tbuckley/cabot-search huggingface dataset:
Otitis Media in Infancy
Authors: R. Derham
Journal: BMJ (1948)

side-effect of benadryl, if indeed the drug was responsible for the loss of weight.Lertigon therapy was started in May, 1947, being administered subcutaneously in increasing doses every fourth day, up to a maximum single dose of 1 ml.Subsequently the dose has been reduced to 1 ml.weekly.No toxic effects have been observed.Since beginning this combined therapy no exacerbations of the disease process have occurred.The patient states that he feels well, his weight is stationary, and the erythrocyte sedimentation rate is within average limits.There is some evidence, however, that hypertension may be developing, possibly secondary to ischaemic renal lesions.Whilst no conclusions can be drawn from a single case, it is felt that therapy along similar lines may hold out promise for the future treatment of periarteritis nodosa, and perhaps of other conditions.Summary Two cases of periarteritis nodosa are reported.One case was diagnosed during life, and 16 months after admission the patient is in good health.The aetiology of the disease is reviewed.It would appear that periarteritis nodosa is an expression of an allergic state to either micro-organisms or drugs-e.g., sulphonamides.Observations are made regarding diagnosis.Emphasis is placed on clinical diagnosis, and the importance of histological examination of cutaneous nodules or muscle tissue in any doubtful case is stressed.The results of treatment with penicillin, benadryl, and lertigon are reported.Encouraging results have followed combined benadryl and lertigon therapy in one case.1 wish to express my thanks to Dr. D. K.
Tick-Borne Relapsing Fever in Colorado
Authors: Timm A. Edell
Journal: JAMA (1979)

Since 1915 the front range of the Colorado Rocky Mountains has been postulated as a focus of endemic tick-borne relapsing fever. However, the disease has rarely been identified: only two cases have been reported in Colorado since 1944. Three sporadic cases in 1977—tightly grouped geographically and temporally—prompted an epidemiologic review. Tick-borne relapsing fever should be considered in the differential diagnosis of recurrent paroxysmal fever—with or without known presence of ticks— whenever exposure in an endemic area is part of a patient's history. (<i>JAMA</i>241:2279-2282, 1979)
A Double Standard for Psychosomatic Papers?
Authors: George L. Engel, Leonard F. Salzman
Journal: New England Journal of Medicine (1973)

The unusual occurrence of two psychosomatic papers (pages 13 and 16) in a single issue of this Journal might suggest that they are of special interest, exceptional importance or exemplary design — or perhaps that the Journal simply has become more receptive to such contributions. Unfortunately, none of these seem to be the case. Rather, the articles are typical of certain psychosomatic studies that from time to time appeal to editors because they seem "more scientific" than usual. Indeed, they may even inspire editorials on their exceptional scientific quality and praise for scholarly refutation of earlier claims of psychosomatic relations. . . .
HYPERTROPHIC CARDIOMYOPATHY PATIENTS UNDERGOING MYECTOMY OFTEN REQUIRE ADDITIONAL REPARATIVE PROCEDURES OF MITRAL VALVULAR AND SUBVALVULAR DISORDERS: INTRAOPERATIVE FINDINGS AND COMPLEX SURGICAL PROCEDURES
Authors: Rabiya Malik, Hassan Rastegar, Martin Maron, Ana González, Amit Arora, Natesa Pandian
Journal: Journal of the American College of Cardiology (2013)
Conditions Simulating the Tetralogy of Fallot
Authors: B. N. SATYANARAYANA RAO, JESSE E. EDWARDS
Journal: Circulation (1974)

Cyanosis on the basis of a right-to-left shunt at the ventricular level results from pulmonary stenosis associated with a ventricular septal defect. While the tetralogy of Fallot is the most common anatomic state underlying this functional abnormality, there are a variety of anatomic states which may yield the same functional disturbance. These may be divided into three groups depending upon the state of the major arterial vessels. In each of the first two of the three groups, there are two arterial vessels. In one group, the great vessels are in normal relationship to each other, while in the second group the great arteries are transposed. In the third group, one arterial vessel leaves the heart and, from it, branches carry blood to the lungs.
Effects of sympathetic stimulation and changes in arterial pressure on segmental resistance of cerebral vessels in rabbits and cats.
Authors: G L Baumbach, D D Heistad
Journal: Circulation Research (1983)

The purpose of this study was to determine directly segmental cerebral vascular resistance during sympathetic stimulation and changes in arterial pressure. We measured pressure in pial arteries in anesthetized rabbits and cats with a servo-null pressure-measuring device. Cerebral blood flow was measured with microspheres. Using these measurements we calculated large artery resistance and small vessel resistance. Under control conditions, large artery resistance accounted for approximately 40% of total cerebral vascular resistance. Sympathetic stimulation increased large artery resistance and reduced pial artery pressure. Cerebral blood flow and total cerebral vascular resistance did not change significantly. To examine constrictor responses of small cerebral vessels, we raised cerebral perfusion pressure by obstructing the descending aorta. During increases in arterial pressure from 70 to 110 mm Hg, large artery resistance tended to increase and small vessel resistance increased significantly. We conclude that, although sympathetic stimulation has little effect on total cerebral vascular resistance under normal conditions, it has important effects on segmental vascular resistance and cerebral microvascular pressure, and that sympathetic stimulation and increases in systemic arterial pressure within the physiological range have markedly different effects on segmental resistance; i.e., sympathetic stimulation produces constriction only in large arteries, and increases in systemic arterial pressure within the physiological range produce constriction primarily in small vessels.
Measurement of bone density in osteoporosis
Authors: W. Perry
Journal: BMJ (1995)

EDITOR,--It is difficult to imagine a more wrong headed approach to osteoporosis than that proposed by E M Tayler.1 The first major misconception is that a bone density scan rarely influences a decision to start or continue hormone replacement therapy. In many patients this is now the main reason for starting, and often the most important for continuing, such treatment, if necessary life long, …
194. Development of Novel DNA Formulations Based on Polymers and Cyclodextrin for Gene Delivery to the Muscle
Authors: Caroline Roques, André Salmon, Marc Y. Fiszman, Elias Fattal, Yves Fromes
Journal: Molecular Therapy (2006)

So far gene transfer to the muscle has mainly been based on viral vectors, given their efficiency to transfer DNA in vivo. However, virus-derived vectors have numbers of limitations, such as insert size, tissue specificity or immunogenicity, therefore restricting the possibilities of repeated administrations. After intramuscular injection, major hurdles remain tissue diffusion and intracellular entry.
Career guidance by computer.
Authors: A Paton
Journal: BMJ (1982)

stage and eminently curable.That picture does not entirely explain the deaths in very young women under 25 years of age.Until a close study of their case histories has been carried out and the histological diagnosis of tumour type is known, however, it would be premature to complicate screening policies to try to anticipate the possibility of a rapidly progressing variant of cervical cancer.
Summarization of Data
Authors: Sidney Shindell
Journal: JAMA (1963)

STUART CHASE lists, as one of his 13 logical fallacies,  category called Figures Prove.1He suggests that there is a tendency on  part of people to assume that if something can be expressed by a number it has some special validity. A corollary to this axiom might be the more numbers,  better. There is, apparently,  too prevalent view that a mass of numbers is all we need in order to find out anything we wish to know. Moreover, today there seems to be a growing feeling that all one must do is feed data to a computer, and, in an even more magical fashion, truth will emerge. Not too long ago it was  statistician who was to perform this magic; we now think we can automate  process.  One purpose of this series is to demonstrate that numbers are only representative of fact and
Liver glut-1 expression: An enigma deepens
Authors: David B. Rhoads
Journal: Hepatology (1994)

The basal hepatocyte phenotype is conferred by the expression of liver-specific genes. In the adult liver, the basal hepatocyte phenotype is further modified by transcriptional and post-transcriptional regulation of genes which result in the appearance of specific proteins in selected hepatocytes. One of these proteins is the erythroid/brain or GLUT-1 glucose transporter. The GLUT-1 protein is detected in the plasma membrane of only one or two hepatocytes located at the end of the liver cell plate, contiguous to the hepatic venule. The objective of this study was to define the molecular mechanisms responsible for the restricted expression of the GLUT-1 protein in rat liver. Hepatocytes were isolated from either the proximal (“periportal”) or the distal (“perivenular”) half of the liver cell plate. The GLUT-1 mRNA as well as the GLUT-1 protein content and intracellular distribution were defined after subcellular fractionation of each hepatocyte population. In addition, the location of the GLUT-1 protein in liver tissue was determined by confocal microscopy. We propose that the GLUT-1 gene is transcribed and the mRNA is translated by both “periportal” and “perivenular” hepatocytes. However, insertion of the GLUT-1 protein into the plasma membrane occurs only in the last two hepatocytes contiguous to the hepatic venule. In other hepatocytes, the protein remains in a different cellular compartment characterized here as a “low density microsomal” fraction.
298 SUSTAINED VIROLOGIC RESPONSE IN HIGH VIRAEMIC GENOTYPE-1 HCV INFECTION CORRELATES WITH PERIPHERAL HCV-SPECIFIC CYTOTOXIC RESPONSE RESTORATION
Authors: J.R. Larrubia, S. Benito, M. Lokhande, J. Miquel, M. Calvino, E. Sanz-de-Villalobos, A. González-Praetorious, S. Albertos, S. García-Garzón, T. Parra-Cid
Journal: Journal of Hepatology (2011)
Chymopapain Chemonucleolysis In Lumbar Disk Disease
Authors: Bernard J. Sussman
Journal: JAMA (1975)

To the Editor.—  I take issue with the quality, accuracy, and content of the article by Wiltse et al on chymopapain therapy for lumbar disk disease (231:474, 1975).   It is remarkable that Wiltse and colleagues have injected intervertebral disks at the rate of 200 patients per year. Those numbers alone suggest at least some error in diagnosis and a questionable acceptance of the principles of conservative management. Moreover, like most chymopapain advocates, they state no exact criteria for injection other than to insist that they are the same as for surgery, but then fail to define their requirements for surgery. It must be understood that any episode of this disease remits in 85% to 90% of patients within two months irrespective of the type of treatment and that many patients are currently being injected during that period of time. It is also pertinent that the chymopapain method of treatment
PNEUMOTHORAX WITH HERNIA INTO LEFT PLEURAL CAVITY
Authors: T. H. Sanderson-Wells
Journal: BMJ (1917)

1917J-PNHiJMOTHOR.AX WITH HERNIA INTO PLEURAL CAVITY. [N A& 68f depthfs^f thie crypts, and surface applications could not be expected to reaclh them.Living cultures of Staphylococcus pyogenes albus lhad also been employed as sprays over thie tonsils in the hope of outgrowing the diphtheria bacillus, and it was usually found that swabs taklen next day were negative for Klebs- Loeffler organisms, but were loaded with staplhylococci.The bacilli, however, reappeared in large numbers within a day or two.The probable e-xplanation is that the large number of staplhylococci collected on the first swabs had outgrown tlle bacilli on the media.If, lhowever, the staphylococci outgrew tlle bacilli on the tonsils, tlhen fresh organisms were soon resupplied from the tonsillar crypts.CONCLUSIONS.
The source of the circulating aggregate of insulin in type I diabetic patients is therapeutic insulin.
Authors: M Maislos, P M Mead, D H Gaynor, D C Robbins
Journal: Journal of Clinical Investigation (1986)

Circulating insulin immunoreactivity (IRI) in type I diabetic patients (insulin-dependent diabetes mellitus [IDDM]) includes a covalent aggregate about twice the size of insulin. These studies were designed to determine the source and conditions promoting the accumulation of this material. Among 31 IDDMs, the aggregate made up 28 +/- 3.6% of the mean fasting plasma IRI. Five of these patients were restudied after 5 d of treatment with equidose intravenous insulin. The relative amount of the aggregate during subcutaneous treatment (40 +/- 8.0%) was indistinguishable (P greater than 0.7) from that at the termination of intravenous treatment (41 +/- 6.8%). To determine whether previous exposure to therapeutic insulin influenced the appearance and accumulation of the aggregate, we intravenously or subcutaneously infused insulin for 5 h in nine healthy volunteers (euglycemic clamp). At the termination of the high-dose intravenous infusion (10 mU X kg-1 X min-1), the concentration of the aggregate was 81 +/- 18 microU/ml, and it accounted for 2.9% of total IRI. At the conclusion of the other infusion protocols, the absolute amounts of aggregate were somewhat less, but they accounted for similar percentages. On polyacrylamide gel electrophoresis, the circulating aggregate was indistinguishable from a material of similar molecular weight contaminating commercial insulin. We conclude that the insulin aggregate found in the blood of IDDMs originates in commercial insulin. Its appearance is independent of the route of insulin administration. Prolonged and continuous use of insulin may increase its concentration but is not necessary for its appearance. The potential biologic and immunologic consequences of the aggregate are important matters that need to be addressed.
Leukopenia in Still's Disease
Authors: Eve Scopelitis
Journal: JAMA (1984)

Two patients, one a 14-year-old girl and the other a 20-year-old man, with typical manifestations of juvenile rheumatoid arthritis had leukopenia and thrombocytopenia, two heretofore unreported findings. The presence of leukopenia should not be used to exclude a diagnosis of Still's disease.
Sympathetic and periodic vagal influences on antegrade and retrograde conduction through the canine atrioventricular node.
Authors: D W Wallick, S L Stuesse, Y Masuda
Journal: Circulation (1986)

Concurrent stimulation of the parasympathetic and sympathetic branches of the autonomic nervous system causes a diminished sympathetic response at high levels of vagal activity. This "accentuated antagonism" has been demonstrated for cardiac chronotropic, inotropic, and dromotropic responses. The effect on conduction was demonstrated with tonic stimulation of the vagus nerve. However, normally the vagus nerve fires periodically at certain times in the cardiac cycle. Thus, we have studied whether a similar interaction exists in the modulation of atrioventricular condition when short bursts of vagal stimulation were placed in various portions of the cardiac cycle. Anesthetized open-chest mongrel dogs were instrumented for stimulation of the cervical vagi and stellate ganglia when the heart was paced. We determined the relationship between cardiac cycle length, direction of action potential propagation, and levels of sympathetic and vagal activation and their effects on atrioventricular conduction times. All of the factors investigated, namely levels of vagal and stellate stimulation, pacing intervals, and direction of propagation of action potentials, affected atrioventricular conduction times. Furthermore, the vagal effect was greater at short cardiac cycle lengths. When bursts of vagal stimulation were timed to result in maximal or minimal prolongation of atrioventricular conduction, no significant effects of sympathetic-parasympathetic interaction on atrioventricular conduction times were apparent. However, an analysis of the differences in prolongation of atrioventricular conduction with periodic vagal stimulation revealed that a significant sympathetic-vagal interaction existed for these differences. Thus, autonomic neurotransmitters differentially affect cardiac conduction times depending on time of application of the stimulus.
Factors Predicting Course of β-cell Function in IDDM
Authors: Alicia Schiffrin, Samy Suissa, Gabriel Weitzner, Philippe Poussier, Daniel Lalla
Journal: Diabetes Care (1992)

OBJECTIVE The purpose of this study was to determine whether the severity o clinical presentation, sex, age, HLA type, and the presence of IAs and ICAs could predict the variation of residual insulin secretion as measured by the serum C-peptide response to a Sustacal meal. RESEARCH DESIGN AND METHODS A cohort of 151 newly diagnosed IDDM children (mean age 10.2 ± 4.6 yr) was followed prospectively for 3 yr. Thirty-five patients (12 males, 23 females) were still secreting C-peptide after 36 mo. RESULTS We found that age (P = 0.0001), sex (P = 0.003), presence of ICA (P = 0.006), severity of clinical presentation (P = 0.001), and symptom duration (P = 0.002) significantly predicted the rate of loss of C-peptide secretion. The risks of accelerated C-peptide disappearance decreased with increasing age, the risk ratios being 0.25 for the older group (&amp;gt; 12 yr) compared with the younger group (&amp;lt; 6 yr) and 0.50 for the intermediate group (6–12 yr) compared with the younger group. The risk for the presence of ICA was 1.7, and the risk for males was 1.7 also. There was a significant negative correlation between ICA titers and C-peptide at 18 and 24 mo after diagnosis (P = 0.04). There were no significant differences in HbA1 values between patients who secreted C-peptide and those who did not. CONCLUSIONS We conclude that younger age of onset, male sex, high titers of ICA, severe clinical presentation, and shorter symptom duration significantly predict accelerated rates of loss of C-peptide secretion.
Reduction of Inflammatory Cytokine Concentrations and Improvement of Endothelial Functions in Obese Women After Weight Loss Over One Year
Authors: Patrizia Ziccardi, Francesco Nappo, Giovanni Giugliano, Katherine Esposito, Raffaele Marfella, Michele Cioffi, Francesco D’Andrea, Anna Maria Molinari, Dario Giugliano
Journal: Circulation (2002)

Visceral fat is a key regulator site for the process of inflammation, and atherosclerotic lesions are essentially an inflammatory response.Fifty-six healthy premenopausal obese women (age range 25 to 44 years, body mass index 37.2+/-2.2, waist to hip ratio range 0.78 to 0.92) and 40 age-matched normal weight women were studied. Compared with nonobese women, obese women had increased basal concentrations of tumor necrosis factor-alpha (TNF-alpha, P<0.01), interleukin-6 (IL-6, P<0.01), P-selectin (P<0.01), intercellular adhesion molecule-1 (ICAM-1, P<0.02), and vascular adhesion molecule-1 (VCAM-1, P<0.05). Vascular responses to L-arginine (3 g IV), the natural precursor of nitric oxide, were impaired in obese women: reductions in mean blood pressure (P<0.02), platelet aggregation to adenosine diphosphate (P<0.05), and blood viscosity (P<0.05) were significantly lower as compared with those in the nonobese group. Concentrations of TNF-alpha and IL-6 were related (P<0.01) to visceral obesity, as well as to adhesin levels and responses to L-arginine. After 1 year of a multidisciplinary program of weight reduction (diet, exercise, behavioral counseling), all obese women lost at least 10% of their original weight (9.8+/-1.5 kg, range 7.5 to 13 kg). Compared with baseline, sustained weight loss was associated with reduction of cytokine (P<0.01) and adhesin (P<0.02) concentrations and with improvement of vascular responses to L-arginine.In obese women, endothelial activation correlates with visceral body fat, possibly through inappropriate secretion of cytokines. Weight loss represents a safe method for downregulating the inflammatory state and ameliorating endothelial dysfunction in obese women.
Subacute Thyroiditis During Interferon Therapy for Chronic Hepatitis B Infection
Authors: Özgür Ömür, Gözde Daglýöz, Ulus Akarca, Zehra Özcan
Journal: Clinical Nuclear Medicine (2003)

Recombinant human interferon-α has been used successfully in the treatment of patients with chronic active hepatitis. In the current report, a patient presented with fatigue, weight loss, irritability, and palpitation while receiving interferon therapy resulting from chronic hepatitis B infection. Thyroid function tests and scintigraphic findings were consistent with subacute thyroiditis, which developed during interferon therapy. The current experience illustrates the necessity of being aware of the clinical history and medications used when interpreting nuclear medicine studies.
Effects of Isoproterenol on the Pulmonary Circulation in Patients with Chronic Obstructive Lung Disease
Authors: M. IRENÉ FERRER, YALE ENSON, MARGARET M. KILCOYNE, RÉJANE M. HARVEY
Journal: Circulation (1971)

Isoproterenol produced an increase in pulmonary blood volume and pulmonary blood flow without a significant change in pulmonary vascular pressures in 14 patients with obstructive lung disease, six of whom had cor pulmonale. These findings are consistent with a vasodilating effect on the pulmonary vasculature. Evidence is presented that muscular pulmonary arteries constricted by hypoxia were affected by the drug. There is little to suggest that the compliance of the elastic arteries was altered by isoproterenol.
Free Fatty Acid Depletion Acutely Decreases Cardiac Work and Efficiency in Cardiomyopathic Heart Failure
Authors: Helena Tuunanen, Erik Engblom, Alexandru Naum, Kjell Någren, Birger Hesse, K. E. Juhani Airaksinen, Pirjo Nuutila, Patricia Iozzo, Heikki Ukkonen, Lionel H. Opie, Juhani Knuuti
Journal: Circulation (2006)

Background— Metabolic modulators that enhance myocardial glucose metabolism by inhibiting free fatty acid (FFA) metabolism may improve cardiac function in heart failure patients. We studied the effect of acute FFA withdrawal on cardiac function in patients with heart failure caused by idiopathic dilated cardiomyopathy (IDCM). Methods and Results— Eighteen fasting nondiabetic patients with IDCM (14 men, 4 women, aged 58.8±8.0 years, ejection fraction 33±8.8%) and 8 matched healthy controls underwent examination of myocardial perfusion and oxidative and FFA metabolism, before and after acute reduction of serum FFA concentrations by acipimox, an inhibitor of lipolysis. Metabolism was monitored by positron emission tomography and [ 15 O]H 2 O, [ 11 C]acetate, and [ 11 C]palmitate. Left ventricular function and myocardial work were echocardiographically measured, and efficiency of forward work was calculated. Acipimox decreased myocardial FFA uptake by &gt;80% in both groups. Rate–pressure product and myocardial perfusion remained unchanged, whereas stroke volume decreased similarly in both groups. In the healthy controls, reduced cardiac work was accompanied by decreased oxidative metabolism (from 0.071±0.019 to 0.055±0.016 min −1 , P &lt;0.01). In IDCM patients, cardiac work fell, whereas oxidative metabolism remained unchanged and efficiency fell (from 35.4±12.6 to 31.6±13.3 mm Hg · L · g −1 , P &lt;0.05). Conclusions— Acutely decreased serum FFA depresses cardiac work. In healthy hearts, this is accompanied by parallel decrease in oxidative metabolism, and myocardial efficiency is preserved. In failing hearts, FFA depletion did not downregulate oxidative metabolism, and myocardial efficiency deteriorated. Thus, failing hearts are unexpectedly more dependent than healthy hearts on FFA availability. We propose that both glucose and fatty acid oxidation are required for optimal function of the failing heart.