tbuckley/cabot-search huggingface dataset:
Disorders of sodium balance
Authors: Rebecca M Reynolds, Paul L Padfield, Jonathan R Seckl
Journal: BMJ (2006)

Disorders of plasma sodium are the most common electrolyte disturbances in clinical medicine, yet they remain poorly understood. Severe hyponatraemia and hypernatraemia are associated with considerable morbidity and mortality,1–3 however, and even mild hyponatraemia is associated with worse outcomes when it complicates conditions such as heart failure,4 although which is cause and which effect is often uncertain. Distinguishing the cause(s) of hyponatraemia may be challenging in clinical practice, and controversies surrounding its management remain. Here, we describe the common causes of disorders of plasma sodium, offer guides to their investigation and management, and highlight areas of recent advance and of uncertainty.

We incorporated the latest consensus from systematic reviews and publications identified by a literature search through Medline and Web of Science with the search strategy terms “hyponatraemia,” “hypernatraemia,” and “sodium.” We found fewer than a dozen randomised controlled trials of treatment of any description. Despite their frequency, plasma sodium disorders have not been reviewed by the Cochrane Library, Clinical Evidence, or Best Evidence.

Under normal conditions, plasma sodium concentrations are finely maintained within the narrow range of 135-145 mmol/l despite great variations in water and salt intake. Sodium and its accompanying anions, principally chloride and bicarbonate, account for 86% of the extracellular fluid osmolality, which is normally 285-295 mosm/kg and calculated as (2× [Na]mmol/l + [urea]mmol.l + [glucose]mmol/l. The main determinant of the plasma sodium concentration is the plasma water content, itself determined by water intake (thirst or habit), “insensible” losses (such as metabolic water, sweat), and urinary dilution. The last of these is under most circumstances the most important and is predominantly determined by arginine vasopressin, which is synthesised in the hypothalamus and then stored in and released from the posterior pituitary. In response to arginine vasopressin, concentrated urine is produced by water reabsorption …
Growth Factors Promote High-Dose Chemotherapy
Authors: Teri Randall
Journal: JAMA (1991)

NEW THERAPY that endows the immune and hematopoietic systems with impressive resilience following chemotherapy has allowed oncologists to surpass the "bone marrow barrier," the dose-limiting factor that has historically determined the maximum chemotherapeutic dose. The therapy calls for patients to be given hematopoietic growth factors in combination with autologous peripheral blood progenitor immune cells immediately following high-dose chemotherapy. Advances in leukapheresis now allow progenitor cells, which develop into the entire spectrum of blood cells, to be drawn from the patient's peripheral blood prior to high-dose chemotherapy. Previously, these cells had to be removed from the bone marrow to achieve the quantities necessary to overcome myelosuppression. In clinical trials that determined the safety and feasibility of the protocol, patients receiving growth factors demonstrated faster neutrophil and platelet recovery than controls who received no growth factors. They also experienced fewer episodes of fever and infection, and fewer days in the hospital. Oncologists
Opening the window of facilitated percutaneous coronary intervention in acute infarction: The role of combined IIb/IIIa inhibition and thrombolytic therapy
Authors: Mitchell W. Krucoff, Cynthia L. Green, Per Johanson, Suzanne W. Crater, Matthew T. Roe, Anatoly Langer, Robert P. Giugliano, A.Michael Lincoff, Robert A. Harrington, Eric J. Topol, Robert M. Califf
Journal: Journal of the American College of Cardiology (2003)
STUDIES CONCERNING THE RELATIONSHIP BETWEEN PNEUMOCOCCI AND STREPTOCOCCI
Authors: Hobart A. Reimann
Journal: The Journal of Experimental Medicine (1927)

Morgenroth and his collaborators grew pneumococci in a medium containing optochin and derived variant forms of bacteria therefrom which were considered to be streptococci of the viridans group. We have repeated these experiments and have also derived variant forms. These atypical races, however, we have found to be identical with the R form of pneumococci which have been obtained by various other methods. That these R cultures are still pneumococci and do not belong in the Streptococcus viridans group is supported by the following observations: 1. These strains are not bile-insoluble, but are more resistant to the lytic action of this agent than are type-specific pneumococci. 2. R strains behave like pneumococci and not like streptococci in the readiness with which cultures spontaneously autolyze and saline suspensions disintegrate during freezing and thawing. 3. Immunological reactions of the variant pneumococci derived by Morgenroth's method are identical with the immunological reactions of R forms of pneumococci derived by various other means. The observations of Morgenroth and his associates in regard to the transformation of Streptococcus haemolyticus into Streptococcus viridans by treatment with rivanol could not be repeated in this laboratory. No explanation is at hand for our failure to produce the change. It is of course possible that none of the twenty-six strains tested had suitable tendencies to variation or that the technic or reagents employed varied from those of Morgenroth.
Long term follow-up of appendiceal and distal right-sided colonic inflammation
Authors: S. Park, S. Yang, M. Kim, D. Yang, K. Jung, K. Kim, B. Ye, J. Byeon, S. Myung, J. Kim
Journal: Endoscopy (2011)

The aim of this study was to investigate the possibility of appendiceal orifice inflammation (AOI) as a preceding lesion in the development of ulcerative colitis. A total of 20 patients were identified (mean age 41.2 years; 11 males) who had ulcerative colitis-like inflammatory lesions at the appendiceal orifice without concomitant typical features of ulcerative colitis, such as rectal involvement. A total of 19 patients were followed up endoscopically for a mean duration of 18.4 months (range 2 – 84 months). Typical ulcerative colitis developed in five patients (25 %; four proctitis, one pancolitis) in a mean time of 18.4 months (range 2 – 36 months). Negative conversion of all inflammatory lesions occurred in seven patients (35 %) after a mean follow-up of 20 months (range 3 – 84 months). In the remaining seven patients (35 %), initial lesions did not progress to ulcerative colitis and did not go into remission during a mean follow-up of 16.9 months (range 2 – 42 months). These results suggest that, at least in some cases, AOI precedes development of ulcerative colitis.
Dead Reckoning: A Therapist Confronts His Own Grief
Authors: L. D. Hankoff
Journal: JAMA (1997)

Centered around the suicide of his 47-year-old mother when he was 20, David Treadway's memoir is of his grief, its subsequent treatment, and its resolution. The psychotherapeutic Odysseys and cures (sometimes) of the mentally afflicted are a well-established genre. Literature, theatre, and motion pictures provide many examples, although most are not as closely autobiographical as Treadway's account. The self-reports of troubled souls have a long and respectable literary history and include such bestsellers as<i>The Confessions of St. Augustine</i>, Goethe's<i>The Sorrows of Young Werther</i>, and de Quincey's<i>Confessions of an English Opium Eater</i>. Even the Egyptians have left us a papyrus,<i>The Dispute With His Soul of One Who Is Tired of Life</i>, on a contemplated suicide. The author of<i>Dead Reckoning</i>, an accomplished marriage and family therapist, was 45, nearly his mother's age at her suicide, when he sought treatment. Feeling vaguely and deeply troubled despite "a good
Botulinum Toxin Injection after Biliary Sphincterotomy
Authors: P. B. Cotton, R. H. Hawes
Journal: Endoscopy (2004)

We were intrigued by the paper by Gorelick et al. [1] concerning the innovative use of botulinum toxin injection after biliary sphincterotomy as a method for reducing the risk of postprocedural pancreatitis. A sham-controlled trial of 26 patients appeared to show a reduction in pancreatitis rates when botulinum toxin was administered; however, the results did not show statistical significance. More important, however, was that the overall pancreatitis rate was no less than 35 %; four of the patients (15 %) developed moderate pancreatitis, and one had a severe episode. These high figures are alarming and surely unacceptable.
Silent Cerebral Infarction in Patients With Nonrheumatic Atrial Fibrillation
Authors: Michael D. Ezekowitz, Kenneth E. James, Sarkis M. Nazarian, John Davenport, Joseph P. Broderick, Sudha R. Gupta, Vijay Thadani, Mark L. Meyer, Samuel L. Bridgers
Journal: Circulation (1995)

Background Cerebral infarction in patients with atrial fibrillation may vary from being clinically silent to catastrophic. The prevalence of silent cerebral infarction and its effect as a risk factor for symptomatic stroke are important considerations for the evaluation of patients with atrial fibrillation. Methods and Results This Veterans Affairs cooperative study was a double-blind controlled trial designed primarily to determine the efficacy of warfarin for the prevention of stroke in neurologically normal patients with nonrheumatic atrial fibrillation. It also was designed to evaluate patients with silent cerebral infarction. Computed tomography scans of the head were performed at entry, at the time of any subsequent stroke, and at termination of follow-up on all patients who completed the study without a neurological event. Of 516 evaluable scans performed at entry, 76 (14.7%) had evidence of one or more silent cerebral infarcts. Age ( P =.011), a history of hypertension ( P =.003), active angina ( P =.012), and elevated mean systolic blood pressure ( P &lt;.001) were associated with the presence of this finding. Silent cerebral infarction occurred during the study at rates of 1.01% and 1.57% per year for the placebo and warfarin treatment groups, respectively (NS). Silent cerebral infarction at entry was not an independent predictor of later symptomatic stroke, but active angina was a significant predictor; 15% of the placebo-assigned patients with angina developed a stroke compared with 5% of the placebo-assigned patients without angina. Conclusions Silent cerebral infarction is frequently seen in asymptomatic patients with atrial fibrillation. Age, history of hypertension, active angina, and elevated mean systolic blood pressure were associated with silent infarction at entry. The sample size was too small to determine whether warfarin had an effect on the incidence of silent infarction during the trial. Active angina at baseline was the only significant independent predictor for the later development of symptomatic stroke.
Overcrowded Emergency Departments
Authors: Jeremiah D. Schuur
Journal: JAMA Internal Medicine (2014)

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THU0545 The Effectiveness of Combined Exercises and Therapeutic Ultrasound to Patients with Knee Osteoarthritis
Authors: A. C. Bighea, S. Patru, I. R. Marcu, R. S. Popescu
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Knee osteoarthritis (KOA) is one of the major health problems, the clinical features as pain, muscular weakness, restricted range of motion and joint deformity leading to disability and poor quality of life. In our clinic we used ultrasound (UUS) to patients with various musculoskeletal conditions for reducing pain, edema, increase flexibility of connective tissues and joint mobility. <h3>Objectives</h3> In this randomized clinical trial we investigated the effectiveness of combined therapeutic ultrasound and isotonic exercises to patients with KOA from Emergency County Hospital Craiova, Department of Rehabilitation. <h3>Methods</h3> 35 subjects diagnosed with knee osteoarthritis (Kellgren-Lawrence grade 1-3 disease) were randomly assigned in two groups: 17 patients to Exercise Group (EG) followed an isotonic muscular strengthening exercises program and the others 18 patients to Ultrasound Group (UG) who received isotonic exercises combined with therapeutic ultrasound (0.5 W/cm<sup>2</sup>, 5 min.), three times/week for 6 weeks. The assessments were made at baseline and at the completion of the study using a pain visual analogue scale, knee range of motion and Lequesne index. <h3>Results</h3> The baseline characteristics were the same in both groups, mean age 64.0±3.7years and 75% female. The pain scores on VAS were initially similar but patients in UG showed a greater decrease of pain degree after 6 weeks of treatment (43% vs. 28.3%). On the beginning of the study the average knee flexion did not markedly differ between groups, but it increased significantly in ultrasound group after treatment (12º vs. 6º). At the end of the study the mean scores on Lequesne index decreased significantly only to patients who received ultrasound combined with exercises (ΔLequesne index 2.7 vs. 1.4). <h3>Conclusions</h3> Ultrasound is a useful physical modality that combined with kinesytherapy may leads to better results on pain, range of motion and disability to patients with knee osteoarthritis. <h3>References</h3> Franke K: The value of minor hydrotherapy (Kneipp method) for the prevention and rehabilitation of arthritis and vascular collagen diseases. Hippokrates 1961, 32:92-94 Stener-Victorin E, Kruse-Smidje C, Jung K: Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip. Clin J Pain 2004, 20:179-185. Foley A, et al.: Does hydrotherapy improve strength and physical function in patients with osteoarthritis – a randomized controlled trial comparing a gym based and hydrotherapy based strengthening programme. Ann Rheum Dis 2003, 62:1162-116 <h3>Disclosure of Interest</h3> None Declared
A CASE OF PURULENT PERICARDITIS IN AN INFANT: OPERATION: DEATH
Authors: J. A. Coutts, R. P. Rowlands
Journal: BMJ (1905)

PURULENT pericarditis is seldom diagnosed in infancy, and the age of the present patient is, perhaps, the youngest at which an operation has been performed for its attempted relief.There are some points, too, in the method of operation that add to the interest of the case and to its value for being recorded.The notes have been compiled from the carelul and elaborate ones taken by Dr. A. E. Hunter, formerly house-physician to the East London Hospital fr Children, and for the sake of brevity only those of a more important and essential character have been dealt with.
ON THE TIME OF REFLEX WINKING
Authors: David P. Mayhew
Journal: The Journal of Experimental Medicine (1897)

I. The mean total time taken from 450 experiments on sixteen subjects was found to be 0.0420 second. II. Natural winks occurring very shortly before the record was taken had no influence. III. The reflex time was found to vary in different individuals, the limits of the mean times being 0.0351 and 0.0491 second. For any given individual there was a close correspondence between averages of sets of experiments obtained under similar conditions. In the case of one man this was true of sets of experiments taken a year apart. Sex has no influence. IV. Apprehension seems to shorten the time.
MRI Breast Density Assessment: An Imaging Biomarker for Identification of Women at an Increased Risk of Breast Cancer
Authors: G.J. Wengert, T. Helbich, P. Baltzer, P. Brader, Z. Bago-Horvath, P. Dubsky, K. Pinker-Domenig, R. Bartsch
Journal: Annals of Oncology (2013)
EVALUATION OF THE MOTILITY OF THE SPERMATOZOA
Authors: GERARD L. MOENCH
Journal: JAMA (1930)

For years the motility of the male sex cells has been considered the chief or even sole criterion by which to judge the fertility of the male. It is too often forgotten, however, that motility is not even an inherent attribute of the spermatozoa, and Schücking<sup>1</sup>believes that in some animals with external fertilization the sperms, themselves not motile, may be brought to the ovum by external circumstances and then fertilize it. This is contradicted by others,<sup>2</sup>but the fact that such a difference of opinion can occur shows that motility alone must not be rated too highly. There are other characteristics of the sperm cells which are just as important as motility, as I<sup>3</sup>have brought out before in previous articles. In animals with internal fertilization the spermatozoa, of course, need motility to reach the ovum, but the degree of motility present under the microscope in
Smad7 suppresses renal fibrosis via altering expression of TGF-β/Smad3-regulated microRNAs
Authors: Arthur C.K. Chung, Yuan Dong, Weiqin Yang, Xiang Zhong, Rong Li, Hui Y. Lan
Journal: Molecular Therapy (2012)

Blockade of transforming growth factor-β (TGF-β) signaling by Smad7 gene therapy is known to prevent experimental renal fibrosis. This study investigated whether Smad7 suppresses renal fibrosis via altering the renal expression of fibrosis-related microRNAs. Application of gene therapy into diseased kidneys of obstructive nephropathy and kidney cells by overexpressing Smad7 restored miR-29b but inhibited the expression of miR-192 and miR-21, resulting in blockade of renal fibrosis. Furthermore, Smad7 overexpression also suppressed advanced glycated end products- and angiotensin II-regulated expression of these microRNAs. In contrast, disruption of Smad7 gene in mice demonstrated opposite results by enhancing the loss of miR-29b and upregulation of miR-192 and miR-21, resulting in promotion of renal fibrosis in ligated kidneys of a model of obstructive nephropathy. More importantly, treatment with anti-miR-29b, miR-21 and miR-192 mimics in Smad7 overexpressing tubular epithelial cells abrogated the suppressive function of Smad7 on renal fibrosis, suggesting that these microRNAs act downstream of Smad7 to override the Smad7 function. In conclusion, Smad7 protects kidneys from fibrosis by regulating TGF-β/Smad3-mediated renal expression of miR-21, miR-192, and miR-29b. Restored renal miR-29b but suppressed miR-192 and miR-21 may be a mechanism by which gene therapy with Smad7 inhibits renal fibrosis. Blockade of transforming growth factor-β (TGF-β) signaling by Smad7 gene therapy is known to prevent experimental renal fibrosis. This study investigated whether Smad7 suppresses renal fibrosis via altering the renal expression of fibrosis-related microRNAs. Application of gene therapy into diseased kidneys of obstructive nephropathy and kidney cells by overexpressing Smad7 restored miR-29b but inhibited the expression of miR-192 and miR-21, resulting in blockade of renal fibrosis. Furthermore, Smad7 overexpression also suppressed advanced glycated end products- and angiotensin II-regulated expression of these microRNAs. In contrast, disruption of Smad7 gene in mice demonstrated opposite results by enhancing the loss of miR-29b and upregulation of miR-192 and miR-21, resulting in promotion of renal fibrosis in ligated kidneys of a model of obstructive nephropathy. More importantly, treatment with anti-miR-29b, miR-21 and miR-192 mimics in Smad7 overexpressing tubular epithelial cells abrogated the suppressive function of Smad7 on renal fibrosis, suggesting that these microRNAs act downstream of Smad7 to override the Smad7 function. In conclusion, Smad7 protects kidneys from fibrosis by regulating TGF-β/Smad3-mediated renal expression of miR-21, miR-192, and miR-29b. Restored renal miR-29b but suppressed miR-192 and miR-21 may be a mechanism by which gene therapy with Smad7 inhibits renal fibrosis.
How Do Mesangial and Endothelial Cells Form the Glomerular Tuft?
Authors: Michael R. Vaughan, Susan E. Quaggin
Journal: Journal of the American Society of Nephrology (2008)

The glomerular capillary tuft is a highly intricate and specialized microvascular bed that filters plasma water and solute to form urine. The mature glomerulus contains four cell types: Parietal epithelial cells that form Bowman's capsule, podocytes that cover the outermost layer of the glomerular filtration barrier, glycocalyx-coated fenestrated endothelial cells that are in direct contact with blood, and mesangial cells that sit between the capillary loops. Filtration begins only after the influx and organization of endothelial and mesangial cells in the developing glomerulus. Tightly coordinated movement and cross-talk between these cell types is required for the formation of a functional glomerular filtration barrier, and disruption of these processes has devastating consequences for early life. Current concepts of the role of mesangial and endothelial cells in formation of the capillary tuft are reviewed here.
HG-03 * A NOVEL MOUSE MODEL OF YOUNG ADULT GLIOBLASTOMA: IN VIVO EXPRESSION OF MUTATED IDH1 (R132H) GENE USING THE SLEEPING BEAUTY TRANSPOSASE SYSTEM
Authors: F. J. Nunez, F. M. Mendez, C. Koschmann, A. Calinescu, M. Dzaman, P. R. Lowenstein, M. G. Castro
Journal: Neuro-Oncology (2015)

Glioblastoma Multiforme (GBM) is a malignant primary brain tumor. Genomic analysis of GBMs revealed somatic mutations associated with particular subtypes, which correlate with age at the time of diagnosis. Young adult GBMs include a mutation in Isocitrate Dehydrogenase 1 gene (IDH1-R132H) and mutations in epigenetic regulators, ATRX and H3.3G34, which define an epigenetic and biological subgroup. IDH1-R132H results in gain of an alternative enzymatic function producing the metabolite 2-hydroxglutarate (2HG) and alterations in histone methylation patterns. Animal models are critical to study and understand disease progression and pathogenesis; therefore we developed an in vivo model of young adult GBM through expression of IDH1-R132H, H3.G34 and ATRX knockdown in neonatal mouse brain using the Sleeping Beauty Transposase system. In this model we are studying the effects of these genetic lesions in tumor development and DNA repair mechanisms. The tumors were induced by injection of NRAS and shP53 plasmids in the lateral ventricle of C57BL/6 neonatal mice with or without pKT/IDH1-R132H, Pkt/H3.G34 or PT2/shATRX. Plasmid delivery into stem cells lining the lateral ventricle and tumor progression was monitored by luciferase imaging. The tumors were also used to generate neurospheres for genetic analysis; moribund animals were perfused and analyzed using immunocytochemistry. IDH1-R132H expression increased the levels of H3K27me3 and enhanced median survival of the mice. The groups representing young adult GBM: NRAS/shP53/shATRX/IDH1-R132H and NRAS/shP53/shATRX/H3.G34 also exhibited increased survival compared with the control (NRAS/shP53) and the pediatric (NRAS/shP53/shATRX) groups. Mice developed brain tumors harboring key features of young adult GBMs. We aim to determine the impact of these genetic lesions in median survival, tumor progression and DNA repair mechanisms “in vivo”. Supported by NIH-NINDS grants, the Department of Neurosurgery and Leah's Happy Hearts Foundation to MGC and PRL, and very generous support from Phil F. Jenkins.