tbuckley/cabot-search huggingface dataset:
Obesity and Serious Infections
Authors: Adam Gilden Tsai, Thomas A. Wadden
Journal: Annals of Internal Medicine (2013)

Letters17 December 2013Obesity and Serious InfectionsAdam Gilden Tsai, MD, MSCE and Thomas A. Wadden, PhDAdam Gilden Tsai, MD, MSCEFrom University of Colorado School of Medicine, Aurora, Colorado; and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. and Thomas A. Wadden, PhDFrom University of Colorado School of Medicine, Aurora, Colorado; and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-12-201312170-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Farmakiotis's thoughtful letter reminds us about other infectious consequences of obesity, particularly moderate to severe obesity (body mass index ≥35 kg/m2), that should concern internal medicine physicians. As with other body systems, physical factors (immobility) and biochemical factors (impaired function of the immune system) increase the risk for these complications. Author, Article, and Disclosure InformationAuthors: Adam Gilden Tsai, MD, MSCE; Thomas A. Wadden, PhDAffiliations: From University of Colorado School of Medicine, Aurora, Colorado; and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L13-1083. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoObesity Adam Gilden Tsai , Thomas A. Wadden Obesity and Serious Infections Dimitrios Farmakiotis Metrics 17 December 2013Volume 159, Issue 12Page: 859KeywordsImmune systemMorbid obesityObesity ePublished: 17 December 2013 Issue Published: 17 December 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Insomniacs give up stress and medications
Authors: Mark L. Fuerst
Journal: JAMA (1983)

Stanford University researchers have devised a nonpharmacologic treatment to help people with pervasive sleep problems eliminate or reduce dependency on drugs, diminish chronic stress, and improve the quality of their sleep. Forty-one insomniacs—23 women and 18 men— have learned how to sleep better by developing good sleep habits, doing relaxation exercises before bedtime, and reducing daytime stress. With sleep hygiene information and encouragement, plus individual drug withdrawal plans, most of the poor sleepers who were dependent on medications were off them—at least temporarily—within six weeks, says psychiatrist Vincent P. Zarcone, Jr, MD. Such a program can be employed successfully by family physicians, the Stanford researchers believe, although it requires more time and effort than dispensing prescriptions. Insomnia ranks third, behind the common cold and headaches, as a reason for seeking professional aid. It disrupts the lives of 50 million people, according to the US government's Project Sleep. Although prescriptions for
Familial Dysalbuminemic Hyperthyroxinemia Associated with Multinodular Goiter and Elevated Radioiodine Uptake
Authors: MORAKINYO OYEWOLE TONEY, JAMES D. HEIRONIMUS
Journal: Clinical Nuclear Medicine (1991)

Familial dysalbumenic hyperthyroxenemia characterized by elevations in serum total thyroxine (T4) and free-thyroxine index and normal free T4 and radioiodine uptake has been previously described. This syndrome is secondary to an autosomal dominant inheritance in which affected individuals are mistakenly diagnosed as thyrotoxic because of the elevation of serum levels of total T4 and free T4. The excess T4 level is caused by the presence of an abnormal serum protein that binds excess T4, thereby raising the level of total T4. The authors report the case of a patient with familial dysalbumenic hyperthyroxenemia who presented with superimposed multinodular goiter and an elevated 24-hour radioiodide uptake.
A hypomorphic R229Q Rag2 mouse mutant recapitulates human Omenn syndrome
Authors: Veronica Marrella, Pietro Luigi Poliani, Anna Casati, Francesca Rucci, Laura Frascoli, Marie-Lise Gougeon, Brigitte Lemercier, Marita Bosticardo, Maria Ravanini, Manuela Battaglia, Maria Grazia Roncarolo, Marina Cavazzana-Calvo, Fabio Facchetti, Luigi D. Notarangelo, Paolo Vezzoni, Fabio Grassi, Anna Villa
Journal: Journal of Clinical Investigation (2007)

Rag enzymes are the main players in V(D)J recombination, the process responsible for rearrangement of TCR and Ig genes. Hypomorphic Rag mutations in humans, which maintain partial V(D)J activity, cause a peculiar SCID associated with autoimmune-like manifestations, Omenn syndrome (OS). Although a deficient ability to sustain thymopoiesis and to produce a diverse T and B cell repertoire explains the increased susceptibility to severe infections, the molecular and cellular mechanisms underlying the spectrum of clinical and immunological features of OS remain poorly defined. In order to better define the molecular and cellular pathophysiology of OS, we generated a knockin murine model carrying the Rag2 R229Q mutation previously described in several patients with OS and leaky forms of SCID. These Rag2R229Q/R229Q mice showed oligoclonal T cells, absence of circulating B cells, and peripheral eosinophilia. In addition, activated T cells infiltrated gut and skin, causing diarrhea, alopecia, and, in some cases, severe erythrodermia. These findings were associated with reduced thymic expression of Aire and markedly reduced numbers of naturally occurring Tregs and NKT lymphocytes. In conclusion, Rag2R229Q/R229Q mice mimicked most symptoms of human OS; our findings support the notion that impaired immune tolerance and defective immune regulation are involved in the pathophysiology of OS.
The lymph node microenvironment promotes B-cell receptor signaling, NF-κB activation, and tumor proliferation in chronic lymphocytic leukemia
Authors: Yair Herishanu, Patricia Pérez-Galán, Delong Liu, Angélique Biancotto, Stefania Pittaluga, Berengere Vire, Federica Gibellini, Ndegwa Njuguna, Elinor Lee, Lawrence Stennett, Nalini Raghavachari, Poching Liu, J. Philip McCoy, Mark Raffeld, Maryalice Stetler-Stevenson, Constance Yuan, Richard Sherry, Diane C. Arthur, Irina Maric, Therese White, Gerald E. Marti, Peter Munson, Wyndham H. Wilson, Adrian Wiestner
Journal: Blood (2010)
Radionuclide Cerebral Imaging Confirming Brain Death
Authors: Jan Arthur Schwartz
Journal: JAMA (1983)

Cerebral blood flow (CBF) was measured by portable radionuclide cerebral imaging (RCI) and by four-vessel cerebral contrast arteriography in 15 clinically brain-dead patients, including six children. Neither technique showed evidence of CBF, although four RCI scans showed sagittal sinus activity. Portable scanning techniques are therefore considered valid determinants of brain death and may be useful in lieu of contrast cerebral arteriography.
Antigen-specific helper factor in man.
Authors: F B Mudawwar, E J Yunis, R S Geha
Journal: The Journal of Experimental Medicine (1978)

Supernates of tetanus toxoid (TT) antigen-stimulated human T cells were studied for the presence of an antigen-specific T-cell helper factor (ASF). Supernates were circulated over an immunosorbent column consisting of insolubilized TT antigen. The material which bound to the column was eluted with 3 M NaCNS and was shown to contain a factor which in the presence of TT-induced specific IgG anti-TT antibody synthesis in autologous B cells without causing readily detectable proliferation. ASF activity was partially inhibited by antisera directed against the B-cell alloantigens of the ASF donor. Immunosorbent columns containing such antisera removed ASF activity. Immunosorbent columns containing antisera to human immunoglobulin heavy chain determinants did not remove ASF activity; whereas immunosorbent columns containing rabbit idiotypic antiserum directed against anti-TT antibodies completely removed ASF activity. ASF was destroyed by treatment with proteolytic enzymes; its molecular weight was estimated by Sephadex G-100 gel column chromatography to be between 25,000 and 75,000 daltons.
Functional Magnetic Resonance Imaging of Human Brain Activation During Cue-Induced Cocaine Craving
Authors: Luis C. Maas, Scott E. Lukas, Marc J. Kaufman, Roger D. Weiss, Sarah L. Daniels, Veronica W. Rogers, Thellea J. Kukes, Perry F. Renshaw
Journal: American Journal of Psychiatry (1998)

Functional magnetic resonance imaging (MRI) was used to test whether brain activation was detectable in regions previously associated with cocaine cue-induced craving.Blood oxygenation level dependent (BOLD) functional activation was measured during presentation of audiovisual stimuli containing alternating intervals of drug-related and neutral scenes to six male subjects with a history of crack cocaine use and six male comparison subjects.Significant activation was detected in the anterior cingulate and left dorsolateral prefrontal cortex in the cocaine-using group. In addition, a correlation between self-reported levels of craving and activation in these regions was found.These results suggest that functional MRI may be a useful tool to study the neurobiological basis of cue-induced craving.
Mild Asymptomatic Primary Hyperparathyroidism Is Not a Risk Factor for Vertebral Fractures
Authors: Robert J. Wilson
Journal: Annals of Internal Medicine (1988)

Study Objective: To determine the prevalence of vertebral fractures in patients with mild asymptomatic primary hyperparathyroidism and to ascertain whether this prevalence is increased in comparison with the rate in a retrospective control group previously studied at the same institution or with current estimates of the risk for vertebral fractures in subjects of similar age. Design: Prospectively collected data were retrospectively analyzed and compared with data from a historical control group at the same institution and with published data. Setting: The outpatient department of a bone and mineral metabolism clinic. Patients: A consecutive series of patients with mild asymptomatic primary hyperparathyroidism diagnosed between 1 January 1976 and 31 December 1985. Criteria for inclusion in the study were the absence of symptoms due to hyperparathyroidism, no current kidney stone disease, no radiographic evidence of osteitis fibrosa, a serum calcium level of less than 3.00 mmol/L, a serum creatinine level of less than 133 µmol/L, and a forearm bone density value not more than 2.5 standard deviations below the age-, sex-, and race-adjusted normal value. Interventions: A conservative nonintervention study. Measurements and Main Results: The prevalence of vertebral fractures in 174 patients (mean age, 62 years) with mild asymptomatic primary hyperparathyroidism was 1.7%; in a subset of white women, the prevalence was 2.8%. These rates were not higher than those expected, by comparison with the rate in a retrospective control group or with the risk for vertebral fractures in subjects of similar age, and may even be lower. Conclusions: The risk for vertebral fractures is not increased in patients with mild asymptomatic primary hyperparathyroidism and is not a reason to recommend surgical intervention in asymptomatic patients. The increased rates of vertebral fractures that occurred in other series are probably due to the use of inappropriate controls and the influence of referral or selection bias, the inclusion of patients with severer disease, and the effect of geographic differences in vitamin D nutrition on the expression of disease. Possible differences between lateral spine and lateral chest radiographs for determining vertebral body shape need further study.
THE PSYCHONEUROTIC FACTOR IN THE "IRRITABLE HEART" OF SOLDIERS
Authors: B. S. Oppenheimer, M. A. Rothschild
Journal: BMJ (1918)

JULY I3, IQE8] THE PSYCHONEUROTIC FACTOR IN "IRRITABLE EEART." to Tm Ba. 29 other cases investigated.The reaction was observed in en cases, of whom six had symptoms of "irritable heart" and four had not.In the heart cases at half to one minute after the injec- tion a bright red blush appeared on the face and neck and spread to a greater or less extent over the trunk as an intense erythema, passing off i-n the course of four or five mirtutes and leaving a blotchy erythema on the slhoulders that faded more slowly.This was accompanied by a feeling of heat in the lhead and to a less extent in all parts of tle bodv.In some instances the patient's breathing deepened or quickened, and lhe spoke of a sensation of dizziness.In the four cases without symptoms of irritable heart no comparable reaction was observed.In two instances a slight fluslhing of the face was seen, one of the cases speaking of a sensation of heat in all parts of the body and the other of slight warmth of face, while in the remaining two no objective or subjective phenomena of any kind occurred.ri'lie rise of pulse-rate and of systolic blood pressure were calculated as in Table I.The rise of pulse-rate varied from 0 to 60, and was almost consistently greater in the heart cases than in the controls, averaging 25.5 in the first group and 10 in the second.The rise of 60 in Case No, 18 was exceptionally higlh, and in this case the erythema was exceptionally intense and widespread.The patient was very nervous and changed colour readily under ordinary conditions of emotion and exertion.The rise of blood pressure varied from 22 to 5 mm. of Hg, and no distinction between the two groups could be ascer- tained in this direction.Erythema was absent in one of the six heart cases and
Pituitary suppression in chronic airways disease?
Authors: P d'A Semple, G H Beastall, W S Watson, R Hume
Journal: BMJ (1979)

and on both occasions a blizzard prevailed.The Mercury, a Hobart newspaper, reported on 21 September 1903, "They had to face a snowstorm, with a strong south-westerly wind.Many of them were dressed only in singlets and light knickers, ... and the top sides of the mountain were covered with some feet of snow...." One of the participants noted some years later, "They were lying over logs, on the ground, and under trees, too exhausted to continue."Thus the deaths were a result-of hypothermia, the end result of exhaustion and inadequate or wet clothing in a cold, windy environment.It is clear that lightly clad runners are vulnerable to environmental conditions, both hot and cold, and the organisers of any community jogging events should realise that weather conditions can create a medical nightmare out of a "fun run."
Physicians' Responses to Financial Incentives
Authors: David Hemenway, Alice Killen, Suzanne B. Cashman, Cindy Lou Parks, William J. Bicknell
Journal: New England Journal of Medicine (1990)

Health Stop is a major chain of ambulatory care centers operating for profit. Until 1985 its physicians were paid a flat hourly wage. In the middle of that year, a new compensation plan was instituted to provide doctors with financial incentives to increase revenues. Physicians could earn bonuses the size of which depended on the gross incomes they generated individually.
Modularity in developmental disorders: Evidence from Specific Language Impairment and peripheral dyslexias
Authors: Naama Friedmann, Aviah Gvion
Journal: Behavioral and Brain Sciences (2002)

Evidence from various subtypes of Specific Language Impairment and developmental peripheral dyslexias is presented to support the idea that even developmental disorders can be modular. However, in developmental letter position dyslexia and neglect dyslexia we show that additional errors can occur because of insufficient orthographic-lexical knowledge.
Frequency of non-fatal heroin overdose: survey of heroin users recruited in non-clinical settings
Authors: M. Gossop, P. Griffiths, B. Powis, S. Williamson, J. Strang
Journal: BMJ (1996)

Heroin users are at risk of overdose, sometimes with fatal consequences. Studies have examined accident and emergency room data1 and recorded deaths,2 though such figures underestimate the full extent to which overdoses occur and are only a rough indicator of the prevalence of overdose among drug takers. A recent Australian study reported that about two thirds of a sample of heroin injectors had taken an overdose.3 The present study describes the frequency of drug overdose and the factors related to overdose among heroin users recruited in non-clinical settings.

During 1994, 438 heroin users were contacted and interviewed by privileged access interviewers4 as part of a study of early and episodic heroin users. Information on demographics, patterns of drug use, and overdose was collected by structured interviews. Onset of heroin use was comparatively recent for many of our sample (11% were in the first year of heroin use and 48% in the first three years of use), and …
Case 65-1963
Authors: Rita M. Kelley, Sheldon Cooperman
Journal: New England Journal of Medicine (1963)

Presentation of Case First admission. A sixty-two-year-old woman entered the hospital because of abdominal pain.Eighteen years previously she was admitted to another hospital because of fatigue, headaches and pain in the arms, legs and lower dorsal spine. On physical examination the spleen was palpable 1 fingerbreadth below the left costal margin, and there was an appendectomy scar; the liver was not enlarged. Examination of the blood revealed anemia, with nucleated red cells and immature white cells in the peripheral blood. X-ray films of the lumbar spine and pelvis were normal. A biopsy of the sternal bone marrow showed . . .
"Reverse coronary steal" induced by coronary vasoconstriction following coronary artery occlusion in dogs.
Authors: M Chiariello, L G Ribeiro, M A Davis, P R Maroko
Journal: Circulation (1977)

The phenomenon of "coronary steal," i.e., the shunting of blood from ischemic to normally perfused areas of myocardium, has been described as an effect of the administration of several vasodilating agents. This study was performed to ascertain whether the reverse situation can be induced, i.e., whether vasoconstriction of the vessels supplying the nonischemic zone could increase the collateral flow to the ischemic area. In 16 open chest dogs, 15 and 30 min after occlusion of the left anterior descending coronary artery, epicardial electrograms were recorded and regional myocardial blood flow (RMBF) was measured with radiolabeled microspheres. Methoxamine was infused intravenously between 17 and 30 min, the mean arterial pressure being kept constant. The results indicate that while the coronary arterial flow to the normal myocardium fell from 90.6 +/- 4.3 to 77.7 +/- 3.2 ml/min/100 g (P less than 0.01), the collateral blood flow to the ischemic area increased from 21.4 +/- 3.5 to 41.0 +/- 4.2 ml/min/100 g (P less than 0.01), and thereby reduced acute myocardial ischemic injury. This favorable redistribution of blood flow might be considered a "reverse coronary steal."
Itraconazole treatment of phaeohyphomycosis
Authors: Patricia Kay Sharkey, John R. Graybill, Michael G. Rinaldi, David A. Stevens, Richard M. Tucker, Jerry D. Peterie, Paul D. Hoeprich, Donald L. Greer, Lisa Frenkel, George W. Counts, James Goodrich, Stephen Zellner, Robert W. Bradsher, Charles M. van der Horst, Karen Israel, George A. Pankey, Charles P. Barranco
Journal: Journal of the American Academy of Dermatology (1990)
Paris court rejects drug company's case against journal
Authors: P. Benkimoun
Journal: BMJ (2011)

A French drug company that sued a journal for criticising one of its drugs has lost its case in a Paris court.

Astellas Pharma had sued the French monthly Prescrire , claiming that the journal had unfairly criticised its product Protopic (tacrolimus ointment). In a ruling published on 2 March the Paris Civil Court rejected the company’s lawsuit.

Prescrire is a monthly journal published by the Association Mieux Prescrire, which describes itself as a non-profit organisation committed to …
Iron overload in hereditary spherocytosis: Association with hla‐linked hemochromatosis
Authors: Corwin Q. Edwards, Mark H. Skolnick, Mary M. Dadone, James P. Kushner
Journal: American Journal of Hematology (1982)

Abstract Heavy iron loading is a rare clinical finding in patients with hereditary spherocytosis. A pedigree was studied in which the proband, a 38‐year‐old man, had both hereditary spherocytosis and overt hemochromatosis. He had never received blood transfusions. The 8‐year‐old son of the proband also had hereditary spherocytosis and mildly increased iron stores. The 39‐year‐old brother of the proband did not have spherocytosis but did have overt hemochromatosis. Since hemochromatosis is transmitted as an HLA‐linked autosomal recessive disorder, HLA haplotypes serve as markers of hemochromatosis alleles. In this pedigree only individuals with two hemochromatosis alleles (homozygosity) had heavy iron loads, whether hereditary spherocytosis was present or not. The presence of hereditary spherocytosis may have contributed to the magnitude of the iron loading but was not a major factor. Our findings suggest that nontransfusional hemochromatosis found in association with hereditary spherocytosis is due primarily to homozygosity for hemochromatosis.
Diagnostic value of visualization of the right ventricle using thallium-201 myocardial imaging.
Authors: F Khaja, M Alam, S Goldstein, D T Anbe, D S Marks
Journal: Circulation (1979)

The diagnostic significance of visualizing the right ventricle on thallium-201 myocardial perfusion scans (T-scan) at rest was studied in 53 patients. In 33 patients the right ventricle was visualized clearly on the T-scan (group A). Hemodynamic evidence of right ventricular hypertension with systolic pressure greater than or equal to 30 mmHg was present in 28 of 33 (85%) of these patients. Right ventricular volume overload with left-to-right shunt greater than 2:1 was present in three patients. Other tests were diagnostic for right ventricular enlargement and or pulmonary hypertension as follows: chest x-ray (58%), echocardiogram (36%) and electrocardiogram (15%). In an unselected group of 20 patients (group B) where resting T-scan did not show visualization of the right ventricle, the right ventricular systolic pressure was less than 30 mm Hg in all. The other noninvasive tests did not reveal presence of right ventricular hypertrophy or enlargement. T-scan appears to be a useful and sensitive test in detecting right ventricular pressure or volume overload compared with other noninvasive tests. This may be useful in detection of patients with right ventricular hypertrophy or enlargement secondary to pulmonary hypertension or other causes.
Epigenetic modifications and improved regulatory T-cell function in subjects undergoing dual sublingual immunotherapy
Authors: Ravi S. Swamy, Neha Reshamwala, Tessa Hunter, Soujanya Vissamsetti, Carah B. Santos, Fuad M. Baroody, Peter H. Hwang, Elisabeth G. Hoyte, Marco A. Garcia, Kari C. Nadeau
Journal: Journal of Allergy and Clinical Immunology (2012)
Dilemmas and Solutions
Authors: Thomas C. Washburn
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I address this letter to the matter of the interaction of medicine and philosophy and religion. I felt that Harrison's COMMENTARY (230:401, 1974) on the interplay between medicine and philosophy was unduly gloomy in its outlook for the future. I believe that important beginnings have already been made by concerned persons in both disciplines. The subsequent editorial by Vaisrub (230:443, 1974) was just as pessimistic about the role of religion in speaking to the ethical dilemmas of medicine. I recently attended one of the seminars for physicians sponsored by the National Endowment for the Humanities. At the University of Texas Medical Branch, 12 of us from the health professions were treated to a remarkable, intensive educational experience. Dr. Tristram Engelhardt led us, via a variety of philosophical concepts, through the maze of issues in biomedical ethics. Aside from refreshing my thirst for knowledge and sharpening my skills