tbuckley/cabot-search huggingface dataset:
Cardiac effects of acute ethanol ingestion unmasked by autonomic blockade.
Authors: J S Child, R B Kovick, J A Levisman, M L Pearce
Journal: Circulation (1979)

We assessed the effects of ethanol and autonomic blockade on left ventricular function in nine normal subjects, age 20--35 years, using M-mode echocardiography and systolic time intervals. On day 1, measurements were made of heart rate, mean velocity of circumferential fiber shortening, and left ventricular pre-ejection period and left ventricular ejection time ratio (PEP/LVET), during a control period and after autonomic blockade. Autonomic blockade was produced with intravenous propranolol (0.2 mg/kg body weight) and atropine (0.04 mg/kg body weight). On day two, measurements were again made during a control period, then with ethanol alone, followed by addition of autonomic blockade to ethanol. One hundred eighty milliliters of ethanol were ingested over 60 minutes, resulting in a mean blood ethanol level of 110 mg/dl (range 77--135 mg/dl) at 60 minutes post-ingestion. There were no significant differences between the control data on days 1 and 2. Blood pressure was unchanged throughout the study. study. On day 1, autonomic blockade alone resulted in the expected increase in heart rate (p less than 0.001), with a proportional increase in mean velocity of circumferential fibr shortening (p less than 0.01), and an increase in PEP/LVET (p less than 0.01). On day 2, ethanol alone resulted in no significant changes except for a slight increase in PEP/LVET (p less than 0.02). Ethanol plus autonomic blockade, (day 2), compared with autonomic blockade alone (day 1), revealed a decrease in mean velocity of circumferential fiber shortening (p less than 0.05), and an increase in PEP/LVET (p less than 0.01), with a decrease in intrinsic heart rate (p less than 0.001). We conclude that in normal subjects: 1) autonomic blockade does not directly affect contractility; 2) acute ethanol ingestion alone does not produce important changes in cardiac function; and, 3) ethanol in the autonomic blockaded heart causes a significant decrease in contractility. Thus, we infer that ethanol has a negative inotropic effect which is masked by catecholamines and/or autonomic nervous system discharge.
Delayed Drug-induced Dystonias
Authors: M. A. Simpson
Journal: BMJ (1974)

A concentration of 15 pig/ml was arbitrarily taken as a level read.lyobtainable in h blood wiLh bo.h antibiotics.Th-19 strains resistant to penicillin and tetracycline only were resis:ant to tetracycline in con- centrations above 20 Ag/lml.This resis ance pattern occurs quite frequently in strains of S. aph.aureus isolated both from hospital patients and from the general comnnunity.It would appear therefore that any micro- biological advantage which minocycline may exert over other tetracyclines is due to its sup rior activity against strains of Staph.aureus which are resistant to tetracycline.' -I am, etc.,
Evolutionary Dynamics of Human Retroviruses Investigated Through Full-Genome Scanning
Authors: P. Lemey
Journal: Molecular Biology and Evolution (2005)

To test hypotheses on the differences in retroviral genetic diversity, we compared the evolutionary dynamics of the human immunodeficiency virus type 1 (HIV-1) group M and the primate T-cell lymphotropic virus (PTLV) using a full-genome analysis. Evolutionary rates and nonsynonymous/synonymous substitution rate ratios were estimated across the genome using a maximum likelihood sliding window approach, and molecular clock properties were investigated. We confirm a remarkable difference in genetic stability and selective pressure at the interhost level. While there is evidence for adaptive evolution in HIV-1, the evolution of PTLV is almost exclusively characterized by negative selection or nearly neutral processes. For both retroviruses, evolutionary rate estimates across the genome reflect the differential selective constraints. However, based on the relationship between evolutionary rate and selective pressure and based on the comparison of synonymous substitution rates, the differences in rate between HIV-1 and PTLV cannot be explained by selective forces only. Several evolutionary and statistical assumptions, examined using a Bayesian coalescent method, were shown to have little influence on our inference.
Effect of Food Additives on Hyperphosphatemia Among Patients With End-stage Renal Disease
Authors: Catherine Sullivan, Srilekha S. Sayre, Janeen B. Leon, Rhoderick Machekano, Thomas E. Love, David Porter, Marquisha Marbury, Ashwini R. Sehgal
Journal: JAMA (2009)

High dietary phosphorus intake has deleterious consequences for renal patients and is possibly harmful for the general public as well. To prevent hyperphosphatemia, patients with end-stage renal disease limit their intake of foods that are naturally high in phosphorus. However, phosphorus-containing additives are increasingly being added to processed and fast foods. The effect of such additives on serum phosphorus levels is unclear.To determine the effect of limiting the intake of phosphorus-containing food additives on serum phosphorus levels among patients with end-stage renal disease.Cluster randomized controlled trial at 14 long-term hemodialysis facilities in northeast Ohio. Two hundred seventy-nine patients with elevated baseline serum phosphorus levels (>5.5 mg/dL) were recruited between May and October 2007. Two shifts at each of 12 large facilities and 1 shift at each of 2 small facilities were randomly assigned to an intervention or control group.Intervention participants (n=145) received education on avoiding foods with phosphorus additives when purchasing groceries or visiting fast food restaurants. Control participants (n=134) continued to receive usual care.Change in serum phosphorus level after 3 months.At baseline, there was no significant difference in serum phosphorus levels between the 2 groups. After 3 months, the decline in serum phosphorus levels was 0.6 mg/dL larger among intervention vs control participants (95% confidence interval, -1.0 to -0.1 mg/dL). Intervention participants also had statistically significant increases in reading ingredient lists (P<.001) and nutrition facts labels (P = .04) but no significant increase in food knowledge scores (P = .13).Educating end-stage renal disease patients to avoid phosphorus-containing food additives resulted in modest improvements in hyperphosphatemia.clinicaltrials.gov Identifier: NCT00583570.
Sail Sound in Ebstein's Anomaly of the Tricuspid Valve
Authors: MARY E. FONTANA, CHARLES F. WOOLEY, Richard S. Goodwin, George F. Rieser
Journal: Circulation (1972)

Ebstein's anomaly represents an anatomic, pathologic, and physiologic spectrum. There have been few hemodynamic correlates for the observed auscultatory events. Multiple components of the first sound and "ejection" sounds are frequently described. Cardiac catheterization, intracardiac sound-pressure studies (Telco), and cineangiograms were performed in three patients with Ebstein's anomaly who had a prominent early systolic sound. The right ventricular pressure pulse was abnormal in all; an initial delta-wave configuration, followed by a more rapid pressure rise, produced a prolonged rise to peak pressure. The right ventricular pressure pulse is not that of a conduction defect alone; rather it suggests that the altered pattern of ventricular contraction and abnormal leaflet placement are contributing factors. The early systolic sound was recorded in the atrialized right ventricle or right ventricle in all. It occurred just after the peak of the c wave in the atrialized right ventricle. In the right ventricle the sound occurred at the point where initial slow delta portion of right ventricular pressure pulse gave rise to rapid upstroke. The early systolic sound most likely occurs when the large, sail-like tricuspid valve reaches the limit of systolic excursion. The sound has been designated as the "sail sound," and may be the most specific auscultatory event in Ebstein's anomaly.
Scintigraphic Patterns of Injury in Amateur Weight Lifters
Authors: HANS VAN DER WALL, ANDREW McLAUGHLIN, WARWICK BRUCE, CLAYTON J. FRATER, SIRI KANNANGARA, I. PROVAN C. MURRAY
Journal: Clinical Nuclear Medicine (1999)

Weight lifting is now a standard part of training in most sports. An increasing number of amateur athletes are doing strength training, mostly in unsupervised situations. A series of injuries in amateur weight lifters was analyzed by bone scintigraphy, with the aim of depicting specific patterns that would accurately identify the primary lesions.Twelve patients (10 men and 2 women) were studied whose ages ranged from 18 to 35 years. Patients were referred for bone scintigraphy with clinical diagnoses based on history, physical examination, and appropriate radiologic investigations. Diagnoses were confirmed by surgery, arthroscopy, arthrography, local steroid injection, and outcome.Most of the injuries were in athletes undertaking free-weight training. Most injuries were in the upper limbs, particularly around the shoulder. Scintigraphic patterns of supraspinatus and bicipital tendons and also rotator cuff lesions were identified. Clavicular osteolysis, avulsion injuries, muscle damage, and vertebral lesions were also noted. Several abnormalities revealed by scintigraphy were clinically unsuspected.Scintigraphic manifestations of several injuries, particularly around the shoulder, have a specific pattern. Recognition of these patterns can enhance the performance of bone scintigraphy. Scintigraphy also has the potential to detect clinically unsuspected disease.
Targeted next-generation sequencing detects point mutations, insertions, deletions and balanced chromosomal rearrangements as well as identifies novel leukemia-specific fusion genes in a single procedure
Authors: V Grossmann, A Kohlmann, H-U Klein, S Schindela, S Schnittger, F Dicker, M Dugas, W Kern, T Haferlach, C Haferlach
Journal: Leukemia (2011)
The effect of systemic venous drainage of the pancreas on insulin sensitivity in dogs.
Authors: J Radziuk, P Barron, H Najm, J Davies
Journal: Journal of Clinical Investigation (1993)

To assess the metabolic consequences of the diversion of the pancreatic venous drainage to the systemic circulation, the pancreaticoduodenal and gastrosplenic veins were anastomosed to the inferior vena cava in nine normal dogs. This procedure maintained the integrity of the entire pancreas while shunting the hormonal output of the pancreas to the periphery. The metabolic effects were assessed from the sensitivity to insulin during a euglycemic hyperinsulinemic glucose clamp using an insulin infusion of 800 microU/kg per min. The studies were controlled by their duplication in seven dogs identically treated but with the pancreatic veins reanastomosed to the portal vein. No differences in systemic insulin levels or insulin sensitivity before and after surgery were seen under these circumstances. After diversion, however, basal insulin levels rose from 4.5 +/- 1.0 to 11.5 +/- 2.5 microU/ml. Basal glucose metabolic clearance rate (MCR) rose to 3.0 +/- 0.4 from 2.0 +/- 0.3 ml/kg per min. On insulin infusion, maximal stimulation of MCR within the 2-h infusion period was to 15.2 +/- 2.5 ml/kg per min preoperatively and to 7.2 +/- 0.8 ml/kg per min after diversion. Using ratios of MCR-to-insulin concentration as an index of insulin sensitivity, it was demonstrated that this index decreased by at least 50% after diversion. These data imply that portal venous drainage of the pancreas is an important factor in the determination of peripheral insulin sensitivity.
Paranoia over Privacy
Authors: Richard L. Neubauer
Journal: Annals of Internal Medicine (2006)

On Being a Patient1 August 2006Paranoia over PrivacyRichard L. Neubauer, MDRichard L. Neubauer, MDFrom Anchorage, AK 99508.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-3-200608010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the fall of 2002, I entered unfamiliar territory. Diagnosed with peripheral neuropathy from primary amyloidosis at age 52, I became a patient. I put my affairs in order, obtained coverage for my busy practice in Anchorage, Alaska, and headed to New York City for an autologous stem-cell transplantation. I was aware that I could not expect a cure, but was hopeful that there was a chance for remission.As I entered this new world, I had many decisions to make. I wanted to be a good patient, having spent over 20 years observing my own patients deal with adversity. ... Author, Article, and Disclosure InformationAffiliations: From Anchorage, AK 99508.Corresponding Author: Richard L. Neubauer, MD, 3500 La-Touche, Suite 310, Anchorage, AK, 99508; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCommentary: Paranoia over Privacy Sylvia R. Cruess and Richard L. Cruess Metrics 1 August 2006Volume 145, Issue 3Page: 228-229KeywordsAmyloidosisFearHealth Insurance Portability and Accountability ActMedical communicationsMedical conditionsMotivationNeurologyPatientsPeripheral neuropathyTransplantation ePublished: 1 August 2006 Issue Published: 1 August 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Novel Role of MDA-9/Syntenin in Regulating Urothelial Cell Proliferation by Modulating EGFR Signaling
Authors: Santanu Dasgupta, Mitchell E. Menezes, Swadesh K. Das, Luni Emdad, Aleksandar Janjic, Shilpa Bhatia, Nitai D. Mukhopadhyay, Chunbo Shao, Devanand Sarkar, Paul B. Fisher
Journal: Clinical Cancer Research (2013)

Abstract Purpose: Urothelial cell carcinoma (UCC) rapidly progresses from superficial to muscle-invasive tumors. The key molecules involved in metastatic progression and its early detection require clarification. The present study defines a seminal role of the metastasis-associated gene MDA-9/Syntenin in UCC progression. Experimental Design: Expression pattern of MDA-9/Syntenin was examined in 44 primary UCC and the impact of its overexpression and knockdown was examined in multiple cells lines and key findings were validated in primary tumors. Results: Significantly higher (P = 0.002–0.003) expression of MDA-9/Syntenin was observed in 64% (28 of 44) of primary tumors and an association was evident with stage (P = 0.01), grade (P = 0.03), and invasion status (P = 0.02). MDA-9/Syntenin overexpression in nontumorigenic HUC-1 cells increased proliferation (P = 0.0012), invasion (P = 0.0001), and EGF receptor (EGFR), AKT, phosphoinositide 3-kinase (PI3K), and c-Src expression. Alteration of β-catenin, E-cadherin, vimentin, claudin-1, ZO-1, and T-cell factor-4 (TCF4) expression was also observed. MDA-9/Syntenin knockdown in three UCC cell lines reversed phenotypic and molecular changes observed in the HUC-1 cells and reduced in vivo metastasis. Key molecular changes observed in the cell lines were confirmed in primary tumors. A physical interaction and colocalization of MDA-9/Syntenin and EGFR was evident in UCC cell lines and primary tumors. A logistic regression model analysis revealed a significant correlation between MDA-9/Syntenin:EGFR and MDA-9/Syntenin:AKT expressions with stage (P = 0.04, EGFR; P = 0.01, AKT). A correlation between MDA-9/Syntenin:β-catenin coexpression with stage (P = 0.03) and invasion (P = 0.04) was also evident. Conclusions: Our findings indicate that MDA-9/Syntenin might provide an attractive target for developing detection, monitoring, and therapeutic strategies for managing UCC. Clin Cancer Res; 19(17); 4621–33. ©2013 AACR.
Overexpression of BCL-2 in transgenic mice protects neurons from naturally occurring cell death and experimental ischemia
Authors: Jean-Claude Martinou, Michel Dubois-Dauphin, Julie K. Staple, Ivan Rodriguez, Harald Frankowski, Marc Missotten, Paola Albertini, Dominique Talabot, Stefan Catsicas, Claudio Pietra
Journal: Neuron (1994)
Comparative Trial of P1496, a New Non-steroidal Oestrogen Analogue
Authors: W. H. Utian
Journal: BMJ (1973)

The results are reported of a preliminary trial of P1496, a new non-steroidal oestrogen analogue, compared with a conjugated equine oestrogen and a placebo. The oestrogenicity of both substances was well substantiated by vaginal epithelial maturation indices. P1496 was superior to conjugated equine oestrogen in producing a significant reduction of plasma calcium levels and a possible reduction in serum cholesterol. Conjugated oestrogen caused slightly more nausea than P1496 but there were no notable side effects from either drug. P1496 is considered to be at least as effective an oestrogenic substance as conjugated oestrogen and worthy of further therapeutic evaluation.
Will Parity in Coverage Result in Better Mental Health Care?
Authors: R G Frank, H H Goldman, T G McGuire
Journal: New England Journal of Medicine (2001)

“Equality between mental health coverage and other health coverage is an affordable and effective objective,” according to a 1999 report by the Surgeon General.1 On the basis of this conclusion and because of the limited effect of the Mental Health Parity Act of 1996 (which expired September 30), Senators Pete Domenici (R-N.M.) and Paul Wellstone (D-Minn.) introduced the Mental Health Equitable Treatment Act of 2001 (S. 543), which was recently approved by the Senate. Since the Mental Health Parity Act of 1996 focused on only one type of difference between insurance coverage for mental health and general medical coverage (yearly . . .
Flexible training for men and women—is this the way forward for medicine?
Authors: Christopher Schofield, Zena Schofield
Journal: BMJ (2005)

H istorically, medicine in the United Kingdom has been a male dominated profession,but female medical graduates now outnumber male graduates ( BMJ 2005;331: 569-72). Many women will go on to have children, and a concern is how this will affect the profession. We are a married couple with two young children and have spent much time considering this issue. The importance of achieving a work-life balance is increasingly recognised in all areas of society. Calls are made for more flexibility in the workforce; and in the Improving Working Lives Standard the government has set an aim of improving flexibility at work in the NHS.

In this debate the role of men has received little attention. In the traditional model of the family in the UK men worked full time and women raised the children full time, but the changing nature of the workforce over the years has meant that women now have much more responsibility to work as well as raise children, while the …
THE NEUROLOGIST'S ART.
Authors: JOSEPH COLLINS
Journal: JAMA (1902)

meeting should be from June 1 to July 1, so as to accom- modate the graduates of all schools.The examination should be both theoretical and practical.Applicants should be taken into the wards of hospitals and be given opportunities to make diagnoses and examine urine, sputum and blood, as well as outline courses of treatment.
Quality of Care-Reply
Authors: Mark R. Chassin
Journal: JAMA (1992)

In Reply.  —Dr Friedell identifies several factors related to the availability of radiation therapy facilities and health insurance coverage that might influence treatment decisions for women with breast cancer. I agree and stated in my Editorial that hospitals should not be blamed for features of the health care system beyond their control that hinder the provision of good quality care. Good measures of quality can assess the price in lowered quality that we as a society pay by failing to provide equal access to good-quality care.  I agree with Dr John that women with early-stage breast cancer should receive complete and objective information about alternative treatments. John believes that providing such data will increase the proportion of women opting for BCS, certainly a reasonable hypothesis. I made a different point in my Editorial: we cannot conclude from the fact that 34% of women with early-stage disease undergo BCS that the
Pathogenesis of Ventricular Fibrillation in Coronary Occlusion
Authors: Callisto Danese
Journal: JAMA (1962)

THERE IS a great deal of evidence suggesting that the most frequent mechanism of death in coronary occlusion is by ventricular fibrillation. Very often this fatal complication may occur following small infarcts which apart from the acute arrhythmia, would have permitted survival with adequate myocardial function. A number of investigators have observed that a larger incidence of ventricular fibrillation occurs in the first 5-20 minutes following the production of the occlusion; thereafter the incidence decreases considerably. Although the pathogenesis of the ventricular fibrillation in coronary occlusion is not completely understood, it is believed that early and late fibrillation differ in the mechanism of their production. This study was carried out to ascertain the role of localized anoxia as a trigger mechanism in early ventricular fibrillation following coronary artery occlusion.For this purpose the artery distal to the occlusion was perfused with a nonoxygenated medium in order to eliminate the stasis which
Hepatic microvascular dysfunction during evolution of dietary steatohepatitis in mice
Authors: Robert S. McCuskey, Yoshiya Ito, Graham R. Robertson, Margaret K. McCuskey, Michael Perry, Geoffrey C. Farrell
Journal: Hepatology (2004)

In alcoholic steatohepatitis, hepatic microvascular changes have pathogenic significance for hepatocellular function, perisinusoidal fibrosis, and portal hypertension. It is unclear whether similar changes occur in other forms of steatohepatitis. We therefore examined whether hepatic microvascular dysfunction occurs in fibrosing steatohepatitis induced by feeding mice a high-fat methionine- and choline-deficient (MCD) diet. Using in vivo microscopic—as well as histological and electron microscopic—methods, together with measurements of alanine aminotransferase (ALT), lipid content, and oxidative stress, hepatic microvascular structure and function were studied in relation to inflammatory and fibrotic changes during evolution of steatohepatitis. At 3 weeks of MCD diet intake, serum ALT was elevated and hepatic steatosis was pronounced. By 5 weeks, necroinflammatory change was noteworthy, and by 8 weeks perisinusoidal fibrosis was established. Compared with mice receiving the high-fat diet supplemented with methionine and choline (controls), levels of hepatic lipid and lipoperoxides were elevated at 3 weeks and beyond. The numbers of perfused sinusoids were significantly reduced at each time point. Enlarged, fat-laden hepatocytes together with perivascular fibrosis narrowed sinusoidal lumens, making vessels tortuous and impairing sinusoidal perfusion. At 3 and 5 weeks, MCD diet caused significant increases in phagocytic activity of macrophages in centrilobular regions. By 8 weeks, macrophage activity was less striking, but the number of leukocytes adherent to the sinusoidal lining had increased 5-fold compared with controls. In conclusion , these results are consistent with a dysfunctional hepatic microvasculature. Thus, microvascular changes may contribute to progressive liver injury in metabolic and toxic forms of steatohepatitis. (Hepatology 2004;40:386-393.)