tbuckley/cabot-search huggingface dataset:
What is Mononucleosis?
Authors: WILLIAM HOROWITZ
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 March 1983What is Mononucleosis?WILLIAM HOROWITZ, M.D.WILLIAM HOROWITZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-3-415_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I take exception to the title, "Familial Chronic Mononucleosis," of the excellent article by Ballow and associates (1). In the discussion section, the paper is described as "the first report of familial chronic mononucleosis in association with mild variable immune abnormalities." By definition, infectious mononucleosis is an acute infection accompanied by irregular fever, severe pharyngitis, adenopathy, splenomegaly, and has characteristic laboratory findings: an absolute lymphocytosis with many "atypical" cells, antibodies against heterologous erythrocytes, and rising titers against the Epstein-Barr virus (2).The family as described has a mild immune deficiency disorder plus abnormal results of serologic studies...References1. BALLOWSEELYPURTILOST. ONGEAAKAMOTORICKLES MJDSKF. Familial chronic mononucleosis. Ann Intern Med. 1982;97:821-5. LinkGoogle Scholar2. WINTROBELEEBOGGSBITHELLATHENSFOERSTER MGDTJJ. Clinical Hematology. 7th ed. Philadelphia: Lea & Febiger; 1976: 1356. Google Scholar1. TOBIRAVIDFELDMAN-WEISS MZV. Prolonged atypical illness associated with serological evidence of persistent Epstein-Barr virus infection. Lancet. 1982;1:61-3. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: WILLIAM HOROWITZ, M.D.Affiliations: Montefiore Hospital & Medical Center Albert Einstein College of Medicine Bronx, NY 10461 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAzithromycin-induced rash in infectious mononucleosis 1 March 1983Volume 98, Issue 3Page: 415-415KeywordsAntibodiesCellsEpstein-Barr virusFeversImmune deficiencyPharyngitisResearch laboratoriesSplenomegaly ePublished: 1 December 2008 Issue Published: 1 March 1983 PDF downloadLoading ...
P1-03-06: Fibroadenomatoid Changes Have a Higher Occurrence Rate in Middle-Aged Benign Breast Disease Patients with the Trend Retained in Cancer Patients.
Authors: A Bekhash, JA Hooke, Y Chen, AJ Kovatich, L Kvecher, RJ Mural, CD Shriver, H Hu
Journal: Cancer Research (2011)

Abstract Background: Fibroadenoma (FA) is a common benign breast lesion known to have a high incidence rate in younger women. There are controversial reports whether FA elevates the risk of developing breast cancers. In clinical practice, FA may be surgically removed due to multiple reasons making it complicated to study its impact on the development of breast cancers that have a higher incidence rate in older women. Fibroadenomatoid change (FAC), also known as fibroadenomatous hyperplasia, is an uncommon lesion with histologic features similar to that of FA but lacking well-defined borders and usually discovered incidentally on breast biopsy specimens. FAC is not surgically targeted. The Walter Reed Army Medical Center, through the Clinical Breast Care Project, has enrolled over 2000 subjects undergoing a biopsy; all the pathology was reviewed by a single pathologist. These subjects provide an opportunity to study the age-dependent pattern of FAC in different patient populations. Methods: Subjects were enrolled following IRB-approved protocols with data collected through two comprehensive questionnaires, a Core Questionnaire and a Pathology Checklist. A total of 1964 female subjects were identified for this study, including 1135 benign/atypical, 192 in situ, and 637 invasive cancer patients. Patients were divided into three age groups: &amp;lt;=45 years, 46–65 years, and &amp;gt;=66 years. Chi-Square test in the SAS was used for statistical analysis. Results: As shown in the table, FA occurrence rate decreases significantly with increasing age in benign disease patients. FAC, on the other hand, shows a significantly higher occurrence rate in middle-aged patients with benign findings, and this trend is retained in the invasive or in situ cancer populations. FAC rate is also significantly higher in patients with cancer (invasive, or invasive and in situ combined) compared to benign patients in each age group with p-values ranging from 0.0001 to 0.019 (not shown). Discussion: Our preliminary results suggest that FAC occurs more often in middle-aged patients. It's significantly lower occurrence in patients with benign findings may be partially explained by the fact that breast cancer patients undergo more extensive surgeries, thus providing more breast tissue for pathologic evaluation. Otherwise, the increased FAC rate may suggest its role as a risk factor for cancer development. Since FAC may be considered a miniature FA that is not surgically targeted, it may be used as a window for the study of FA on its impact in cancer development. Further study needs to be performed to explain why FA and FAC have different age-dependent patterns and whether FA or FAC is a risk factor for breast cancer development. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-03-06.
Immune Thrombocytopenic Purpura
Authors: Douglas B. Cines, Victor S. Blanchette
Journal: New England Journal of Medicine (2002)

Immune thrombocytopenic purpura, which may lead to bleeding, is typically caused by antibodies directed against the platelet glycoprotein IIb/IIIa complex. Since the management of the disorder is different for children and adults, the authors of this up-to-date review provide separate sections on the two age groups. Along with advances in management, they also discuss the current understanding of pathophysiology and, in particular, the way in which autoantibodies against platelets are generated.
Secondary Sex Ratio among Women Exposed to Diethylstilbestrol <i>in Utero</i>
Authors: Lauren A. Wise, Julie R. Palmer, Elizabeth E. Hatch, Rebecca Troisi, Linda Titus-Ernstoff, Arthur L. Herbst, Raymond Kaufman, Kenneth L. Noller, Robert N. Hoover
Journal: Environmental Health Perspectives (2007)

Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women during the mid-1900s, is a potent endocrine disruptor. Previous studies have suggested an association between endocrine-disrupting compounds and secondary sex ratio.Data were provided by women participating in the National Cancer Institute (NCI) DES Combined Cohort Study. We used generalized estimating equations to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of in utero DES exposure to sex ratio (proportion of male births). Models were adjusted for maternal age, child's birth year, parity, and cohort, and accounted for clustering among women with multiple pregnancies.The OR for having a male birth comparing DES-exposed to unexposed women was 1.05 (95% CI, 0.95-1.17). For exposed women with complete data on cumulative DES dose and timing (33%), those first exposed to DES earlier in gestation and to higher doses had the highest odds of having a male birth. The ORs were 0.91 (95% C, 0.65-1.27) for first exposure at > or = 13 weeks gestation to < 5 g DES; 0.95 (95% CI, 0.71-1.27) for first exposure at > or = 13 weeks to > or = 5 g; 1.16 (95% CI, 0.96-1.41) for first exposure at < 13 weeks to < 5 g; and 1.24 (95% CI, 1.04-1.48) for first exposure at < 13 weeks to > or = 5 g compared with no exposure. Results did not vary appreciably by maternal age, parity, cohort, or infertility history.Overall, no association was observed between in utero DES exposure and secondary sex ratio, but a significant increase in the proportion of male births was found among women first exposed to DES earlier in gestation and to a higher cumulative dose.
Mechanism of fluid secretion common to aglomerular and glomerular kidneys
Authors: Klaus W. Beyenbach, Philip L-F Liu
Journal: Kidney International (1996)

Isolated renal proximal tubules of sea water fish net secrete fluid in vitro. The principal electrolytes in secreted fluid are Na, Cl, Mg and S. Transepithelial voltages may be lumen-negative or -positive by a few millivolts, and transepithelial resistances are low partly due to high paracellular Na and Cl permeabilities. Transepithelial electrochemical potentials indicate secretion of Mg into the tubule lumen by active transport. As Mg concentration in secreted fluid rises, Na concentration falls. Surprisingly, these observations of fluid secretion are made in glomerular and aglomerular proximal tubules, suggesting a fundamental mechanism common to both. Central to this commonality appears to be their behavior as open Donnan systems. Mg actively secreted into the tubule lumen from which it cannot diffuse back into the peritubular medium causes the transepithelial secretion of diffusible Na and Cl. Water follows by osmosis. Since there is flow out of the distal end of the tubule Donnan equilibrium is not attained. Instead, a dynamic Donnan system is maintained, driven by active transport of Mg. A mathematical model of tubular electrolyte and fluid secretion confirms the operation of this open, dynamic Donnan system in aglomerular and glomerular proximal tubules.
High pressure, retrograde, coronary venous delivery of FGF-2 protein improves coronary blood flow in a porcine model of myocardial ischemia
Authors: William F. Fearon, Mehrdad Rezaee, Bonnie L. Hiatt, Fumiaki Ikeno, Lynn Bailey, Takeshi Suzuki, Niall Herity, Peter J. Fitzgerald, Andrew J. Carter, Alan C. Yeung, Paul G. Yock
Journal: Journal of the American College of Cardiology (2002)
Chlorpromazine: unlocking psychosis
Authors: T. Turner
Journal: BMJ (2007)

Background: Histone deacetylase (HDAC) inhibitors are promising antitumoral drugs. Currently there are no data regarding the comparison of different HDAC inhibitors on hepatoma cells. Materials and Methods: Hepatoma cells were incubated with the HDAC inhibitors MS-275, SAHA, FK901228 and trichostatin. Proliferation was assessed via BrdU incorporation and apoptosis rate via flow cytometry. Trichostatin, SAHA and MS-275 were applied in a rat hepatoma model. Results: The agents showed antiproliferative and pro-apoptotic effects time- and dose-dependently. SAHA and MS-275 were moderately effective at 10 μM, while trichostatin A and FK901228 showed higher potency. Caspases 3 and 8 were activated upon treatment with the drugs. The agents increased the acetylation rate. Hyperacetylation did not correlate with antitumoral efficacy. In vivo, SAHA was superior to MS-275 and trichostatin A. Conclusion: The HDAC inhibitors were effective both in vitro and in vivo. The potency of SAHA and MS-275 was similar. In spite of differing affinity to the 11 known HDACs, the agents induced comparable effects. These findings suggest that these agents have further antitumoral effects apart from HDAC inhibition.
Enforcing Informed Consent Requirements: Form or Substance?
Authors: Ruth R. Faden
Journal: JAMA (1989)

In his article "Enforcing Patient Preferences: Linking Payment for Medical Care to Informed Consent," in this issue ofThe Journal,<sup>1</sup>Kapp argues that many medical interventions currently are being imposed on patients in the absence of voluntary, competent, and informed consent. He proposes that utilization review organizations link financial reimbursement for medical services to "a requirement of valid patient (or surrogate) consent."<sup>1</sup>The proposal by Kapp is that individual and institutional health care providers will not be paid for a medical service unless a signed consent form covering that service is found in the patient's chart. There are difficulties in Kapp's formulation of the problem, and many more with his formulation of the solution. With regard to the problem, although empirical research is limited, there is indeed evidence of a gap between the rhetoric of informed consent and the frequency with which physicians involve patients in medical decisions
Dermo-epidermal separation is associated with induced tenascin expression in human skin
Authors: S. SCHENK, L. BRUCKNER-TUDERMAN, R. CHIQUET-EHRISMANN
Journal: British Journal of Dermatology (2006)

Tenascin, a large glycoprotein of the extracellular matrix, shows a site-restricted distribution during embryogenesis, and can be found in adults in a variety of pathological conditions. In normal skin, tenascin is expressed at low levels, but it is upregulated in skin tumours, in a number of skin diseases with epidermal hyperproliferation and during wound healing. Several tenascin variants have been described, and these arise by alternative splicing. Using a monoclonal antibody recognizing all tenascin variants, and polyclonal antibodies specific for the large tenascin variants, we have investigated tenascin expression in bullous diseases such as epidermolysis bullosa, pemphigus, bullous pemphigoid and pemphigoid gestationis. By immunohistochemistry, we have found increased tenascin staining in all patient skin samples, with a more pronounced tenascin expression in samples of autoimmune bullous diseases. The large tenascin variants seem to be major forms of tenascin occurring in healthy skin. In patients with blistering diseases, however, these large variants appear to represent a subpopulation of the induced tenascin accumulation. These findings suggest different functions for the tenascin variants in normal and diseased skin.
The Care-Based Ethic of Nazi Medicine and the Moral Importance of What We Care About
Authors: Warren T. Reich
Journal: The American Journal of Bioethics (2001)

This article reports on an inquiry into ideas used to justify the shift of medical ethos in Germany prior to and during the Nazi era, specifically the principles of care advocated by Erwin Liek and Karl Kotschau, the era's most influential medical theorists, who argued that commitments to care of individual sick persons (Fursorge) had to give way to a preventive care that respects emerging needs of the entire society (Vorsoge). The article examines both the socio-cultural factors that shaped, and the far-reaching effects of, this manipulation of care. It argues that we should be attentive to the meaning and requirements of the care revealed in this debate, the ancient Greek idea of care as a concerned moral option.
Sex difference in prescription of asthma drugs is smaller than previously found
Authors: B D Pethica, A Tomlin, J Hall, A Penrose, G Frost
Journal: BMJ (1999)

<h3>Objective:</h3> To explore the phenotypic spectrum and pathophysiology of human disease deriving from mutations in the <i>CNTNAP1</i> gene. <h3>Methods:</h3> In a field study on consanguineous Palestinian families, we identified 3 patients carrying homozygous mutations in the <i>CNTNAP1</i> gene using whole-exome sequencing. An unrelated Irish family was detected by screening the GENESIS database for further <i>CNTNAP1</i> mutations. Neurophysiology, MRI, and nerve biopsy including electron microscopy were performed for deep phenotyping. <h3>Results:</h3> We identified 3 novel <i>CNTNAP1</i> mutations in 5 patients from 2 families: c.2015G&gt;A:p.(Trp672*) in a homozygous state in family 1 and c.2011C&gt;T:p.(Gln671*) in a compound heterozygous state with c.2290C&gt;T:p.(Arg764Cys) in family 2. Affected patients suffered from a severe CNS disorder with hypomyelinating leukodystrophy and peripheral neuropathy of sensory-motor type. Arthrogryposis was present in 2 patients but absent in 3 patients. Brain MRI demonstrated severe hypomyelination and secondary cerebral and cerebellar atrophy as well as a mega cisterna magna and corpus callosum hypoplasia. Nerve biopsy revealed very distinct features with lack of transverse bands at the paranodes and widened paranodal junctional gaps. <h3>Conclusions:</h3> <i>CNTNAP1</i> mutations have recently been linked to patients with arthrogryposis multiplex congenita. However, we show that arthrogryposis is not an obligate feature. <i>CNTNAP1</i>-related disorders are foremost severe hypomyelinating disorders of the CNS and the peripheral nervous system. The pathology is partly explained by the involvement of CNTNAP1 in the proper formation and preservation of paranodal junctions and partly by the assumed role of CNTNAP1 as a key regulator in the development of the cerebral cortex.
Hodgkin Lymphoma Post-Transplant Lymphoproliferative Disorder Following Pediatric Renal Transplant
Authors: William Makis, Robert Lisbona, Vilma Derbekyan
Journal: Clinical Nuclear Medicine (2010)

Post-transplant lymphoproliferative disorder (PTLD) occurs in 1.2% of pediatric renal transplant patients, and is frequently Epstein-Barr Virus mediated. Hodgkin Lymphoma PTLD is the rarest of the 4 types of PTLDs recognized by the World Health Organization, with an incidence of <4% of all PTLD patients. It has a distinct clinical course and treatment from all other types of PTLD. This is a case of a 16-year-old girl who had a renal transplant in 2000 due to Moya Moya disease. Her first F-18 FDG PET/CT done in 2006 showed mildly FDG-avid mediastinal adenopathy (histologically nonspecific reactive nodes), however in 2009, after presenting with fevers, a repeat PET/CT showed extensive intensely FDG-avid disease. Biopsy of a supraclavicular node identified Hodgkin Lymphoma PTLD. The patient was treated with chemotherapy and reimaged, showing excellent response to therapy. In contrast, classic PTLD is treated by withdrawal of immunosuppression and administration of Rituximab. F-18 FDG PET/CT is known to be very useful in the staging and monitoring of response to therapy in the setting of classic PTLD. In this case, serial F-18 FDG PET/CT scans proved very useful in the evaluation and follow-up of the rare and distinct Hodgkin Lymphoma PTLD subtype.
The estrogen receptor agonist/antagonist temoxifen improves endothelial function in postmenopausal women
Authors: J. Lekakis, C. Papamichael, P. Athanasiadis, N. Desses, C. Vemmos, A. Gika, A. Voutsas, S. Stamatelopoulos
Journal: Journal of the American College of Cardiology (1998)
Propranolol and lidocaine inhibit neural norepinephrine release in hearts with increased extracellular potassium and ischemia.
Authors: X J Du, R A Riemersma, K A Fox, A M Dart
Journal: Circulation (1993)

BACKGROUND Propranolol and lidocaine are effective antiarrhythmic drugs in myocardial ischemia and infarction. As sympathetic nerve activation and norepinephrine release in ischemic hearts are arrhythmogenic, we tested the possibility that both agents inhibit neural norepinephrine release following sympathetic activation in the ischemic environment. METHODS AND RESULTS The model used was an in situ perfused innervated rat heart. Norepinephrine release was induced by electrical stimulation of the left cervicothoracic stellate ganglion and analyzed using radioenzymatic assay or high-performance liquid chromatography. In normoxically perfused hearts, evoked norepinephrine release was not affected by either of the two agents at doses of 1 to 10 mumol/L when extracellular K+ concentration was 4 mmol/L but dose-dependently reduced at 10 mmol/L K+ (D,L-propranolol: -53 +/- 4% at 1 mumol/L and -64 +/- 6% at 10 mumol/L K+, lidocaine: -37 +/- 11% at 0.1 mumol/L, -67 +/- 5% at 1 mumol/L, and -75 +/- 6% at 10 mumol/L). At 10 mmol/L K+, norepinephrine release was not affected by timolol or atenolol (both 10 mumol/L but was equally inhibited by D- or L-propranolol at 10 mumol/L (-56 +/- 5% and -53 +/- 9%, respectively), indicating a beta-blocking-independent mechanism. In hearts with metabolic acidosis (pH 6.85) at K+ of 4 mmol/L, neural norepinephrine release was also reduced by propranolol at 10 mumol/L (-37%). Finally, in hearts perfused with 4 mmol/L K+ and subjected to 6-minute periods of ischemia, neural norepinephrine release was similarly suppressed by D,L-propranolol (-38 +/- 6% at 0.1 mumol/L, -44 +/- 5% at 1 mumol/L, and -78 +/- 3% at 10 mumol/L) or lidocaine (-39 +/- 7% at 0.1 mumol/L, -58 +/- 9% at 1 mumol/L, and -91 +/- 3% at 10 mumol/L). CONCLUSIONS These data indicate that propranolol and lidocaine inhibit neural norepinephrine release via a Na+ channel-blocking mechanism that is synergistic with changes induced by ischemia, primarily raised extracellular K+. This mechanism may contribute to the anti-ischemic and antiarrhythmic properties of both agents in acute myocardial ischemia, which induces increased extracellular K+ and sympathetic activation.
Arteriovenous-Shunt Thrombosis
Authors: A. Kaegi, G. F. Pineo, A. Shimizu, H. Trivedi, J. Hirsh, M. Gent
Journal: New England Journal of Medicine (1974)

The effects of sulfinpyrazone and a placebo on the incidence of thrombosis of arteriovenous shunts was investigated in a double-blind study in 52 patients on chronic hemodialysis over a six-month period. Thrombi occurred in 86 per cent of patients on placebo and 50 per cent of those on sulfinpyrazone (p<0.01). The incidence of thrombosis was reduced from 0.76 thrombi per patient month in the placebo group to 0.18 thrombi per patient month in the sulfinpyrazone group (p<0.001). Venous-shunt revisions were required in 48 per cent of patients given placebo and in only 16 per cent of those receiving sulfinpyrazone (p<0.05). Side effects were minimal and necessitated withdrawal from the study in only one patient. This study supports the results of animal experiments showing that sulfinpyrazone decreases thrombus formation the high-flow systems. (N Engl J Med 290:304–306, 1974)
Clinical and Ethical Aspects of Placebos in Clinical Practice—Reply
Authors: Andrew L. Avins
Journal: JAMA Internal Medicine (2013)

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