tbuckley/cabot-search huggingface dataset:
Impairment of renal function during moderate physical exercise in cirrhotic patients with ascites: Relationship with the activity of neurohormonal systems
Authors: J Salo, M Guevara, G Fernandez-Esparrach, R Bataller, A Gines, W Jimenez, P Gines, F Rivera, V Arroyo, J Rodes
Journal: Hepatology (1997)

Moderate physical exercise does not affect glomerular filtration rate (GFR) and renal excretory function in normal subjects. This study is aimed at assessing the effects of moderate physical exercise on renal function in 21 nonazotemic cirrhotic patients with ascites. Arterial pressure, heart rate, and renal function were assessed in the patients after 2 hours in the supine position and during 30 minutes of moderate cycloergometric exercise in the sitting position. The activity of the renin-aldosterone and sympathetic nervous systems and the plasma levels of antidiuretic hormone (ADH) and atrial natriuretic peptide (ANP) were determined at the end of each period. Physical exercise induced a marked reduction in GFR (75 ± 10 to 49 ± 6 mL/min), free-water clearance (6.1 ± 1 to 3.4 ± 1 mL/min), and sodium excretion (7.8 ± 2 to 4.3 ± 1 μEq/min) in 10 patients (Group I). In the remaining 11 cases (Group II) there were no changes in these parameters. Renal perfusion significantly decreased in both groups although the reduction was greater in Group I (-34.7% ± 4.6% vs. -7.5% ± 3.1%, P &lt; .001). Physical exercise was associated with a significant and comparable increase in arterial pressure, heart rate, and plasma levels of renin, aldosterone, and norepinephrine (NE) in the two groups of patients. The ANP concentration did not change. Patients from Groups I and II differed significantly ( P &lt; .05) only in plasma renin activity (PRA) and NE concentration, which were higher in Group I patients both in the supine rest (renin: 4.7 ± 1.6 vs. 1.4 ± 0.5 ng/mL x h; NE: 576 ± 115 vs. 288 ± 42 pg/ mL) and during exercise (renin: 7.1 ± 1.8 vs. 2.6 ± 1 ng/ mL x h; NE: 925 ± 135 vs. 630 ± 90 pg/mL). In conclusion, moderate physical exercise has no detrimental effects on renal function in cirrhotic patients with ascites with no or mild activation of the renin-aldosterone and sympathetic nervous systems. However, moderate physical exercise causes a marked impairment in the renal function of patients with ascites with marked stimulation of these vasoconstrictor systems.
US teenager's parents sue school over depression screening test
Authors: Jeanne Lenzer
Journal: BMJ (2005)

The parents of an Indiana teenager have filed a suit in a federal court in the state's Northern District, charging that school officials violated their privacy rights and parental rights by subjecting their daughter to a mental health screening examination without their permission.

The suit is seen as significant because President Bush has promoted a controversial plan to encourage widespread mental health screening for people “of all ages” in the United States ( BMJ 2004;328; 1458).

The screening programme at the centre of the legal suit, TeenScreen, was endorsed as a “model” programme …
Multicentric reticulohistiocytosis associated with idiopathic myelofibrosis.
Authors: N.H. Cox, N.C. West, A.W. Popple
Journal: British Journal of Dermatology (2001)

Journal Article Multicentric reticulohistiocytosis associated with idiopathic myelofibrosis Get access N.H. Cox, N.H. Cox Departments of Dermatology and †Pathology, Cumberland Infirmary, Carlisle, CA2 7HY, U.K. *Department of Haematology, West Cumberland Hospital, Whitehaven, U.K. Search for other works by this author on: Oxford Academic Google Scholar N.C. West, N.C. West Departments of Dermatology and †Pathology, Cumberland Infirmary, Carlisle, CA2 7HY, U.K. *Department of Haematology, West Cumberland Hospital, Whitehaven, U.K. Search for other works by this author on: Oxford Academic Google Scholar A.W. Popple A.W. Popple Departments of Dermatology and †Pathology, Cumberland Infirmary, Carlisle, CA2 7HY, U.K. *Department of Haematology, West Cumberland Hospital, Whitehaven, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 145, Issue 6, 1 December 2001, Pages 1033–1034, https://doi.org/10.1046/j.1365-2133.2001.04483.x Published: 01 December 2001
Cholinergic Afferent Stimulation Induces Axonal Function Plasticity in Adult Hippocampal Granule Cells
Authors: Katiuscia Martinello, Zhuo Huang, Rafael Lujan, Baouyen Tran, Masahiko Watanabe, Edward C. Cooper, David A. Brown, Mala M. Shah
Journal: Neuron (2015)

Acetylcholine critically influences hippocampal-dependent learning. Cholinergic fibers innervate hippocampal neuron axons, dendrites, and somata. The effects of acetylcholine on axonal information processing, though, remain unknown. By stimulating cholinergic fibers and making electrophysiological recordings from hippocampal dentate gyrus granule cells, we show that synaptically released acetylcholine preferentially lowered the action potential threshold, enhancing intrinsic excitability and synaptic potential-spike coupling. These effects persisted for at least 30 min after the stimulation paradigm and were due to muscarinic receptor activation. This caused sustained elevation of axonal intracellular Ca2+ via T-type Ca2+ channels, as indicated by two-photon imaging. The enhanced Ca2+ levels inhibited an axonal KV7/M current, decreasing the spike threshold. In support, immunohistochemistry revealed muscarinic M1 receptor, CaV3.2, and KV7.2/7.3 subunit localization in granule cell axons. Since alterations in axonal signaling affect neuronal firing patterns and neurotransmitter release, this is an unreported cellular mechanism by which acetylcholine might, at least partly, enhance cognitive processing.
Vasodilators in Chronic Congestive Heart Failure
Authors: Jacob Zatuchni
Journal: JAMA (1988)

To the Editor.—  In the treatment of chronic congestive heart failure, Mulrow et al 1 concluded that all vasodilators except hydralazine hydrochloride were associated with improved functional status. However, feeling better usually occurred early and was not sustained. Moreover, combined therapy with nitrates and hydralazine offered no protective benefit, and therapy with nitrates alone was associated with a trend to increased (sic) mortality. In studies evaluating α-antagonists, the longest trial (six months) found no significant functional improvement either early or late. In those given angiotensin converting enzyme inhibitors, a significant protective effect was found but individuals who profited most could not be identified. Moreover, questions were raised in the minds of the authors about causality of any benefit of angiotensin converting enzyme inhibitors because control groups were not balanced according to amount of diuretics employed. Finally, this study is a metaanalysis, without contact with a single patient and based only
Withdrawal of Mixtard 30: who on earth cares?
Authors: I. Iheanacho
Journal: BMJ (2010)

In the end, numbers alone aren’t enough. That one in every 300 of the world’s people have had their lives or wellbeing ruined by a stunning natural catastrophe seems to have provoked little more than a shrug of indifference from the other 299. The underwhelming global reaction to the flooding in Pakistan should be food for sobering thought for those wishing to bring health and social problems to the attention of an otherwise uncommitted audience.

If minds aren’t engaged by the plight of 20 million, what …
The Risk of Breast Cancer in Postmenopausal Women Who Have Used Estrogen Replacement Therapy
Authors: Phyllis A. Wingo
Journal: JAMA (1987)

We studied the association between estrogen replacement therapy (ERT) and the risk of breast cancer as part of the Cancer and Steroid Hormone Study. All subjects in the analysis were postmenopausal women enrolled from eight geographic areas. Women 25 to 54 years old with newly diagnosed breast cancer were identified through population-based tumor registries and diagnosed between Dec 1,1980, and Dec 31,1982. Controls were selected from the same eight geographic areas by the random digit dialing of residential telephone numbers. Analyses included 1369 cases and 1645 controls. Among women with bilateral oophorectomy, the relative risk of breast cancer for women who had ever used ERT was 1.3, compared with women who had never used ERT. Among women who had undergone hysterectomy but who still had at least one ovary, the relative risk was 1.1; among women who reported a natural menopause, the relative risk was 0.8. Overall, the risk of breast cancer did not appear to increase appreciably with increasing ERT duration or latency, even for durations and latencies of 20 years or longer. (<i>JAMA</i>1987;257:209-215)
Information for patients on medicines
Authors: Joanne M Shaw, Geraldine Mynors, Caroline Kelham
Journal: BMJ (2005)

Compassion for the worried and sometimes grief stricken individual will occasionally mislead a physician-encouraged by the person at risk-to recommend an intensified surveillance programme even though little evidence exists to endorse this.Although this may comfort the affected person and his or her family, the possible medical risks and socioeconomic consequences of an intensified surveillance programme must be borne in mind.For responsible patient guidance, we have to detach ourselves from the individual case to a certain extent and, keeping Goethe's words in mind, take a look at the big picture.Only if we are able to merge the recent diagnostic advances in familial colorectal cancer with its clinical presentation will we be able to provide better recommendations for adequate surveillance of patients at variable risk of colorectal cancer.Then, indeed, we will have gone from bench to bedside.
Abstract B48: Sensitization of Hepatocellular Carcinoma Cells to TRAIL by a Novel Aκt/NF-kappaB Signaling Inhibitor
Authors: Hany A. Omar, El-Shaimaa A. Arafa, Jing-Ru Weng
Journal: Clinical Cancer Research (2012)

Abstract Tumor necrosis factor-related apoptosis ligand (TRAIL) represents a promising cancer therapeutic agent considering its selectivity in targeting malignant cells while sparing normal cells. However, hepatocellular carcinoma (HCC) cells are intrinsically resistant to TRAIL, in part, due to the compensatory activation of nuclear factor-kappaB (NF-κB). Previously, based on the scaffold of indole-3-carbinol, we developed a potent Akt/NF-κB signaling inhibitor, OSU-A9, that exhibits in vitro and in vivo efficacy in suppressing HCC cell growth. In this study, we report the sensitizing effect of OSU-A9 on TRAIL-induced cell death in Hep3B and Huh7 HCC cells by antagonizing TRAIL-induced NF-κB activation. Even at 1 μM, OSU-A9 could restore the sensitivity of these cells to TRAIL-mediated antitumor effect to a level comparable to that of TRAIL-sensitive PC-3 cells. Exposure to OSU-A9 led to a dose-dependent reduction in the expression and nuclear localization of RelA/p65 by suppressing Akt activation and RelA expression, which was accompanied by parallel decreases in the expression of antiapoptotic Bcl-xL, Mcl-1, cIAP1, cIAP2, and survivin. In addition, OSU-A9 upregulated death receptor (DR)5 expression via a reactive oxygen species-dependent mechanism. Concertedly, these effects gave rise to increased capsase-3 and caspase-8 activities and PARP cleavage in TRAIL-treated cells, indicative of therapeutic synergy between OSU-A9 and TRAIL. Moreover, this synergistic effect was abolished by the ectopic expression of NF-κB/p65, supporting the role of NF-κB inhibition in OSU-A9-mediated sensitization of HCC cells to TRAIL. Taken together, the ability of OSU-A9 to accentuate TRAIL-induced apoptosis by inactivating NF-κB signaling might foster a promising therapeutic strategy for HCC.
Does blinding of readers affect the results of meta-analyses?
Authors: Jesse A Berlin
Journal: The Lancet (1997)

Meta-analysis of randomised clinical trials is gaining wide acceptance. Because of the potential for bias in any retrospective study, researchers as early as 1987 1 Sacks HS Berrier J Reitman D Acona-Berk VA Chalmers TC Meta-analysis of randomized control trials. N Engl J Med. 1987; 316: 450-455 Crossref PubMed Scopus (1054) Google Scholar have recommended that readers evaluating or extracting data from original papers for a meta-analysis be blinded to information in the paper about the identity of the authors, the institutional affiliations of the authors, the study results (when readers are evaluating the quality of the methods), and even the identity of the treatment and control groups. Although this recommendation has high face validity, no study has yet evaluated whether blinding actually reduces or prevents bias. To resolve this issue, we conducted a study to determine whether meta-analyses conducted with readers blinded to identifying information produce systematically different results than those same meta-analyses conducted with unblinded readers. A more detailed version of this report is published elsewhere. 2 Berlin JA, Miles CG, Crigliano MD, et al. Does blinding of readers affect the results of metaanalyses? Results of a randomized trial. Online J Curr Clin Trials. Document no 205. Google Scholar
THE DANGER OF DUST AS A CAUSE OF TUBERCULOSISIN DOMESTIC HOUSEHOLDS, CLUBS, HOTELS, SCHOOLS AND CERTAIN OTHER ESTABLISHMENTS.
Authors: GEORGE HOMAN
Journal: JAMA (1907)

placed on the eyes.Ophthalmologists have come to com- prehend, too, that near-sightedness, or myopia, is not only a retrograde step in refraction, and an annoyance to those who are near-sighted, from the necessity of wearing glasses to obtain sharp vision, but that it is actually a disease of the eye which frequently induces changes in the tissues of the eyeballs which after a time may render all near use of the eyes impossible and in graver cases lead to partial or even to total blindness. Numerous statistics have been recorded which showRead before the Mississippi Valley Medical Association, Hot
Survival of the fittest: retrospective cohort study of the longevity of Olympic medallists in the modern era
Authors: P. M. Clarke, S. J. Walter, A. Hayen, W. J. Mallon, J. Heijmans, D. M. Studdert
Journal: BMJ (2012)

<b>Objective</b> To determine whether Olympic medallists live longer than the general population. <b>Design</b> Retrospective cohort study, with passive follow-up and conditional survival analysis to account for unidentified loss to follow-up. <b>Setting and participants</b> 15 174 Olympic athletes from nine country groups (United States, Germany, Nordic countries, Russia, United Kingdom, France, Italy, Canada, and Australia and New Zealand) who won medals in the Olympic Games held in 1896-2010. Medallists were compared with matched cohorts in the general population (by country, age, sex, and year of birth). <b>Main outcome measures</b> Relative conditional survival. <b>Results</b> More medallists than matched controls in the general population were alive 30 years after winning (relative conditional survival 1.08, 95% confidence interval 1.07 to 1.10). Medallists lived an average of 2.8 years longer than controls. Medallists in eight of the nine country groups had a significant survival advantage compared with controls. Gold, silver, and bronze medallists each enjoyed similar sized survival advantages. Medallists in endurance sports and mixed sports had a larger survival advantage over controls at 30 years (1.13, 1.09 to 1.17; 1.11, 1.09 to 1.13) than that of medallists in power sports (1.05, 1.01 to 1.08). <b>Conclusions</b> Olympic medallists live longer than the general population, irrespective of country, medal, or sport. This study was not designed to explain this effect, but possible explanations include genetic factors, physical activity, healthy lifestyle, and the wealth and status that come with international sporting glory.
Erratum: Corrigendum: STAT1-cooperative DNA binding distinguishes type 1 from type 2 interferon signaling
Authors: Andreas Begitt, Mathias Droescher, Thomas Meyer, Christoph D Schmid, Michelle Baker, Filipa Antunes, Markus R Owen, Ronald Naumann, Thomas Decker, Uwe Vinkemeier
Journal: Nature Immunology (2014)
Patients with rheumatoid arthritis in clinical care
Authors: J S Smolen, D Aletaha
Journal: Annals of the Rheumatic Diseases (2004)

The challenge of following process, damage, and function

Rheumatoid arthritis (RA) differs from most other chronic inflammatory arthropathies in its high propensity towards joint destruction.1 The mechanisms leading to this destruction are not fully elucidated, but proinflammatory cytokines and activation of osteoclasts appear to have pivotal pathogenic roles.2–4

The highly destructive nature of the disease is manifested by the development of erosions in 10–26% of patients with RA within 3 months from the onset of disease,5,6 in over 60% within 1 year,7 and within 2 years about 75% of patients with RA have erosive joint damage.8 Such data are mostly derived from patients in whom a definitive diagnosis of RA had been established. However, even in a community based inception cohort of patients with inflammatory polyarthritis, who only cumulatively fulfil classification criteria for RA, the prevalence of erosive disease was 36% within 2 years.9 The degree of joint destruction accrues with time,10,11 and increasing radiographic joint destruction correlates with decreasing function as measured by patient questionnaires.12

Functional assessment by self report questionnaires has become standard in randomised clinical trials13–17 as well as clinical research. The most commonly used among the many questionnaires18 is the Stanford Health Assessment Questionnaire (HAQ)19 and its derivatives. These questionnaires measure primarily function and health related quality of life, the improvement of which is the most important aspect in the care for our patients. Nevertheless, these questionnaires do not allow differentiation between the degree to which an impairment in functional activity is due to current disease activity (and thus is process related and potentially reversible), and the extent to which it is a consequence of accrued, long term, largely irreversible damage (and thus constitutes a reflection of the process induced outcome). …
Hemodynamics, Myocardial Metabolism, and Therapeutical Response in Cardiogenic Noncoronary (NCS), Coronary (CS), and Mixed Shock (MS).
Authors: Hiltrud S. Mueller
Journal: Annals of Internal Medicine (1969)

s1 May 1969Hemodynamics, Myocardial Metabolism, and Therapeutical Response in Cardiogenic Noncoronary (NCS), Coronary (CS), and Mixed Shock (MS).Hiltrud S. Mueller, M.D., John J. Gregory, M.D., F.A.C.P., Stephen M. Ayres, M.D., F.A.C.P., Stanley Giannelli Jr., M.D., William J. Grace, M.D., F.A.C.P.Hiltrud S. Mueller, M.D.Search for more papers by this author, John J. Gregory, M.D., F.A.C.P.Search for more papers by this author, Stephen M. Ayres, M.D., F.A.C.P.Search for more papers by this author, Stanley Giannelli Jr., M.D.Search for more papers by this author, William J. Grace, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1079_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMetabolic differences between coronary and noncoronary cardiogenic shock may explain reported differences in response to sympathiocomimetic amines. Cardiac index (CI), mean aortic pressure (MAP), coronary blood flow (CBF), myocardial oxygen consumption (MVO2), oxygen, lactate, and pyruvate extraction ratios (ExO2, ExT, and Exn), and arterial lactate pyruvate ratios (L/P) were measured as follows: in five patients in noncoronary shock after mitral and aortic valve replacement; in eight patients in coronary shock after acute myocardial infarction; and in six patients in mixed shock after hemorrhage and sepsis.The hemodynamics did not vary significantly between the three groups, except for coronary blood flow.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1079-1079KeywordsBlood flowHemodynamicsHemorrhageLactatesMyocardial infarctionOxygenOxygen consumptionPyruvateSepsisShock Issue Published: 1 May 1969 PDF DownloadLoading ...
Role of the coinhibitory receptor cytotoxic T lymphocyte antigen-4 on apoptosis-Prone CD8 T cells in persistent hepatitis B virus infection
Authors: Anna Schurich, Pooja Khanna, Ross A. Lopes, Ki Jun Han, Dimitra Peppa, Lorenzo Micco, Gaia Nebbia, Patrick T.F. Kennedy, Anna-Maria Geretti, Geoffrey Dusheiko, Mala K. Maini
Journal: Hepatology (2011)

Abstract An excess of coinhibitory signals has been proposed to drive the T-cell exhaustion characteristic of persistent viral infections. In this study we examined the contribution of the coinhibitory receptor cytotoxic T lymphocyte antigen-4 (CTLA-4) to CD8 T cell tolerance in chronic hepatitis B virus (HBV) infection (CHB). CD8 T cells in patients with CHB have an increased propensity to express the coinhibitory receptor CTLA-4 and this correlates with viral load. CTLA-4 is up-regulated on those HBV-specific CD8 T cells with the highest levels of the proapoptotic protein Bim, which we have previously shown mediates their premature attrition; abrogation of CTLA-4-mediated coinhibition can reduce Bim expression. Longitudinal study of CHB patients beginning antiviral therapy reveals that HBV DNA suppression induces transient reconstitution of HBV-specific CD8 T cells but does not reprogram their CTLA-4hiBimhi tolerogenic phenotype. Blocking CTLA-4 is able to increase the expansion of interferon gamma (IFN-γ)-producing HBV-specific CD8 T cells in both the peripheral and intrahepatic compartments. The rescue of anti-HBV responses by either CTLA-4 or PD-L1 blockade is nonredundant. Conclusion: CTLA-4 is expressed by HBV-specific CD8 T cells with high levels of Bim and helps to drive this proapoptotic phenotype. CTLA-4 blockade could form one arm of a therapeutic approach to modulate the diverse patterns of coregulation of T-cell exhaustion in this heterogeneous disease. (Hepatology 2011;)
A Comparison of Surgical and Medical Therapy for Atrial Septal Defect in Adults
Authors: Stavros Konstantinides, Annette Geibel, Manfred Olschewski, Lothar Görnandt, Helmut Roskamm, Gerhard Spillner, Hanjörg Just, Wolfgang Kasper
Journal: New England Journal of Medicine (1995)

The surgical closure of an atrial septal defect is frequently recommended for patients over 40 years of age. However, the prognosis for such patients with unrepaired defects is largely unknown, and the outcome for patients operated on after the fourth decade of life has not yet been compared with that for medically treated patients in a controlled follow-up study.
US gets least for healthcare spending; Netherlands the most
Authors: B. Roehr
Journal: BMJ (2010)

The US continues to spend more on health care and gets less for it than other industrialised countries in the latest side by side comparisons issued by health research charity, the Commonwealth Fund.

US citizens spent $7290 (£4925; €5890) per person on health care in 2007 (16% of GDP) and ranked last on the cumulative measures rated. The Netherlands had the highest overall health index and spent only about half that amount per person ($3837, 9.8% GDP).

Infant mortality was substantially higher in the US (6.7 per 1000 births) compared with the leading country Germany (3.8). The US also struggled with 110 per 100 000 deaths that could have …
Intramyocardial synthesis of pro- and anti-inflammatory cytokines in infants with congenital cardiac defects
Authors: Ma Qing, Kathrin Schumacher, Ruth Heise, Michael Wöltje, Jaime F Vazquez-Jimenez, Thomas Richter, Monika Arranda-Carrero, John Hess, Götz von Bernuth, Marie-Christine Seghaye
Journal: Journal of the American College of Cardiology (2003)