tbuckley/cabot-search huggingface dataset:
Carpal Tunnel Syndrome
Authors: William L. Newmeyer
Journal: JAMA (1976)

To the Editor.—  I read with considerable interest the article by Hoffman (233:983-984, 1975).  The point he makes about sensory nerve conduction studies in diagnosis is a good one. In the case cited, however, it seems to me from the history that the diagnosis is, if not clear-cut, certainly extremely suggestive of a carpal tunnel syndrome, and one wonders why it was not suspected before a number of fairly elaborate and expensive tests were done.  In the practice of hand surgery, we see a large number of persons with symptoms similar to this. It has been our practice to carefully inject the carpal tunnel with a cortisone preparation and lidocaine with a No. 27, 1-cm needle. At the same time, a cock-up splint to put the hand in the position of function is made for night use. These steps serve as both a diagnostic and a therapeutic maneuver since relief
Safety in Car Design
Authors: M. Hamilton
Journal: BMJ (1965)

BMICISH 477 estimated at similar intervals before and after feeding of the drug.The results of the first series of experiments can be seen in Table I and the second series of experiments in Table II.It can be seen that the normal serum S.G.O.T. values varied from 0.5 unit to 7.5 units.In no instance did the S.G.O.T. value suddenly rise after administering the steroid to any rabbit.In only one animal the S.G.O.T. level rose to 6.2 units from 0.5 unit after it suffered an injury to the right hind- leg which was possibly responsible for this rise.This rabbit had to be sacrificed.The results obtained with these two anovulatory steroids indicate that in rabbits they have shown to be devoid of any hepatotoxic effect when hepadc damage was evaluated by estimating the S.G.O.T. level in serum.This is the method which Eisalo et al.5 have mentioned as being the only one which would detect these changes.These authors state that this type of hepatic injury cannot be detected by tests like total bilirubin or alkaline phosphatase.
Gastrointestinal Telangiectasia as a Cause of Severe Blood Loss in Systemic Sclerosis
Authors: P.C.M. Rosekrans, D.J. de Rooy, F.T. Bosman, F. Eulderink, A. Cats
Journal: Endoscopy (1980)

Two patients with progressive scleroderma had severe gastrointestinal blood loss. Endoscopical examination revealed multiple telangiectases in the upper gastrointestinal tract, especially in the stomach. The telangiectases in the skin and the mucosa in systemic sclerosis are indistinguishable endoscopically and histologically from those seen in hereditary hemaorrhagic telangiectasia. Recurrent and severe gastrointestinal hemorrhage originating from telangiectases is an unusual complication of systemic sclerosis.
Abstract 1709: Transforming Growth Factor Beta Inhibition Increases Matrix Metalloproteinase-9 Activity and Enhances Elastin Degradation in a Murine Model of Kawasaki Disease
Authors: Cristina M Alvira, Yu-Mee Kim, Christophe Guignabert, LingLi Wang, Marlene Rabinovitch
Journal: Circulation (2008)

Background: Kawasaki disease (KD) is a leading cause of acquired heart disease in children. However, the molecular mechanisms leading to coronary aneurysms, and the host factors determining high-risk patients are unknown. We have previously shown that mice haploinsufficient for tropoelastin (EL ±), develop more severe destruction of the coronary elastin compared to wild type (WT) mice after injection with Lactobacillus casei wall extract (LCWE), an inducer of coronary arteritis. In contrast to the beneficial effect of TGFβ blockade on the aneurysms that form in Marfan syndrome (MS), we hypothesized that TGFβ protects against aneurysm formation in this inflammatory model by: enhancing tropoelastin; and suppressing proteolytic activity. Methods: WT and EL ± mice were given either TGFβ neutralizing antibody (TGFβ-Nab) or control IgG in addition to LCWE. At 14d, tropoelastin and plasminogen activator inhibitor-1 (PAI-1) protein was determined, and matrix metalloproteinase (MMP)-2 and -9 and serine elastase activity was measured. Elastin degradation and total medial elastin content was assessed by morphometric analysis at 42d. Results: TGFβ blockade worsened the LCWE-mediated fragmentation of the coronary elastin, with areas of complete dissolution of the external lamina in WT mice, and even more severe features in EL ± mice. Tropoelastin protein was 40% lower in the EL ± vs. WT mice after LCWE (P &lt; 0.05), and TGFβ blockade further exaggerated this discrepancy. TGFβ-Nab markedly reduced PAI-1 in the WT mice after LCWE (P &lt; 0.05), and produced a similar pattern in the EL ± mice, and induced a four-fold induction of MMP-9 activity in both genotypes. This effect was associated with increased elastin fragmentation (P &lt; 0.05), and decreased total medial elastin content (P &lt; 0.05), despite inhibition of the LCWE-mediated induction of serine elastase activity. Conclusions: We conclude that: diminished tropoelastin expression worsens elastin destruction in the setting of acute coronary arteritis; and TGFβ protects the vasculature in this model by maintaining PAI-1 levels and suppressing activation of MMP-9. Thus strategies to block TGFβ, currently in use to prevent aneurysms in MS, are unlikely to be beneficial in KD, and may be detrimental. This research has received full or partial funding support from the American Heart Association, AHA National Center.
Disappearance of I<sup>131</sup>-Labeled Insulin from Plasma as a Guide to Management of Diabetes
Authors: Robert E. Bolinger, J. Harold Morris, Frank G. McKnight, Dennis A. Diederich
Journal: New England Journal of Medicine (1964)

THE extremely labile diabetic patient presents a problem in management that can often be only partially solved by manipulation of the diet and insulin. A high proportion of such patients are found among the adults who have received insulin for a number of years for a growth-onset type of diabetes. The factors contributing to this "brittle" state are poorly understood. Somogyi1 has emphasized the role of excessive insulin dosage although simple reduction in dosage too often results in an increasing frequency of periods of ketoacidosis.The capricious response of such patients to insulin therapy suggests among other things an altered . . .
Periodontitis: bad medicine?
Authors: M. R. Laurent
Journal: BMJ (2014)

<h3>PURPOSE</h3> We wanted to describe small, independent primary care practices’ performance in meeting the Million Hearts ABCSs (aspirin use, blood pressure control, cholesterol management, and smoking screening and counseling), as well as on a composite measure that captured the extent to which multiple clinical targets are achieved for patients with a history of arteriosclerotic cardiovascular disease (ASCVD). We also explored relationships between practice characteristics and ABCS measures. <h3>METHODS</h3> We conducted a cross-sectional, bivariate analysis using baseline data from 134 practices in New York City. ABCS data were extracted from practices’ electronic health records and aggregated to the site level. Practice characteristics were obtained from surveys of clinicians and staff at each practice. <h3>RESULTS</h3> The proportion of at-risk patients meeting clinical goals for each of the ABCS measures was 73.0% for aspirin use, 69.6% for blood pressure, 66.7% for cholesterol management, and 74.2% screened for smoking and counseled. For patients with a history of ASCVD, only 49% were meeting all ABC (aspirin use, blood pressure control, cholesterol management) targets (ie, composite measure). Solo practices were more likely to meet clinical guidelines for aspirin (risk ratio [RR] =1.17, <i>P</i> =.007) and composite (RR=1.29, <i>P</i> = .011) than practices with multiple clinicians. <h3>CONCLUSION</h3> Achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (ie, 70% or greater). Practices were less likely to meet consistently clinical targets that apply to patients with a history of ASCVD risk factors. Greater emphasis is needed on providing support for small practices to address the complexity of managing patients with multiple risk factors for primary and secondary ASCVD.
871. Surface Modification of Adenovectors with TAT- and Antp-Containing Polymers Protects Them from Neutralizing Antibodies and Increases Expression of Reporter Genes In Vitro and In Vivo
Authors: Ilia Fishbein, Ivan S. Alferiev, Richard Gaster, Meizan Lai, Robert J. Levy
Journal: Molecular Therapy (2006)

The relative inefficiency of adenovirus (Ad)-based transduction vectors in cardiovascular tissues is related to the low expression of the CAR receptor on the surface of endothelial and smooth muscle cells as well as to the rapid neutralization of Ad by anti-Ad antibodies. Polymer modification of Ad surface potentially addresses these problems by masking Ad particles from neutralizing antibodies and providing a convenient platform for the conjugation of ligands possessing transduction-facilitating properties, such as TAT and Antp peptides.
Disruption of microtubules as an early sign of irreversible ischemic injury. Immunohistochemical study of in situ canine hearts.
Authors: K Iwai, M Hori, A Kitabatake, H Kurihara, K Uchida, M Inoue, T Kamada
Journal: Circulation Research (1990)

Structural disruption of the cytoskeleton may be involved in irreversible ischemic injury. In the present study, ischemic changes in microtubules during various periods of myocardial ischemia were studied with an immunohistochemical technique in open-chest dogs. In intact myocardium, microtubules were stained as a filamentous network throughout cytoplasm and a circular network around the nucleus, which disappeared with colchicine treatment. In brief ischemia of less than 15 minutes, microtubule patterns were unaltered. After 20 minutes, however, characteristic microtubule stains were partly lost in patchy lesions. As an increase in ischemic period, lesions of loss of microtubule stains were increased in number and size. After 120 minutes of reperfusion following 60 minutes of ischemia, the lesions with intact actin filaments but with disrupted microtubules were replaced by the severely injured cells in which the regular myofibrillar registrations were distinctly disrupted. After 24 hours of reperfusion following 40 minutes of occlusion of the left circumflex artery, the percent area of disrupted microtubules at 40 minutes of ischemia was replaced by that of irreversibly injured lesions in the posterior papillary muscle. These results indicate that disruption of microtubules during ischemia heralds irreversible ischemic injury. However, in in vitro study, the myocardium incubated in hypoxic solution for 60-120 minutes demonstrated earlier disruption of the microtubules than the vinculin. Electron microscopic study also showed minimal irreversible changes in the lesions with disrupted microtubules. Thus, taken together, we conclude that microtubules that support the structural integration of myofibrils and other organelles are disrupted in severe myocardial ischemia before the irreversible injury, promoting the irreversible change after reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Work stress raises risk of heart disease among women under 50, study finds
Authors: R. Wilkins
Journal: BMJ (2010)

High pressure in the workplace can increase the risk of heart disease among women under the age of 50, a Danish study of nurses indicates, but not among women aged between 50 and 64, as other factors become more important in determining the risk.

The link among men between stress at work and a higher risk of heart disease is well documented. However, the authors of the study, led by Karen Allesoe at the Research Centre for …
Insulin action in human adipose tissue in acromegaly.
Authors: J Bolinder, J Ostman, S Werner, P Arner
Journal: Journal of Clinical Investigation (1986)

The mechanisms underlying insulin resistance in acromegaly were investigated. Adipose tissue was obtained from nine patients with acromegaly who had in vivo insulin resistance and from 14 matched healthy control subjects. Receptor binding and the antilipolytic effect of insulin were determined in isolated fat cells. Insulin-induced glucose oxidation at a physiological hexose concentration was investigated in fat segments. In fat cells obtained from acromegaly patients after an overnight fast, insulin binding at low hormone concentrations was significantly reduced by 20-30%, insulin-induced antilipolysis was unchanged, but glucose oxidation was unresponsive to insulin. Since it has recently been observed that glucose feeding may rapidly modify insulin action in human adipocytes, fat cells were also obtained 60 min after an 100-g oral glucose load. In this situation, insulin binding at low hormone concentrations was further reduced to one-half of that in the control group, and the sensitivity of insulin-induced antilipolysis was markedly decreased in acromegaly. It is concluded that, in the fasting state, the action of insulin on glucose utilization but not on lipolysis is impaired in adipose tissue of acromegalic patients because of a postreceptor defect. After glucose ingestion, the resistance to insulin in acromegaly is further enhanced and antilipolysis is also impaired. Altered coupling between receptor and effector alone or in combination with an additional decrease in receptor binding may explain the enhancement of insulin resistance. These mechanisms may be essential factors in the pathogenesis of insulin resistance in acromegaly.
Epicardial Fat: An Unrecognized Cause of Artifact on Myocardial Perfusion Imaging
Authors: Olakunle O. Akinboboye, Kenneth Nichols, Uzodinma R. Dim, Yi Wang, Shalini Chhabra, Tom Milo
Journal: Clinical Nuclear Medicine (2006)

Myocardial count defects are noted in regions without perfusion abnormalities, usually because of soft tissue attenuation. We present 3 examples in this report in which we found that, despite attenuation correction using standard commercially available hardware and software, focal perfusion abnormalities were seen that were anomalous, because both wall motion and wall thickening were normal as seen on both nuclear and cardiac MR imaging. These defects appear to be caused by unusually prominent focal epicardial fat as demonstrated in the accompanying examples showing epicardial fat revealed by MRI at sites coincident with count defects of the fused nuclear tomograms. In a prospective study of 21 patients with diabetes who underwent same-day cardiac magnetic resonance and Tc-99m sestamibi-gated SPECT imaging, we found that anomalous decreased counts resulting from the presence of epicardial fat was seen in 48% of patients. These apparent perfusion defects were considered to be of potential clinical significance in 10% of cases. In all cases, both visual and quantitative wall motion and wall thickness were normal. The only clinical correlates for the presence of an epicardial fat pad were body surface area and waist circumference.
Aortic Arch Atheroma Progression and Recurrent Vascular Events in Patients With Stroke or Transient Ischemic Attack
Authors: Souvik Sen, Alan Hinderliter, Pranab K. Sen, Jennifer Simmons, James Beck, Steven Offenbacher, E. Magnus Ohman, Stephen M. Oppenheimer
Journal: Circulation (2007)

Background— It is not known whether progression of aortic arch (AA) atheroma is associated with vascular events in patients with stroke or transient ischemic attack (TIA). Methods and Results— AA atheroma was detected on baseline transesophageal echocardiogram in 167 consecutive patients who had prevalent stroke or TIA. Of these, 125 consented to a follow-up transesophageal echocardiogram at 12 months. Adequate paired AA images were obtained in 117 (78 with strokes, 39 with TIAs), which allowed detailed measurements of plaques. On admission for their index stroke or TIA, patients were assessed for stroke risk factors, stroke subtypes, baseline AA plaque characteristics, and laboratory parameters. Progression of AA atheroma was observed in 33 patients (28%) on 12-month follow-up transesophageal echocardiogram. It was determined that the progression group had significantly higher adjusted homocysteine levels ( P &lt;0.0001) and neutrophil counts ( P &lt;0.0001) than the no-progression group. These patients were followed up for a median of 1.7 years from the index stroke/TIA (range 0.5 to 4.5 years) for vascular events including stroke, TIA, myocardial infarction, and death due to vascular causes. Kaplan-Meier curves showed fewer patients with AA atheroma progression remained free of the composite vascular end point (49% compared with 89% in the no-progression group; P &lt;0.0001). AA atheroma progression was associated with composite vascular events (hazard ratio 5.8, 95% confidence interval 2.3 to 14.5, P =0.0002) after adjustment for a propensity score based on confounders. Conclusions— In this preliminary study of stroke/TIA patients with AA atheroma on transesophageal echocardiogram, AA atheroma progression was associated with recurrent vascular events.
Increased Levels of Soluble P-Selectin in Hypercholesterolemic Patients
Authors: Giovanni Davı̀, Mario Romano, Andrea Mezzetti, Antonio Procopio, Stefano Iacobelli, Teresa Antidormi, Tonino Bucciarelli, Paola Alessandrini, Franco Cuccurullo, Gabriele Bittolo Bon
Journal: Circulation (1998)

Background —Hypercholesterolemia is considered a major risk factor for the development of atherosclerosis. Enhanced lipid peroxidation and persistent platelet activation can be observed in vivo in hypercholesterolemic patients and may have pathophysiological implications in the occurrence of cardiovascular events. P-selectin may play an important role in the pathogenesis of multicellular events, including atherosclerosis. We studied the impact of hypercholesterolemia and oxidative stress on plasma levels of P-selectin. Methods and Results —Plasma levels of P-selectin were measured by means of an enzyme immunoassay in 20 hypercholesterolemic patients with no clinical evidence of cardiovascular disease and in 20 sex- and age-matched normocholesterolemic subjects. Hypercholesterolemic patients had higher levels of P-selectin compared with that of control subjects (98±61 versus 56±14 ng/mL; P =.001). They also displayed increased von Willebrand Factor (vWF) levels (176±22 versus 119±12%; P =.0001). A direct correlation was observed between P-selectin and LDL cholesterol levels (ρ=.453). Administration of vitamin E (600 mg/d for 2 weeks) to hypercholesterolemic patients significantly reduced plasma P-selectin (40%), and an inverse correlation was observed between vitamin E and P-selectin plasma levels (ρ=−.446). Conclusions —Hypercholesterolemia is associated with elevated plasmatic P-selectin. Altered oxidative processes leading to endothelial dysfunction and persistent platelet activation may contribute to increased soluble P-selectin levels. P-selectin may be proposed as a marker of endothelial dysfunction in hypercholesterolemic patients.
Diabetic Cystopathy: Epidemiology and Related Disorders
Authors: CAI FRIMODT-MØLLER
Journal: Annals of Internal Medicine (1980)

The precise incidence and prevalence of diabetic cystopathy are difficult to determine because of the insidious onset, discrete symptoms, and differences in the definition of bladder dysfunction. Diabetic cystopathy, classified according to urophysiological criteria, was shown to occur in 43% to 87% of insulin-dependent diabetics, with no sex or age differences. Another study showed an average 25% prevalence of diabetic cystopathy in patients on oral hypoglycemic treatment. A Scandinavian study showed that in patients who have had diabetes for 10 years, the prevalence of diabetic cystopathy in those who were insulin-dependent was two to four per 1000 and in those on oral hypoglycemic agents was one to three per 1000. The correlation between diabetic cystopathy and peripheral neuropathy ranged from 75% to 100%. Nephropathy was seen in 30% to 40% of cases. The higher frequency of urinary tract infections in diabetics is not related to diabetic cystopathy but to the frequent occurrence of non-neurogenic bladder outlet disorders, especially in older women.
Colonic NK/T-cell lymphoma mimicking Crohn’s disease
Authors: Satimai Aniwan, Rungsun Rerknimitr, Naruemon Wisedopas, Pinit Kullavanijaya
Journal: Endoscopy (2014)

A 29-year-old man presented at another institution with bloody diarrhea. Colonoscopy showed multiple discrete ulcers in the ascending colon. Histological study revealed moderate chronic inflammation with negative stain for acid-fast bacilli. A computed tomographic scan showed asymmetrical thickening of the ascending colonic wall with no lymphadenopathy ([Fig. 1]). After a month's trial of anti-tuberculosis medication, the diarrhea still persisted. Subsequent colonoscopy showed more extensive colonic ulcers from the sigmoid to the ascending colon ([Fig. 2]). The second histological study revealed more severe inflammation. At this point, Crohn's disease was suspected, and the patient's diarrhea partially improved after prednisolone treatment (40 mg/day). However, a month later, he developed sudden abdominal pain. He underwent an emergency right hemicolectomy as treatment for spontaneous ileal perforation ([Fig. 3]). Histological study demonstrated more severe ulcers with granuloma and reactive nodes. The patient was kept on prednisolone (40 mg/day) and azathioprine (2 mg/kg per day).
New device production for preventive measures against the hallux-valgus deformity
Authors: Y Urabe, N Kamiya, Y Yamanaka, M Shintaku
Journal: British Journal of Sports Medicine (2011)

Background Many athletes have foot deformity of hallux-valgus. These deformities lead to decrease of foot function and sports performance. The authors were developed a new device for decrease the angle of hallux-valgus. This device was socks and in use underwear in sports activity and daily living. Objective The purpose of this study was following four points. Does this device can change the hallux-valgus angle? Does this device can change the foot pain? Does this device influence centre of pressure (COP) of the foot? Does this device can decrease the deformity for long-term use? Design Prospective and randomised controlled trial design. Setting This study was clinical setting for athletes. Participants The subjects were 34 female volunteer athletes. The hallux-valgus group was consisted 17 athletes, all who has hallux-valgus angle above 20° and complaint of foot pain. The control group was 17, all who has hallux-valgus angle below 19° and pain free of each foot. Intervention The subjects were used this socks 3 months of their daily life and sports activities. Main outcome measurements The hallux-valgus angle and COP of standing position were measured, and checked again after the 3 months. Results The hallux-valgus angle was decreased 7.1° at instance of wearing the socks with hallux-valgus group and 5.5° with control group. The foot pain was decreased 50% at instance of wearing socks with hallux-valgus group and 70% decrease at 2.3 months uses the socks. The COP of the body was changed 3.7% forward on the foot of hallux-valgus group. The 2.3 months later, hallux-valgus angle was decreased 4.7° of average at the bare foot with hallux-valgus group. Conclusions This study showed the hallux-valgus prevention socks were decreased not only deformity angle at instance but also use prolonged more angle decreased.