TC II) as a means of exploring vitamin B12 status. In order to further evaluate the significance of plasma holoTC II in determining tissue cobalamin, we have chosen the red blood cell-vitamin B12 (RBC-B12) assay as a measure of tissue vitamin B12 content and studied the relationship between RBC-B12 and plasma holoTC II levels. Plasma holoTC II and RBC-B12 concentrations were concomitantly assayed in 20 hematologically normal controls and cancer patients. In our groups of controls, the mean value of RBC-B12 was determined as 241 +/- 51 pg/ml of packed erythrocytes (PE) with a range varying from 180 to 355 pg/ml PE. Preliminary results obtained in 32 cancer patients revealed lower holoTC II and RBC-B12 levels than the control group and a required threshold value of 70 pg/ml of holoTC II in order to maintain a normal RBC-B12 greater than 180 pg/ml PE.
An unusual cause of breathlessness
Authors: R. Orme, C. Hill, A. Allahabadia, B. Harrison, E. Grech
Journal: BMJ (2013)

A 68 year old woman was referred by her general practitioner with a history of exertional breathlessness over the past 10 years. Her symptoms had become more noticeable over the previous few months, especially when walking up inclines and climbing stairs. Echocardiography had shown good biventricular function and no evidence of valvular disease. Chest radiography was not performed at this time. She had been investigated for ischaemic heart disease in the past, and coronary angiography had excluded OK atherosclerotic disease.

Basic spirometry was within normal limits and a flow-volume loop was not performed.

Her medical history included hypertension, for which she was prescribed a calcium channel blocker. She had never smoked and drank alcohol very occasionally.

On examination she appeared well and was not dyspnoeic at rest. Her blood pressure was slightly raised at 145/90 mm Hg and her pulse was 80 beats/min in sinus rhythm. Cardiovascular examination was normal and auscultation of her chest identified bilateral late inspiratory basal crepitations.

Routine biochemical and haematological blood test results were normal. Thyroid stimulating hormone was slightly raised at 5.6 mIU/L (normal range 0.27-4.2) and free thyroxine 15.8 pmol/L (normal range 12.0-22.0; 1 pmol/L=0.08 ng/dL).

She underwent chest radiography …
The McConnell Missile Accident
Authors: Charles C. Yockey
Journal: JAMA (1980)

Twenty-four men were refueling a missile when a large spill of oxidizer occurred. Three crewmen were exposed to very high concentrations of the oxides of nitrogen. One died within minutes. Severe respiratory distress syndrome developed in the other two, one of whom survived. Twenty-one other workers were exposed to minimal to moderate concentrations of the gas. Most remained asymptomatic while six had shortness of breath, cough, or hemoptysis. The three with persistent symptoms received corticosteroid therapy; the complaints resolved in two. Corticosteroid therapy for four asymptomatic patients who had moderate hypoxemia two weeks after the accident may have aborted the second stage of nitrogen dioxide injury. Six patients with minimal exposure had persisting headaches, visual disturbances, and emotional difficulties. These latter findings may represent an unusual complication of exposure to these gases. (<i>JAMA</i>244:1221-1223, 1980)
High-dose vitamin B supplements did not slow cognitive decline in mild-to-moderate Alzheimer disease
Authors: Sudeep S. Gill
Journal: Annals of Internal Medicine (2009)

ACP Journal Club17 February 2009High-dose vitamin B supplements did not slow cognitive decline in mild-to-moderate Alzheimer diseaseSudeep S. Gill, MD, MScSudeep S. Gill, MD, MScQueen's University, Kingston, Ontario, Canada (S.S.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-4-200902170-02007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationAisen PS, Schneider LS, Sano M, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease:a randomized controlled trial. JAMA. 2008;300:1774-83. https://pubmed.ncbi.nlm.nih.gov/18854539Clinical Impact RatingsGIM/FP/GP: Mental Health: Geriatrics: Neurology: References1 Selhub J. The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J Nutr. 2006;136:1726-30S. [PMID: 16702347] Google Scholar2 Balk EM, Raman G, Tatsioni A, Chung M, Lau J, et al. Vitamin B6, B12, and folic acid supplementation and cognitive function: a systematic review of randomized trials. Arch Intern Med. 2007;167:21-30. [PMID: 17210874] Google Scholar3 Malouf R, Grimley Evans J. Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Cochrane Database Syst Rev. 2008;(4):CD004514. [PMID: 18843658] Google Scholar4 Clarke RJ, Bennett DA. B vitamins for prevention of cognitive decline: insufficient evidence to justify treatment [Editorial]. JAMA. 2008;300:1819-21. [PMID: 18854547] Google Scholar Author, Article, and Disclosure InformationAffiliations: Queen's University, Kingston, Ontario, Canada (S.S.G.)This article was published at Annals.org on 3 February 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 February 2009Volume 150, Issue 4Page: JC2-7KeywordsActivities of daily livingAlzheimer diseaseDementiaElderlyFolic acidSafetySafety studiesSedatives ePublished: 17 February 2009 Issue Published: 17 February 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Increased endothelial nitric oxide synthase activity in the hyperemic vessels of portal hypertensive rats
Authors: Paul A. Cahill, Eileen M. Redmond, Robert Hodges, Shuangmin Zhang, James V. Sitzmann
Journal: Journal of Hepatology (1996)

Background/Aim: Portal hypertension is characterized by splanchnic hyperemia due to a reduction in mesenteric vascular resistance.Mediators of this hyperemia include nitric oxide.This is based on several reports indicating a marked splanchnic hyporesponsiveness in portal hypertension to vasoconstrictor stimuli both in vitro and in viva, and a subsequent reversal using specific inhibitors of nitric oxide synthase.The objective of this study was to determine firstly whether the functional activity and/or expression of nitric oxide synthase is altered in portal hypertensive vasculature and secondly which isoenxyme form was responsible for the preferential response to nitric oxide blockade in these animals.Methods: We compared nitric oxide synthase functional activity in the hyperemic vasculature of sham and portal hypertensive rats (following partial portal vein ligation).Nitric oxide synthase activities were determined by measuring the conversion of L-argimne to citrulline using ion-exchange chromotagraphy and the amount of immunodetectable nitric oxide synthase in sham and portal hypertensive vessels was determined by Western blot.C HRONIC portal hypertension (PHT) results in increased portal pressure and reduced splanchnic vascular resistance, leading to marked splanchnic hyperemia ( 14).In addition, there is decreased peripheral vascular response to vasoconstrictor stimuli (5-11).However, neither the mechanism of the systemic hemodynamic changes nor its relationship to splanchnit vascular reactivity in PHT is well understood.
PATIENTS WITH WEIGHT REGAIN AFTER BARIATRIC SURGERY HAVE CONTINUED REVERSAL OF METABOLIC SYNDROME BUT NOT CARDIAC REMODELING: 10 YEAR LONGITUDINAL ECHOCARDIOGRAPHIC FOLLOW UP
Authors: Christina Wei, Lauren Ranson, Lance Davidson, Ted Adams, Richard Gress, Steven Hunt, Sheldon Litwin
Journal: Journal of the American College of Cardiology (2014)
Pressure mounts over patients with hepatitis C
Authors: C. Dyer
Journal: BMJ (1994)

The British government is coming under pressure to compensate haemophilic patients and others who have contracted hepatitis C from contaminated blood or blood products after the revelation that 12 haemophilic patients have died of liver disease in the past year.

Some 2000 haemophilic patients are thought to be infected—most of the adult haemophilic patients who rely on regular treatment with blood clotting factors. All were infected before heat treatment of blood products began …
TORUS FRACTURES OF THE LOWER EXTREMITY OF THE FOREARM IN CHILDREN
Authors: CARL L. GILLIES
Journal: JAMA (1933)

Torus or folding fractures (stauchungsbruch, par tassement) of the lower extremity of the forearm is the most common bony injury of childhood.1It is characterized by a localized expansion or torus of the cortex accompanied by very little or, in some cases, no displacement of the lower end of the bone.  These fractures have long been recognized. Thore,2in 1844, was first to collect observations, which he supplemented with studies on cadavers. De Quervain,3Iselin,4Vulliet,5Burnham,6Troell1and many others have studied and written of this type of fracture. In spite of this fact, these injuries are not generally understood and are not discussed in most textbooks devoted to the study of fractures.  These bony injuries are of importance, first, because of their extreme frequency and, secondly, because they are true fractures, as evidenced in late cases by the production of callus.
Clinical impact of neutropenia related with the preemptive therapy of CMV infection in solid organ transplant recipients
Authors: Cecilia Martín-Gandul, Pilar Pérez-Romero, Francisco M. González-Roncero, Soledad Berdaguer, Miguel A. Gómez, Ernesto Lage, Magdalena Sánchez, José M. Cisneros, Elisa Cordero
Journal: Journal of Infection (2014)
A tale of mind and body
Authors: B. Rapoport
Journal: BMJ (2009)

I have always been a firm believer in the so called mind-body connection. As a family doctor, I have witnessed time and again the effects of depression and anxiety on patients with chronic illness, and likewise the conundrum of unexplained physical symptoms that defy all attempts to reduce them into a particular diagnostic category. Indeed patients with multiple unexplained symptoms are a tremendous challenge to the general practitioner as well …
Differential Survival of Patients With AIDS According to the 1987 and 1993 CDC Case Definitions
Authors: Stefano Vella
Journal: JAMA (1994)

<h3>Objective.</h3> —To evaluate the impact of the 1993 Centers for Disease Control and Prevention (CDC) revised classification system for human immunodeficiency virus and expanded surveillance case definition for acquired immunodeficiency syndrome (AIDS) on the number of cases and on survival of patients with AIDS. <h3>Design.</h3> —Retrospective analysis of data from a prospective cohort study of patients treated with zidovudine. <h3>Patients.</h3> —A total of 3515 patients enrolled in the Italian National Registry of Zidovudine-Treated Patients between July 1987 and December 1991 were analyzed. <h3>Main Outcome Measures.</h3> —Numbers and survival probability estimates (using the Kaplan-Meier method) for patients satisfying the 1993 CDC case definition compared with patients fulfilling the 1987 CDC classification. Multiple regression analysis was also used to analyze the combined effect of independent variables on survival. <h3>Results.</h3> —According to the new classification system, the number of AIDS cases in the study population would increase by 188%. While the median survival of patients meeting the 1987 definition was 24 months, at the end of 57 months 53% of patients meeting the 1993 definition were still alive. Among the patients meeting the laboratory criteria for AIDS diagnosis using the new definition (CD4+ lymphocyte count &lt;0.20×10<sup>9</sup>/L [200/μL]), the presence of an AIDS-defining illness was a strong independent predictor of death. <h3>Conclusions.</h3> —The application of the new definition results in a considerable increase in the number of cases. Survival for patients classified according to the 1993 definition is much longer than for those classified with the 1987 definition. Clinical status plays a major role in predicting survival outcome among patients whose CD4<sup>+</sup>lymphocyte counts meet the new case definition. (<i>JAMA</i>. 1994;271:1197-1199)
Comparable expression of matrix metalloproteinases 1 and 2 in pouchitis and ulcerative colitis
Authors: A Stallmach, C C Chan, K W Ecker, G Feifel, H Herbst, D Schuppan, M Zeitz
Journal: Gut (2000)

<h3>BACKGROUND AND AIMS</h3> Matrix metalloproteinases (MMPs) are implicated in the tissue destruction associated with inflammatory diseases. Proctocolectomy with ileo-anal pouch (IAP) anastomosis is associated with pouchitis, particularly in patients with ulcerative colitis (UC). The aim of this study was to quantify MMP-1 and MMP-2 in inflamed and uninflamed pouches of patients with UC compared with those with active UC. IAP patients with familial adenomatous polyposis (FAP) served as controls. <h3>METHODS</h3> Biopsies were taken from 33 patients with IAP (UC, n=25; FAP, n=8) and from 10 UC patients. MMP-1 and MMP-2 were quantified using sandwich enzyme linked immunosorbent assays. In addition, northern and western blotting and in situ hybridisation experiments were performed. <h3>RESULTS</h3> In pouchitis (n=11), MMP-1 and MMP-2 concentrations were increased compared with uninflamed pouches of patients with UC (n=14) or FAP (n=8) (MMP-1 17.7 ng/mg protein <i>v</i> 7.8 (UC)<i>v</i> 7.6 (FAP), p⩽0.05; MMP-2 16.4<i>v </i>9.5 (UC) <i>v</i> 6.3 (FAP), p⩽0.05). Western and northern blots revealed increased MMP-1 and MMP-2 protein and transcript concentrations in inflamed pouches. Mesenchymal cells were identified as major producers of MMP-1 and MMP-2 in pouchitis. A similar increase in MMPs was observed in tissues of patients with active UC. <h3>CONCLUSIONS</h3> Our results support the hypothesis that MMPs are involved in mucosal destruction and crypt hyperplasia, as seen in pouchitis.
Microalbuminuria in Patients With NIDDM: An Overview
Authors: Aus A Alzaid
Journal: Diabetes Care (1996)

We have come a long way in our understanding of the epidemiology, pathophysiology, and clinical significance of albuminuria in patients with NIDDM. However, substantial gaps remain to be defined. NIDDM nephropathy is a serious and increasingly burdensome disease for both the diabetic individual and the society at large. Onset of microalbuminuria, an early but common manifestation of NIDDM nephropathy, marks an ominous turn for the NIDDM patient, in whom its development forecasts a grave cardiovascular outcome. Interception of albuminuria with antihypertensive agents such as ACE inhibitors in otherwise healthy NIDDM subjects holds a significant promise but must first await further investigation.
Surgical Treatment of Cardiac Defects Associated with Corrected Transposition of the Great Vessels
Authors: GRADY L. HALLMAN, SARJIT S. GILL, ROBERT D. BLOODWELL, DAN G. MCNAMARA, JOSEPH R. LATSON, ROBERT D. LEACHMAN, DENTON A. COOLEY
Journal: Circulation (1967)

Corrected transposition of the great vessels is characterized by transposition of the aorta in front and to the left of the pulmonary artery and inversion of the ventricles and atrioventricular valves. Unless it is associated with an intracardiac defect, the circulation of blood inside the heart is normal, and the anomaly may not be recognized clinically. The altered anatomy requires important modifications in the technical features of operative correction of associated cardiac defects. Among 53 patients with corrected transposition of the great vessels, 31 underwent operation for associated intracardiac defects. These were ventricular septal defects (11 patients), tetralogy of Fallot (seven), common ventricle (five), single ventricle (three), tetralogy of Fallot with pulmonary atresia (two), pulmonary stenosis (one), pulmonary atresia (one), and tetralogy of Fallot with common ventricle (one). Postoperative complete heart block, which usually leads to a fatal outcome, may follow closure of ventricular septal defect when conventional techniques are used. Although only one death from heart block occurred in seven patients operated on through a right ventriculotomy, we have employed left ventriculotomy in the last two patients to reduce the risk of heart block and to afford better exposure of the ventricular septal defect. The presence of preoperative complete heart block does not contraindicate correction of associated defects, but consideration should be given to insertion of a pacemaker at the time the lesion is corrected since these patients are likely to have Stokes-Adams attacks later. The anatomical features of associated common ventricle, single ventricle, and tetralogy of Fallot present such severe technical problems that complete correction of these anomalies is accompanied by a high risk. Total correction of tetralogy of Fallot was successfully carried out in only one of seven patients. Others were treated by some form of systemic-pulmonary shunt with good results. Two patients with tetralogy of Fallot and pulmonary atresia and one patient with pulmonary atresia were also treated by systemic-pulmonary shunts and obtained satisfactory palliation. One patient with pulmonary stenosis underwent successful transventricular pulmonary valvulotomy. A ventricular septum was created in five patients with common ventricle. There were only two survivors; the other three died of complete heart block. Recognition of corrected transposition of the great vessels associated with an intracardiac defect that requires operative repair is important because of technical problems that the morphological alterations of ventricular inversion impose.
Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: a prospective study in Mauritius.
Authors: E J Boyko, M de Courten, P Z Zimmet, P Chitson, J Tuomilehto, K G Alberti
Journal: Diabetes Care (2000)

OBJECTIVE: To assess the independent and joint effects of the components of the metabolic syndrome, including leptin, which is a recently proposed addition to this syndrome, in predicting the cumulative incidence of impaired glucose tolerance (IGT) and diabetes among individuals with normal glucose tolerance. RESEARCH DESIGN AND METHODS: This prospective study involved 2,605 residents of Mauritius with normal glucose tolerance who were followed for 5 years for IGT or diabetes onset in relation to total and regional adiposity (BMI, waist-to-hip ratio [WHR]), fasting and 2-h 75-g oral glucose load glucose and insulin, total and HDL cholesterol, blood pressure, serum uric acid, triglyceride, and leptin levels. RESULTS: A multivariate logistic regression model adjusted for age, sex, ethnicity, and diabetes family history showed a significantly higher linear increase in risk of IGT and diabetes in association with the following variables only: fasting glucose (odds ratio 1.89 [95% CI 1.51-2.34]), 2-h glucose (1.68 [1.50-1.88]), WHR (1.30 [1.10-1.52]), BMI (1.04 [1.00-1.08]), and serum uric acid (1.37 [1.20-1.57]). However, a nonlinear increase was seen with serum triglyceride and plasma leptin concentrations. No risk factors resulted in joint effects that were greater than expected from combining individual effects. CONCLUSIONS: Metabolic syndrome features independently predict a higher risk of diabetes or IGT in normoglycemic subjects but in combination confer no higher-than-expected risk of these outcomes. At higher concentrations of triglycerides and leptin, risk plateaus and even declines slightly.