tbuckley/cabot-search huggingface dataset:
Internet Medical Resources
Authors: Jerry Glowniak
Journal: Annals of Internal Medicine (1996)

Letters1 February 1996Internet Medical ResourcesJerry Glowniak, MD, MDJerry Glowniak, MD, MDVeterans Affairs Medical Center; Portland, OR 97201Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-3-199602010-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The Internet is a relatively new form of electronic communication that has undergone explosive growth within the last 2 years. Unlike commercial on-line services, which are highly structured and often narrowly focused, the Internet by its very nature incorporates a diverse collection of resources and services that have little underlying organization. Because of the ease of obtaining information at publicly accessible computers on the Internet, the amount of information on the Internet is growing rapidly, especially since the introduction of graphic World Wide Web browsers at the end of 1993. As Dr. Dolin points out, finding information on ...References1. Giuse NB, Huber JT, Giuse DA, et al. Information needs of health care professionals in an AIDS outpatient clinic as determined by chart review. Journal of the American Medical Informatics Association. 1994; 1:395-403. Google Scholar2. Glowniak JV. Medical resources on the Internet. Ann Intern Med. 1995; 123:123-31. Google Scholar Author, Article, and Disclosure InformationAffiliations: Veterans Affairs Medical Center; Portland, OR 97201 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1996Volume 124, Issue 3Page: 375KeywordsAIDSComputer graphicsComputersDatabasesForecastingInternet Issue Published: 1 February 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Bilateral Lacrimal Gland Disease
Authors: Sunny X. Tang, Renelle P. Lim, Saad Al-Dahmash, Sean M. Blaydon, Raymond I. Cho, Christina H. Choe, Michael A. Connor, Vikram D. Durairaj, Lauren A. Eckstein, Brent Hayek, Paul D. Langer, Gary J. Lelli, Ronald Mancini, Alexander Rabinovich, Javier Servat, John W. Shore, Jason A. Sokol, Angelo Tsirbas, Edward J. Wladis, Albert Y. Wu, Jerry A. Shields, Carol Shields, Roman Shinder
Journal: Ophthalmology (2014)
220. Long-Term Implantation of Photo-Crosslinked Alginate Microcapsules
Authors: Feng Shen, Anna A. Li, Murray A. Potter, Patricia L. Chang
Journal: Molecular Therapy (2005)

Top of pageAbstract
Microencapsulated cells engineered to secrete therapeutic proteins have proven effective in treating several murine genetic disorders such as dwarfism, lysosomal storage disease and hemophilia, as well as multifactorial disorders such as cancer. Microcapsules are most commonly fabricated from the naturally occurring polysaccharide, alginate, and cross-linked with Ca2+ to form a hydrogel. Beads of alginate containing the cells are coated with poly-L-lysine and a further layer of alginate to make alginate-poly-L-lysine-alginate (APA) microcapsules. A concern with APA microcapsules is loss of structural integrity during long term implantation, especially in large animals. We have now improved the stability by creating covalent linkages in these hydrogel microcapsules to form an interpenetrating polymer network (IPN) with photo-polymerized sodium acrylate and N-vinyl-pyrrolidone (NVP). For application in gene therapy, these novel microcapsules must be stable, non-toxic, supportive of cell survival, biocompatible, and effective perm-selective immuno-isolating devices. We now report on some of these biological functional properties of the novel microcapsules.

While the polymers creating the IPN were safety sequestered, the viability of the encapsulated cells was adversely affected during the photo-polymerization. On the day after NVP capsule fabrication, the number of viable cells was decreased by about 50% compared to APA capsules. Alamar blue test showed the average encapsulated cell number per NVP capsule kept roughly consistent from 1 month to 9 months of implantation (530|[plusmn]|67 at 3 months, compared to 1250|[plusmn]|120 for APA capsules at 3 months). The NVP capsules were well tolerated, with no apparent toxicity clinically. Hematological monitoring showed that the neutrophil fraction at 1 week was significantly higher, reflecting an acute inflammatory reaction in the animals. However, this response was resolved after 4 weeks, and remained normal until 9 months, indicating that there was no chronic inflammatory response to the implants. Liver enzyme levels were normal for both groups throughout the experiment. The mechanical stability of NVP capsules, as measured with an osmotic pressure test at 5.2 mOsm, was twofold higher than that for classical APA capsules after up to three months of implantation. After 6 and 9 months' impanation, the NVP capsules remained stable while almost all of the APA capsules were broken. In the osmotic pressure test the retrieved NVP capsules implanted into mice for 6 and 9 months remained 45% intact (at 5.2 mOsm), compared to 60% for the capsules before implantation.

In conclusion, the NVP covalently-modified microcapsules have shown a high level of biocompatibility and safety, along with an increase in stability for use as immuno-isolation devices in gene therapy.
Longitudinal Study of Psychiatric Symptoms, Disability, Mortality, and Emigration Among Bosnian Refugees
Authors: Richard F. Mollica
Journal: JAMA (2001)

Evidence is emerging that psychiatric disorders are common in populations affected by mass violence. Previously, we found associations among depression, posttraumatic stress disorder (PTSD), and disability in a Bosnian refugee cohort.To investigate whether previously observed associations continue over time and are associated with mortality emigration to another region.Three-year follow-up study conducted in 1999 among 534 adult Bosnian refugees originally living in a refugee camp in Croatia. At follow-up, 376 (70.4%) remained living in the region, 39 (7.3%) were deceased, 114 (21.3%) had emigrated, and 5 (1%) were lost to follow-up. Those still living in the region and the families of the deceased were reinterviewed (77.7% of the original participants).Depression and PTSD diagnoses, based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and measured by the Hopkins Symptom Checklist-25 and the Harvard Trauma Questionnaire, respectively; disability, measured by the Medical Outcomes Study Short-Form 20; and cause of death, determined by family interviews with review of death certificates, if available.In 1999, 45% of the original respondents who met the DSM-IV criteria for depression, PTSD, or both continued to have these disorders and 16% of respondents who were asymptomatic in 1996 developed 1 or both disorders. Forty-six percent of those who initially met disability criteria remained disabled. Log-linear analysis revealed that disability and psychiatric disorder were related at both times. Male sex, isolation from family, and older age were associated with increased mortality after adjusting for demographic characteristics, trauma history, and health status (for male sex, adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 1.17-5.92; living alone, OR, 2.40; 95% CI, 1.07-5.38; and each 10-year increase in age, OR, 1.91; 95% CI, 1.34-2.71). Depression was associated with higher mortality in unadjusted analysis but was not after statistical adjustment (unadjusted OR, 3.12; 95% CI, 1.55-6.26; adjusted OR, 1.85; 95% CI, 0.82-4.16). Posttraumatic stress disorder was not associated with mortality or emigration. Spending less than 12 months in the refugee camp (OR, 11.30; 95% CI, 6.55-19.50), experiencing 6 or more trauma events (OR, 3.34; 95% CI, 1.89-5.91), having higher education (OR, 1.90; 95% CI, 1.10-3.29), and not having an observed handicap (OR, 0.11; 95% CI, 0.02-0.52) were associated with higher likelihood of emigration. Depression was not associated with emigration status.Former Bosnian refugees who remained living in the region continued to exhibit psychiatric disorder and disability 3 years after initial assessment. Social isolation, male sex, and older age were associated with mortality. Healthier, better educated refugees were more likely to emigrate. Further research is necessary to understand the associations among depression, emigration status, and mortality over time.
Aortic Plaque Morphology and Vascular Events
Authors: Ariel Cohen, Christophe Tzourio, Bernard Bertrand, Christophe Chauvel, Marie-Germaine Bousser, Pierre Amarenco
Journal: Circulation (1997)

Background Atherosclerotic disease of the aortic arch has been found to be associated with the risk of ischemic stroke. We have shown that atherosclerotic plaques ≥4 mm in thickness in the ascending aorta and proximal arch detected by transesophageal echocardiography are a risk factor for ischemic stroke. The purpose of this study was to evaluate the impact, if any, of plaque morphology (ulceration, hypoechoic plaques or calcification) on the risk of subsequent vascular events. Methods and Results We followed for a period of 2 to 4 years, a cohort of 334 patients 60 years or older who were consecutively admitted with brain infarction and who had transesophageal echocardiography. The risk of vascular events in patients with plaques in the aortic arch according to the presence of surface ulceration, calcifications, and sessile or mobile thrombus was estimated during a total of 788 person-years of follow-up. Hypoechoic plaques, calcifications, and ulceration were more frequently found in patients with plaques ≥4 mm as compared with those with plaques &lt;4 mm. The presence of ulceration did not increase the relative risk of vascular events in patients with plaque ≥4 mm (the relative risk was 4.3 [ P &lt;.001] in those with ulceration and 5.7 [ P &lt;.001]) in those without ulceration. The lack of calcification did increase the risk of vascular events in patients with plaque ≥4 mm. The highest relative risk of events was found among the patients with noncalcified plaques (relative risk, 10.3; 95% confidence interval, 4.2 to 25.2; P &lt;.001). The risk of events was systematically higher in patients without calcifications than in patients with calcifications regardless of what other morphological features were considered. Conclusions In patients with brain infarction, the risk associated with aortic plaque thickness (≥4 mm) is markedly increased by the absence of plaque calcifications. These findings are important for the design of therapeutic trials in such patients.
Resting Myocardial Blood Flow Is Impaired in Hibernating Myocardium
Authors: Joseph B. Selvanayagam, Michael Jerosch-Herold, Italo Porto, David Sheridan, Adrian S.H. Cheng, Steffen E. Petersen, Nick Searle, Keith M. Channon, Adrian P. Banning, Stefan Neubauer
Journal: Circulation (2005)

Background— Although impairment in perfusion reserve is well recognized in hibernating myocardium, there is substantial controversy as to whether resting myocardial blood flow (MBF) is reduced in such circumstances. Quantitative first-pass cardiovascular magnetic resonance (CMR) perfusion imaging allows absolute quantification of MBF. We hypothesized that MBF assessed at rest by quantitative CMR perfusion imaging is reduced in hibernating myocardium. Methods and Results— Twenty-seven patients with 1 or 2-vessel coronary disease and at least 1 dysfunctional myocardial segment undergoing PCI were studied with preprocedure, early (24 hours), and late (9 months) postprocedure CMR imaging. First-pass perfusion images at rest were acquired in 3 short-axis planes by use of a T1-weighted turboFLASH sequence. In each slice, MBF was determined for 8 myocardial segments in mL · min −1 · g −1 by deconvolution of signal intensity curves with an arterial input function measured in the left ventricular blood pool. Cine MRI for assessment of global and segmental function and delayed enhancement MRI for detection of viability were also obtained. All coronary lesions were 80% to 95% stenosis in severity. Over all segments, mean MBF normalized by rate-pressure product (“corrected MBF”) was 1.2±0.3 mL · min −1 · g −1 · (mm Hg · bpm/10 4 ) −1 in segments without significant coronary stenosis and 0.7±0.2 mL · min −1 · g −1 · (mm Hg · bpm/10 4 ) −1 in segments with coronary stenosis before PCI (mixed model controlling for slice and segment z =−23.9, P &lt;0.001). Early after the procedure, the MBF was 1.2±0.2 mL · min −1 · g −1 · (mm Hg · bpm/10 4 ) −1 in revascularized segments and 1.3±0.2 mL · min −1 · g −1 · (mm Hg · bpm/10 4 ) −1 in nondiseased segments ( z =−6.1, P &lt;0.001). Late after PCI, the systolic wall thickening and end-diastolic wall thickness both increased significantly more (both P &lt;0.001) in the myocardial segments subtended by severe coronary stenosis (8±17% to 40±19% and 6.5±1.1 to 9.3±2 mm, respectively) than in the myocardial segments supplied by nondiseased vessels. Mean MBF in dysfunctional segments with significantly improved contraction after revascularization was 0.8±0.2 mL · min −1 · g −1 · (mm Hg · bpm/10 4 ) −1 before PCI and 1.2±0.2 mL · min −1 · g −1 · (mm Hg · bpm/10 4 ) −1 after PCI ( z =2.0, P =0.04). Conclusions— CMR perfusion imaging detects impaired resting MBF in hibernating myocardial segments.
Diagnostic Strategies for Excluding Pulmonary Embolism in Clinical Outcome Studies
Authors: Marieke J.H.A. Kruip, Monique G.L. Leclercq, Cees van der Heul, Martin H. Prins, Harry R. Bller
Journal: Annals of Internal Medicine (2003)

Pulmonary embolism is a common clinical disorder that is associated with high morbidity and mortality if untreated. It is important to confirm or rule out the diagnosis in patients with clinical suspicion of the disease.To evaluate various diagnostic strategies for excluding pulmonary embolism.MEDLINE (1966 to February 2003), EMBASE, and DARE; study investigators; and reference lists.Prospective clinical outcome studies.The researchers recorded the frequency of symptomatic venous thromboembolism over 3 months of follow-up in patients in whom pulmonary embolism had been excluded according to various strategies. Strategies were divided into three categories according to the number of rounds of diagnostic tests needed to exclude pulmonary embolism.25 studies involving more than 7000 patients were included. In all referred patients, two strategies-normal results on pulmonary angiography or lung scintigraphy and normal d -dimer levels combined with low clinical probability-safely excluded pulmonary embolism (failure rates < or = 3%). In the second round of diagnostic tests, in patients who had had a nondiagnostic lung scan, both pulmonary angiography and serial leg testing for venous thrombosis were accurate and safe. When d -dimer testing combined with clinical probability was inconclusive, a normal perfusion lung scan safely excluded pulmonary embolism. Accumulating evidence shows that normal results on spiral computed tomography may also safely exclude the disease.Many diagnostic strategies to exclude pulmonary embolism have been evaluated in consecutive patients. Interest is likely to increase in a simple, fast strategy, starting with a normal perfusion lung scan or a combination of normal d -dimer levels and low clinical probability. After the initial round of testing, a reliable diagnostic method, such as angiography or lung scintigraphy, is warranted.
Preferential influx and decreased fractional loss of lipoprotein(a) in atherosclerotic compared with nonlesioned rabbit aorta.
Authors: L B Nielsen, S Stender, M Jauhiainen, B G Nordestgaard
Journal: Journal of Clinical Investigation (1996)

The aim was to investigate the atherogenic potential of lipoprotein(a) (Lp(a)) and to further our understanding of the atherogenic process by measuring rates of transfer into the intima-inner media (i.e., intimal clearance) and rates of loss from the intima-inner media (i.e., fractional loss) of Lp(a) and LDL using cholesterol-fed rabbits with nonlesioned (n = 13) or atherosclerotic aortas (n = 12). In each rabbit, 131I-Lp(a) (or 131I-LDL) was injected intravenously 26 h before and 125I-Lp(a) (or 125I-LDL) 3 h before the aorta was removed and divided into six consecutive segments of similar size. The intimal clearance of Lp(a) and LDL was similar and markedly increased in atherosclerotic compared with nonlesioned aortas (ANOVA, effect of atherosclerosis: P < 0.0001). Fractional losses of labeled Lp(a) and labeled LDL in atherosclerotic aorta were on average 25 and 43%, respectively, of that in nonlesioned aortas (ANOVA, effect of atherosclerosis: P < 0.0001). Fractional loss of Lp(a) was 73% of that of LDL (ANOVA, effect of type of lipoprotein: P = 0.07). These data suggest that the development of atherosclerosis is associated with increased influx as well as decreased fractional loss of Lp(a) and LDL from the intima. Accordingly, Lp(a) may share with LDL the potential for causing atherosclerosis.
Secretion of chemokines and other cytokines in allergen-induced nasal responses: inhibition by topical steroid treatment.
Authors: T C Sim, L M Reece, K A Hilsmeier, J A Grant, R Alam
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

We have demonstrated the detection of proallergic cytokines in the nasal secretions after antigen challenges. Our aim was to determine the secretion kinetics of chemokines (interleukin [IL]-8, macrophage inflammatory protein-1 alpha [MIP-1 alpha], and RANTES) and other cytokines (IL-1 beta and granulocyte/macrophage colony-stimulating factor [GM-CSF] after allergen challenges and their inhibition by steroid therapy. Ten allergic patients were given either beclomethasone dipropionate (BDP) or placebo in a double-blind, randomized, crossover manner. Allergen challenges were performed after 1 wk of treatment. Nasal secretions were collected serially for 11 h after allergen challenge by a matrix method. Subjects maintained symptom scores at each time point of nasal secretion recovery. Cytokines were measured by specific enzyme-linked immunosorbent assays. The mean peak values for each cytokine and total symptom scores during the early (ER) and/or late-phase reactions (LPR) were significantly reduced during the BDP treatment period (p < 0.05). The levels of cytokine correlated (p < 0.05) with corresponding total symptom scores during ER (IL-1 beta and MIP-1 alpha) and LPR (all cytokines). Our findings document local elevations of IL-1 beta, GM-CSF, and chemokines in the nasal secretions after allergen challenges and their inhibition by steroids. We speculate that the inhibition of cytokine production and secretion in the nasal mucosa may contribute to the clinical efficacy of topical steroids.
Olujimi Akanbi Soboyejo
Authors: George Thorpe
Journal: BMJ (2005)

Former consultant physician Lagos, Nigeria (b Lagos 1920; q Birmingham, England, 1950; TDD, DPH, FMPCH, FWACP), d 28 June 2004.

Returning to Nigeria from the United Kingdom in 1952, Jimi, as he was affectionately known, joined the Federal Ministry of Health, becoming a consultant physician in 1961. He was promoted to senior specialist in charge of the Federal Tuberculosis Unit. In 1968 Jimi was appointed the first permanent secretary, Ministry of Health and Social Welfare, in the newly created Lagos state government, a post that he held until his retirement in 1975. Jimi was chief of his tribe and was actively involved in many organisations, including the Nigerian Medical Association, the Scouts, and his church. He leaves a wife, Vivienne, and four daughters.
Thyroid Function and Mortality in Patients Treated for Hyperthyroidism
Authors: Jayne A. Franklyn
Journal: JAMA (2005)

Hyperthyroidism has been reported to cause excess all-cause and circulatory mortality. Whether this can be reversed is unknown, as is the influence of mild persisting thyroid dysfunction and treatment-induced hypothyroidism.To determine whether radioiodine treatment is associated with increased mortality and to determine the influences of mild thyroid dysfunction and the development of overt hypothyroidism treated with thyroxine (T(4)).A population-based study of 2668 individuals aged 40 years or older treated for overt hyperthyroidism with radioiodine in the West Midlands region of England from 1984-2002.Cause of death compared with age- and period-specific mortality in England and Wales and assessment of the influence of T(4) therapy for radioiodine-induced hypothyroidism and subclinical thyroid dysfunction on mortality.In 15,968 person-years of follow-up, 554 died vs 487 expected deaths (standardized mortality ratio [SMR], 1.14; 95% confidence interval [CI], 1.04-1.24, P=.002). Increased risks of all-cause and circulatory deaths vs age- and period-specific mortality were observed in follow-up in those not requiring, or prior to, T(4) therapy. These increased risks were not observed during follow-up on T(4) therapy (circulatory disease SMR prior to T(4), 1.33; 95% CI, 1.14-1.53 vs SMR, 0.91; 95% CI, 0.70-1.17 during T(4)). Patients receiving T(4) had decreased risk of mortality vs risk in the period not requiring, or prior to, T(4) therapy (all-cause mortality hazard ratio [HR], 0.65; 95% CI, 0.54-0.79; circulatory mortality HR, 0.65; 95% CI, 0.48-0.87). Increased all-cause mortality vs the background population was observed in the period prior to T(4) therapy in follow-up associated with low, normal, and high serum thyrotropin. The SMR for ischemic heart disease increased slightly when analyzed by serum thyrotropin, high serum thyrotropin being the highest SMR (low thyrotropin SMR, 1.06; 95% CI, 0.75-1.45; normal thyrotropin SMR, 1.17; 95% CI, 0.76-1.71; high thyrotropin SMR, 1.48; 95% CI, 0.86-2.37). Comparison within the cohort showed that mild hypothyroidism prior to T(4) therapy was associated with increased risk of mortality from ischemic heart disease vs biochemical euthyroidism (HR, 2.08; 95% CI, 1.04-4.19).Patients treated with radioiodine for hyperthyroidism had increased mortality vs age- and period-specific mortality in England and Wales, a finding no longer evident during T(4) therapy. This supports treating hyperthyroidism with doses of radioiodine sufficient to induce overt hypothyroidism. The association within the cohort of mortality from ischemic heart disease with subclinical hypothyroidism suggests T(4) replacement should be considered should this biochemical abnormality develop after radioiodine therapy.