tbuckley/cabot-search huggingface dataset:
Stroke Prevention Guidelines
Authors: David B. Matchar
Journal: Annals of Internal Medicine (1995)

Letters1 February 1995Stroke Prevention GuidelinesDavid B. Matchar, MDDavid B. Matchar, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-3-199502010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Recent clinical trials, including SPAF, have shown that anticoagulation with warfarin sodium can reduce the risk for stroke in patients with atrial fibrillation. As stated in our review, this relative risk reduction may not be worth the risks attendant to anticoagulation in patients in whom the absolute risk is small [1].The crucial question is, who has a small absolute risk? The answer has been, and continues to be, a moving target. Indeed, since the submission of our manuscript, a pooled analysis by the Atrial Fibrillation Investigators has shown that persons with lone atrial fibrillation had a relatively ...References1. Matchar DB, McCrory DC, Barnett HJ, Feussner JR. Medical treatment for stroke prevention. Ann Intern Med. 1994; 121:41-53. Google Scholar2. Atrial Fibrillation Investigators. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized, controlled trials. Arch Intern Med. 1994; 154:1449-57. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1995Volume 122, Issue 3Page: 235-236KeywordsAtrial fibrillationClinical trialsMedical risk factorsRelative riskSodiumStroke Issue Published: 1 February 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Gonadotropin Therapy
Authors: Melvin L. Taymor
Journal: JAMA (1968)

The individual patient response to menotropins therapy was found to be extremely variable. Failure to appreciate this variability can lead to ovarian overstimulation. Overstimulation was found to be associated with abnormally high excretion levels of total estrogen. The author concluded that daily monitoring of estrogen excretion by a rapid chemical method was necessary to determine the optimum time for the administration of chorionic gonadotropin and, at the present time, provided the best method for preventing ovarian overstimulation.
Prehospital Emergency Care
Authors: Roy D. Ary
Journal: JAMA (1997)

<i>Prehospital Emergency Care</i>premiered with the January/March 1997 issue as the official journal of the National Association of EMS Physicians (NAEMSP) and the National Association of State EMS Directors. The stated mission of this journal is "to foster and disseminate EMS literature of the highest quality." The editor-in-chief also has also noted that recognition of success in this venture will be the eventual indexing of<i>Prehospital Emergency Care</i>by the National Library of Medicine. The CINAHL (Cumulated Index to Nursing and Allied Health) already has arranged to index it back to the first issue. This journal has information relevant to the practice, educational advancement, and investigation of prehospital emergency care. Emergency medical services (EMS) impacts all emergency physicians on a daily basis. These physicians need to be informed about the prehospital care provided to their patients. The care rendered must be under close physician direction and surveillance to ensure the
Low-Level Environmental Cadmium Exposure Is Associated with DNA Hypomethylation in Argentinean Women
Authors: Mohammad Bakhtiar Hossain, Marie Vahter, Gabriela Concha, Karin Broberg
Journal: Environmental Health Perspectives (2012)

Background: Cadmium, a common food pollutant, alters DNA methylation in vitro. Epigenetic effects might therefore partly explain cadmium's toxicity, including its carcinogenicity; however, human data on epigenetic effects are lacking.Objective: We evaluated the effects of dietary cadmium exposure on DNA methylation, considering other environmental exposures, genetic predisposition, and gene expression.Methods: Concentrations of cadmium, arsenic, selenium, and zinc in blood and urine of nonsmoking women (n = 202) from the northern Argentinean Andes were measured by inductively coupled mass spectrometry. Methylation in CpG islands of LINE-1 (long interspersed nuclear element-1; a proxy for global DNA methylation) and promoter regions of p16 [cyclin-dependent kinase inhibitor 2A (CDKN2A)] and MLH1 (mutL homolog 1) in peripheral blood were measured by bisulfite polymerase chain reaction pyrosequencing. Genotyping (n = 172) for the DNA (cytosine-5-)-methyltransferase 1 gene (DNMT1 rs10854076 and rs2228611) and DNA (cytosine-5-)-methyltransferase 3 beta gene (DNMT3B rs2424913 and rs2424932) was performed with Sequenom iPLEX GOLD SNP genotyping; and gene expression (n = 90), with DirectHyb HumanHT-12 (version 3.0).Results: Cadmium exposure was low: median concentrations in blood and urine were 0.36 and 0.23 µg/L, respectively. Urinary cadmium (natural log transformed) was inversely associated with LINE-1 methylation (β = –0.50, p = 0.0070; β = –0.44, p = 0.026, adjusted for age and coca chewing) but not with p16 or MLH1 methylation. Both DNMT1 rs10854076 and DNMT1 rs2228611 polymorphisms modified associations between urinary cadmium and LINE-1 (p-values for interaction in adjusted models were 0.045 and 0.064, respectively). The rare genotypes demonstrated stronger hypomethylation with increasing urinary cadmium concentrations. Cadmium was inversely associated with DNMT3B (rS = –0.28, p = 0.0086) but not with DNMT1 expression (rS = –0.075, p = 0.48).Conclusion: Environmental cadmium exposure was associated with DNA hypomethylation in peripheral blood, and DNMT1 genotypes modified this association. The role of epigenetic modifications in cadmium-associated diseases needs clarification.
Effects of Levosimendan on Left Ventricular Relaxation and Early Filling at Maintained Preload and Afterload Conditions After Aortic Valve Replacement for Aortic Stenosis
Authors: Kirsten Jörgensen, Odd Bech-Hanssen, Erik Houltz, Sven-Erik Ricksten
Journal: Circulation (2008)

We determined the effects of levosimendan, a calcium sensitizer, on left ventricular (LV) diastolic function in patients with LV hypertrophy.In this prospective, randomized, blinded study, 23 patients received either levosimendan (0.1 and 0.2 microg x kg(-1) x min(-1); n=12) or placebo (n=11) after aortic valve replacement for aortic stenosis. The effects on LV performance, dimensions, filling patterns, and isovolumic relaxation time, as well as systemic hemodynamics, were assessed by pulmonary artery thermodilution catheterization and transesophageal 2-dimensional Doppler echocardiography. To circumvent the confounding effects of the levosimendan-induced hemodynamic changes on Doppler echocardiographic indexes of LV early relaxation, heart rate and mean arterial and central venous pressures were kept constant during levosimendan/placebo infusion by atrial pacing, vasopressor, and colloid infusions. In the levosimendan group, dose-dependent increases in cardiac output (28%; P<0.001) and stroke volume (26%; P<0.001) and a decrease in systemic vascular resistance (-22%; P<0.001) were observed. There was a trend for an increase in LV ejection fraction (12%; P=0.058) with levosimendan. There were no significant differences in systolic, diastolic arterial, or LV filling pressures or LV end-diastolic area between the 2 groups. Isovolumic relaxation time decreased (-23%; P<0.001), as did the deceleration slope of early diastolic filling (-45%; P<0.01), whereas peak early diastolic filling velocity (16%, P<0.01) and peak late diastolic filling velocity (15%; P<0.001) increased after levosimendan compared with placebo.Levosimendan, in addition to its inotropic effects, exerts a direct positive lusitropic effect in patients with LV hypertrophy as it shortens isovolumic relaxation time and improves LV filling.
Expectations and morality: A dilemma
Authors: Eric Mandelbaum, David Ripley
Journal: Behavioral and Brain Sciences (2010)

Abstract We propose Knobe's explanation of his cases encounters a dilemma: Either his explanation works and, counterintuitively, morality is not at the heart of these effects; or morality is at the heart of the effects and Knobe's explanation does not succeed. This dilemma is then used to temper the use of the Knobe paradigm for discovering moral norms.
Incomplete Traumatic Quadriplegia
Authors: Albert Bosch
Journal: JAMA (1971)

Incomplete quadriplegia following closed injuries to the cervical spine is studied for future prognosis of this increasingly common lesion. Sixty patients were included in this study and classified into one of four clinical syndromes to correlate the different types of quadriplegia to its final outcome. Interest was focused primarily in the return of function to the lower and upper extremities and to rectal and bladder control. This communication concentrates on two major groups—the central spinal cord syndrome and the anterior spinal cord syndrome which, combined, represent 90% of our series. An ambulation follow-up comparison is made of central cord syndrome and anterior cord syndrome. A more accurate prognosis of cervical cord lesions can be established on a statistical basis.
A Companion to Medical Studies, vol 2: Pharmacology, Microbiology, General Pathology and Related Subjects
Authors: Lester S. King
Journal: JAMA (1970)

This work is a complete but succinct review of the thymic role in human immunobiology. By confining themselves to the human species and stressing the clinical relevance of experimental and developmental studies, the authors have been able to admirably fulfill their goal of filling a need not "met by reports of conferences and other reviews dealing mainly with experimental aspects of thymic function" yet keep the volume to an attractive size. The book is extremely well written and characteristic of texts written by those to whom "English" English is the mother tongue. It will be not only understood but enjoyed by all who read it. The heavy stress on clinical significance of the experimental studies will make the book invaluable to practitioners who wish an authoritative introduction to thymology as it relates to clinical medicine. The book is profusely illustrated; the photographs are first rate and the publishers deserve full
Reduced prostaglandin release from the stunned porcine heart--significance for attenuated reactive hyperaemia
Authors: K. A. Kirkeboen, G. Aksnes, A. Ilebekk
Journal: Cardiovascular Research (1991)

Study objective — Since both reactive hyperaemia and membrane phospholipids are altered even after short lasting ischaemic periods, the release of PGE2and PGI2 in the basal state and during early reperfusion was examined to determine whether it was changed in the stunned myocardium. The effect of prostaglandin synthesis inhibition on reactive hyperaemia was also examined. Design — The distal left anterior descending coronary artery was occluded for brief periods and coronary flow was recorded by Doppler flowmetry. In subgroups: (1) a shunt was established draining the ischaemic region for determination of myocardial prostaglandin release associated with 2 min of ischaemia before and after a 10 min occlusion; (2) prostaglandin synthesis was blocked between two 2 min occlusions by infusing indomethacin into the left anterior descending artery; and (3) segment lengths were measured in the left anterior descending artery region subjected to consecutive periods of 2, 10, and 2 min of ischaemia, and in a control region. Experimental material — 21 pentobarbitone sodium anaesthetised pigs, weight 21-30 kg, were used. Measurements and main results — 30 min after the 10 min occlusion, systolic shortening was reduced by 38(18-57)% (median +95% confidence interval; p<0.05). Concomitantly, basal PGE2 and PGI2 release was reduced by 69(30-77)% (p<0.05) and 58(7-81)% (p<0.05), respectively. During early reperfusion after 2 min of ischaemia, PGE2 release was reduced by 53(17-86)% (p<0.05) after development of stunning, whereas PGI2 release remained unaltered. Blockade of prostaglandin synthesis did not affect reactive hyperaemia either in normal or in stunned myocardium. Conclusions — Prostaglandin release from the stunned myocardium is reduced. Since indomethacin did not affect reactive hyperaemia, the attenuated PGE2 release during early reperfusion in stunned myocardium cannot explain the concomitant reduction in reactive hyperaemia.
Allogeneic hematopoietic stem cell transplantation in Fanconi anemia: the European Group for Blood and Marrow Transplantation experience
Authors: Régis Peffault de Latour, Raphael Porcher, Jean-Hugues Dalle, Mahmoud Aljurf, Elisabeth T. Korthof, Johanna Svahn, Roelof Willemze, Cristina Barrenetxea, Valerie Mialou, Jean Soulier, Mouhab Ayas, Rosi Oneto, Andrea Bacigalupo, Judith C. W. Marsh, Christina Peters, Gerard Socie, Carlo Dufour
Journal: Blood (2013)
Proposed heparin binding site in antithrombin based on arginine 47. A new variant Rouen-II, 47 Arg to Ser.
Authors: J Y Borg, M C Owen, C Soria, J Soria, J Caen, R W Carrell
Journal: Journal of Clinical Investigation (1988)

Antithrombin Rouen-II, a new inherited variant of antithrombin-III, was found in two members of a family with no definite history of thrombosis. The subjects had normal antigenic concentrations of antithrombin and normal progressive inhibitory activity. However, the variant had defective heparin and heparan sulfate cofactor activities, and was not activated by a synthetic pentasaccharide representing the minimum heparin sequence. The abnormal antithrombin was isolated using heparin-Sepharose chromatography, and on electrophoresis at pH 8.6 migrated more anodally than normal. Two-dimensional peptide mapping of tryptic and Staphylococcus aureus V8 protease digests was performed and the abnormal peptide was located by tryptophan staining. Amino acid sequence studies demonstrated a substitution of arginine at residue 47 by a serine. Evidence strongly suggests that arginine 47 is a prime heparin binding site in antithrombin and that it forms part of a proposed positively charged linear site (to which heparin binds) that stretches across the surface of the molecule from the A to the D helix.
Population-Based Norms for the Mini-Mental State Examination by Age and Educational Level
Authors: Rosa M. Crum
Journal: JAMA (1993)

To report the distribution of Mini-Mental State Examination (MMSE) scores by age and educational level.National Institute of Mental Health Epidemiologic Catchment Area Program surveys conducted between 1980 and 1984.Community populations in New Haven, Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Calif.A total of 18,056 adult participants selected by probability sampling within census tracts and households.Summary scores for the MMSE are given in the form of mean, median, and percentile distributions specific for age and educational level.The MMSE scores were related to both age and educational level. There was an inverse relationship between MMSE scores and age, ranging from a median of 29 for those 18 to 24 years of age, to 25 for individuals 80 years of age and older. The median MMSE score was 29 for individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of schooling, and 22 for those with 0 to 4 years of schooling.Cognitive performance as measured by the MMSE varies within the population by age and education. The cause of this variation has yet to be determined. Mini-Mental State Examination scores should be used to identify current cognitive difficulties and not to make formal diagnoses. The results presented should prove to be useful to clinicians who wish to compare an individual patient's MMSE scores with a population reference group and to researchers making plans for new studies in which cognitive status is a variable of interest.
Renal cortex taurine content regulates renal adaptive response to altered dietary intake of sulfur amino acids.
Authors: R W Chesney, N Gusowski, S Dabbagh
Journal: Journal of Clinical Investigation (1985)

Rats fed a reduced sulfur amino acid diet (LTD) or a high-taurine diet (HTD) demonstrate a renal adaptive response. The LTD results in hypotaurinuria and enhanced brush border membrane vesicle (BBMV) accumulation of taurine. The HTD causes hypertaurinuria and reduced BBMV uptake. This adaptation may relate to changes in plasma or renal cortex taurine concentration. Rats were fed a normal-taurine diet (NTD), LTD, or HTD for 14 d or they underwent: (a) 3% beta-alanine for the last 8 d of each diet; (b) 3 d of fasting; or (c) a combination of 3% beta-alanine added for 8 d and 3 d of fasting. Each maneuver lowered the cortex taurine concentration, but did not significantly lower plasma taurine values compared with controls. Increased BBMV taurine uptake occurred after each manipulation. Feeding 3% glycine did not alter the plasma, renal cortex, or urinary taurine concentrations, or BBMV uptake of taurine. Feeding 3% methionine raised plasma and urinary taurine excretion but renal tissue taurine was unchanged, as was initial BBMV uptake. Hence, nonsulfur-containing alpha-amino acids did not change beta-amino acid transport. The increase in BBMV uptake correlates with the decline in renal cortex and plasma taurine content. However, since 3% methionine changed plasma taurine without altering BBMV uptake, it is more likely that the change in BBMV uptake and the adaptive response expressed at the brush border surface relate to changes in renal cortex taurine concentrations. Finally, despite changes in urine and renal cortex taurine content, brain taurine values were unchanged, which suggests that this renal adaptive response maintains stable taurine concentrations where taurine serves as a neuromodulator.
Chernobyl, childhood cancer, and chromosome 21
Authors: J Boice, M Linet
Journal: BMJ (1994)

In 1986 the accident at the nuclear reactor in Chernobyl in the former Soviet Union released large amounts of radioactivity into the atmosphere. Adjacent areas were heavily contaminated, while more distant regions were affected less. International committees concluded that valuable information on the effects of radiation might result from long term follow up of workers affected by the accident, many of whom received doses in the range of 250-1000 mSv. The committees also recommended that studies should be carried out of residents living within a 30 km radius of the reactor and of residents of substantially contaminated regions in Belarus, the Ukraine, and Russia, who may have received doses of 50-60 mSv. The scientific value of investigations in Europe and other parts of the former Soviet Union was questioned, however, because estimated exposures (<1 mSv) were believed to have been too low to cause a detectable excess of cases of cancer or genetic defects.1 For comparison, annual doses from natural background radiation are 1-2 mSv.2

Nevertheless, because of widespread concern among populations in Europe living in areas of low fallout, the International Agency for Research on Cancer organised the …
ESRD Program Projections and Experience
Authors: R. M. Klar
Journal: JAMA (1979)

<h3>To the Editor.—</h3> From the outset, implementation of the Medicare End-Stage Renal Disease (ESRD) Program has been complicated by problems of inadequate or inaccurateinformation of policies and progress. Considerable attention has been given to recent articles and testimony suggesting that the total costs have far exceeded expectations and that the Department of Health, Education, and Welfare failed to recognize or support in-home dialysis and transplantation as the preferable, and least costly, treatment alternatives. The following information will record that these suggestions are incorrect. In late 1972, before implementation of Section 2991 of the Social Security Amendments of 1972 began, a comprehensive analysis of the cost and survival implications of various dialysis and transplantation alternatives, including life-cost tables factoring multiple permutations of incidence, mortality, treatment pathway, and patient distribution, was developed by the Office of the Assistant Secretary for Health. Compared with the actual experience for the first five years,
Effects of corticosteroids on the growth and metabolism of fibroblasts cultured from human skin
Authors: G. C. PRIESTLEY
Journal: British Journal of Dermatology (1978)

Hydrocortisone, betamethasone 17-valerate, clobetasone butyrate and clobetasol propionate were tested in vitro for effects on the proliferation and metabolism of six strains of fibroblasts from normal human skin. The different cell strains gave similar results: hydrocortisone and betamethasone valerate slightly enhanced growth at all concentrations (0.0001-10 microgram/ml), but high concentrations of clobetasone butyrate and clobetasol propionate significantly reduced proliferation. Secretion of acid mucopolysaccharide was most inhibited by clobetasone butyrate and clobetasol propionate, then by betamethasone valerate, with hydrocortisone having the least effect. Clobetasol propionate and betamethasone valerate at 10 microgram/ml both reduced collagen synthesis by about 50%; other protein synthesis was less affected.
Cough and Angioneurotic Edema Associated with Angiotensin-Converting Enzyme Inhibitor Therapy
Authors: Zafar H. Israili, W. Dallas Hall
Journal: Annals of Internal Medicine (1992)

Objective: To review available information on cough and angioneurotic edema associated with angiotensin-converting enzyme (ACE) inhibitors. Data Sources: All relevant articles from 1966 through 1991 were identified mainly through MEDLINE search and article bibliographies. Study Selection: More than 400 articles were identified; 200 reporting incidence or possible mechanisms for the side effects or both were selected. Data Extraction and Synthesis: All pertinent information, including incidence and mechanisms of ACE inhibitor-induced cough and angioedema, was reviewed and collated. Conclusions: Cough occurs in 5% to 20% of patients treated with ACE inhibitors, recurring with reintroduction of the same or another ACE inhibitor. It is more common in women. The mechanism may involve accumulation of prostaglandins, kinins (such as bradykinin), or substance P (neurotransmitter present in respiratory tract C-fibers); both bradykinin and substance P are degraded by ACE. A 4-day trial of withdrawal of the ACE inhibitor or temporary substitution of another class of antihypertensive agent inexpensively and easily ascertains if the ACE inhibitor caused the cough. Change to another ACE inhibitor or additive therapy with nonsteroidal anti-inflammatory drugs is not recommended. Prompt recognition of ACE inhibitor-related cough can prevent unnecessary diagnostic testing and treatment. Angioedema occurs in 0.1% to 0.2% of patients receiving ACE inhibitors. The onset usually occurs within hours or, at most, 1 week after starting therapy. The mechanism may involve autoantibodies, bradykinin, or complement-system components. Treatment involves first protecting the airway, followed by epinephrine, antihistamines, and corticosteroids if needed. Therapy is then resumed with an alternate class of antihypertensive agent.