tbuckley/cabot-search huggingface dataset:
Sleep-disordered Breathing and Hypotension
Authors: CHRISTIAN GUILLEMINAULT, JOHN L. FAUL, RICCARDO STOOHS
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

We investigated the presence of low blood pressure (BP) in 4,409 subjects referred for overnight polysomnography. A low resting arterial BP (systolic BP < 105 mm Hg, diastolic BP < 65 mm Hg) was present in 101 subjects (2.3%). Low BP was more prevalent in subjects with upper airway resistance syndrome (UARS) (23%) than in subjects with obstructive sleep apnea syndrome (OSAS) (0.06%), parasomnia (0.7%), restless leg syndrome (0.9%), or psychological insomnia (0.9%). In order to investigate BP homeostasis, we conducted polysomnography followed by tilt-table testing on 15 subjects with orthostatic intolerance (OI) and UARS, five normotensive subjects with UARS, five subjects with insomnia and low BP, 15 subjects with OSAS, and 15 healthy control subjects. Fifteen subjects with UARS and OI and 15 healthy controls also underwent 24-h ambulatory BP monitoring. Subjects with OI and UARS had lower mean daytime systolic (119 +/- 28 mm Hg) and diastolic (75 +/- 18 mm Hg) BP than did control subjects (131 +/- 35 mm Hg and 86 +/- 19 mm Hg, respectively) (p < 0.05). During tilt-table testing, subjects with UARS and a history of OI had a greater decrease in systolic BP (27 +/- 3 mm Hg) than did control subjects (7.5 +/- 1.6 mm Hg), subjects with OSAS (6.8 +/- 1.2 mm Hg), normotensive subjects with UARS (7.2 +/- 0.84 mm Hg), or hypotensive insomniacs (7.4 +/- 1.1 mm Hg) (p < 0.01). We conclude that approximately one fifth of subjects with UARS have low BP and complain of OI. Tilt-table testing may be indicated to confirm orthostatic intolerance in subjects with UARS.
The Case for a Smoker's License
Authors: Simon Chapman
Journal: PLoS Medicine (2012)

Background to the debate Tobacco continues to kill millions of people around the world each year and its use is increasing in some countries, which makes the need for new, creative, and radical efforts to achieve the tobacco control endgame vitally important. One such effort is discussed in this PLOS Medicine Debate, where Simon Chapman presents his proposal for a "smoker's license" and Jeff Collin argues against. Chapman sets out a case for introducing a smart card license for smokers designed to limit access to tobacco products and encourage cessation. Key elements of the smoker's license include smokers setting daily limits, financial incentives for permanent license surrender, and a test of health risk knowledge for commencing smokers. Collin argues against the proposal, saying that it would shift focus away from the real vector of the epidemic—the tobacco industry—and that by focusing on individuals it would censure victims, increase stigmatization of smokers, and marginalize the poor.
Risk Factors Associated with Severe Proliferative Retinopathy in Insulin-dependent Diabetes Mellitus
Authors: H J Bodansky, A G Cudworth, P L Drury, Eva M Kohner
Journal: Diabetes Care (1982)

The natural history of disease and suspected risk factors for bad prognosis were investigated in 40 subjects with insulin-dependent diabetes mellitus who had severe retinopathy and in 22 patients with a similar duration of diabetes without evidence of complications. The retinopathy group showed a marked excess of men (ratio 2:1). Examination of the data in the literature also showed a striking excess of men, 61% (P &amp;lt; 0.001) in patients with insulin-dependent diabetes and severe microvascular disease. In addition, proliferative retinopathy was found to have significant associations with current poor diabetic control, hypertension, and previous treatment with once-daily insulin regimens, particularly with protamine zinc insulin.
Long-term trial of local guanethidine in treatment of eye signs of thyroid dysfunction and idiopathic lid retraction.
Authors: A L Crombie, A A Lawson
Journal: BMJ (1967)

The advent of adrenergic blocking agents has provided a new tool in the treatment of the eye signs of thyroid dysfunction and idiopathic lid retraction. The increasing availability of local ophthalmic preparations of these drugs has resulted in the trial of some of them in the treatment of these distressing eye conditions. For example, Lee, Morimoto, Bronsky, and Waldstein (1961) described the therapeutic use of local phentol amine, and Sneddon and Turner (1966) and Gay and Wolkstein (1966), in almost simultaneous communications, reported favourably on the short-term use of local guanethidine (Ismelin). Sneddon and Turner (1966) also reported on the effects of conjunctival administration of the ?-adrenergic block ing agent propranolol, and Gay, Salmon, and Wolkstein (1967) have suggested that local bethanidine may also be of value.
Resting-State Functional Magnetic Resonance Imaging Activity and Connectivity and Cognitive Outcome in Traumatic Brain Injury
Authors: Eva M. Palacios, Roser Sala-Llonch, Carme Junque, Teresa Roig, Jose M. Tormos, Nuria Bargallo, Pere Vendrell
Journal: JAMA Neurology (2013)

The study of brain activity and connectivity at rest provides a unique opportunity for the investigation of the brain substrates of cognitive outcome after traumatic axonal injury. This knowledge may contribute to improve clinical management and rehabilitation programs.To study functional magnetic resonance imaging abnormalities in signal amplitude and brain connectivity at rest and their relationship to cognitive outcome in patients with chronic and severe traumatic axonal injury.Observational study.University of Barcelona and Hospital Clinic de Barcelona, Barcelona, and Institut Guttmann-Neurorehabilitation Hospital, Badalona, Spain.Twenty patients with traumatic brain injury (TBI) were studied, along with 17 matched healthy volunteers.Resting-state functional magnetic resonance imaging and diffusion tensor imaging data were acquired. After exploring group differences in amplitude of low-frequency fluctuations (ALFF), we studied functional connectivity within the default mode network (DMN) by means of independent component analysis, followed by a dual regression approach and seed-based connectivity analyses. Finally, we performed probabilistic tractography between the frontal and posterior nodes of the DMN.Signal amplitude and functional connectivity during the resting state, tractography related to DMN, and the association between signal amplitudes and cognitive outcome.Patients had greater ALFF in frontal regions, which was correlated with cognitive performance. Within the DMN, patients showed increased connectivity in the frontal lobes. Seed-based connectivity analyses revealed augmented connectivity within surrounding areas of the frontal and left parietal nodes of the DMN. Fractional anisotropy of the cingulate tract was correlated with increased connectivity of the frontal node of the DMN in patients with TBI.Increased ALFF is related to better cognitive performance in chronic TBI. The loss of structural connectivity produced by damage to the cingulum tract explained the compensatory increases in functional connectivity within the frontal node of the DMN.
Time-dependent risk of and predictors for cardiac arrest recurrence in survivors of out-of-hospital cardiac arrest with chronic coronary artery disease.
Authors: T Furukawa, J J Rozanski, A Nogami, K Moroe, A J Gosselin, J W Lister
Journal: Circulation (1989)

One hundred one consecutive patients with chronic coronary artery disease who had survived out-of-hospital cardiac arrest in the absence of acute myocardial infarction underwent electrophysiologic evaluation and were followed prospectively. Ventricular tachyarrhythmias were inducible in 76 patients (75%) in the control state and were suppressed by antiarrhythmic drugs or surgery in 32 of the 76 patients (42%). During a mean follow-up of 27 months, cardiac arrest recurred in 21 patients: in two of the 25 patients in whom ventricular tachyarrhythmias were not inducible in the control state, three of the 32 in whom inducible ventricular tachyarrhythmias were suppressed after treatment, and 16 of the 44 in whom inducible ventricular tachyarrhythmias could not be suppressed after treatment. Actuarial rate of cardiac arrest recurrence was 11.2% during the first 6 months of follow-up ("high-risk early phase") and then decreased to less than 4% in each subsequent 6-month period. Multivariate Cox proportional hazards analysis identified an ejection fraction less than 35% (p = 0.0013) and persistent inducibility of ventricular tachyarrhythmias (p = 0.0025) as independent predictors of cardiac arrest recurrence for the entire follow-up period. Separate analysis of variables within and after the first 6 months showed that an ejection fraction less than 35% was the strongest predictor for early phase recurrence (p = 0.0078) but had only marginally significant predictive value for late phase recurrence (p = 0.0516). Persistent inducibility of ventricular tachyarrhythmias had no significant predictive value for early phase recurrence (p = 0.1382) but was the strongest predictor for late phase recurrence (p = 0.0061). These data suggest that, in patients with chronic coronary artery disease who survive out-of-hospital cardiac arrest, poor ejection fraction and persistent inducibility of ventricular tachyarrhythmias have a different predictive influence on early and late phase recurrence. Time-dependent risk factor analysis may have great clinical relevance in assessing an individual's changing risk over time.
Absence of Response to Levodopa in Parkinson's Disease
Authors: R. J. Mones
Journal: JAMA (1971)

To the Editor.—  This letter is in regard to the treatment of patients with Parkinson's disease who are non-responsive to levodopa. For the past six months, six patients with Parkinson's disease who have been unresponsive to levodopa in doses of 6 to 8 gm per day for a period of 6 to 12 months have been studied. These patients are somewhat unique in that they have had no therapeutic response to levodopa nor have they had any dyskinesias due to this longterm levodopa therapy.  These patients have been studied, and their response to levodopa alone was compared to their clinical response to levodopa plus MK 486, a Dopa decarboxylase inhibitor. During the trial of levodopa and the trial of MK 486 plus levodopa, blood levels of levodopa were determined, as were the homovanillic acid levels in the lumbar cerebrospinal fluid (CSF). These six patients had no clinical response to the
Brachial Neuritis with Colitic Arthritis
Authors: MICHAEL G. COHEN
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 May 1987Brachial Neuritis with Colitic ArthritisMICHAEL G. COHEN, M.B., B.S., JOHN WEBB, M.D.MICHAEL G. COHEN, M.B., B.S.Search for more papers by this author, JOHN WEBB, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-5-780_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Neurologic abnormalities have rarely been described in patients with inflammatory bowel disease, are diverse in nature, and have not been reported in patients with colitic arthritis. We present the report of a patient who had brachial neuritis possibly caused by colitic arthritis.A 32-year-old woman was hospitalized with fluctuating, asymmetrical polyarthritis of 2 months' duration, persistent abdominal cramping, diarrhea, weight loss, and subsequent severe bilateral shoulder and arm pain. She had had two previous episodes of oligoarthritis and a 10-year history of recurrent episodes of abdominal pain with diarrhea, marked by up to ten bowel movements a...References1. GOODUTSINGER AP. Enteropathic arthritis. In: KELLEY WN, HARRIS ED, RUDDY S, SLEDGE CB, eds. Textbook of Rheumatology. Philadelphia: W. B. Saunders Company; 1985:1031-41. Google Scholar2. GOOD A. Reiter's disease: a review with special attention to cardiovascular and neurologic sequellae. Semin Arthritis Rheum. 1974;3:253-86. CrossrefMedlineGoogle Scholar3. RANKINWATTSMELNYKKELLEY GHCM. National Co-operative Crohn's Disease Study: extraintestinal manifestations and perianal complications. Gastroenterology. 1979;77:914-20. CrossrefMedlineGoogle Scholar4. GENDELMANPRESENTJANOWITZ SDH. Neurological complications of inflammatory bowel disease (IBD) [Abstract]. Gastroenterology. 1982;82:1065. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Royal North Shore Hospital of Sydney St. Leonards Australia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAcquired NeuropathiesPolyneuropathie sensitivomotrice au cours d'une poussée de maladie de CrohnBilateral foot drop, weight loss and rectal bleeding as an acute presentation of Crohn's disease.Facial Palsy and Partial Accommodative Insufficiency Associated with Sulphasalazine Treatment in a Patient with Ankylosing SpondylitisRheumatic manifestations of inflammatory bowel diseaseNeurophysiologic Studies of Patients with Crohn's Disease on Long-Term Treatment with MetronidazolePolyneuropathy: an unusual extraintestinal manifestation of Crohn's diseaseNeurologic Manifestations of Gastrointestinal Disease 1 May 1987Volume 106, Issue 5Page: 780-781KeywordsAbdominal painArthritisDiarrheaInflammatory arthritisInflammatory bowel diseaseShouldersWeight loss Issue Published: 1 May 1987 PDF DownloadLoading ...
Death in Hospital
Authors: J. D. W. Whitney, B. R. Collier, B. Jones, P. B. Dando
Journal: BMJ (1974)

<h3>Summary</h3> FGFs are key developmental regulators which typically direct cell proliferation, survival, and migration following the engagement of tyrosine kinase receptors. We find that coordinate loss of <i>Fgfr1</i> and <i>Fgfr2</i> in cranial neural crest cells results in facial clefting and mandibular defects with high levels of apoptosis, and that suppressing cell death alleviates the mutant phenotype. To identify critical downstream signaling pathways that regulate these processes, we generated allelic series of knock-in point mutations in each gene that disrupt binding of signaling effectors to the receptors, alone or in combination, as well as a kinase dead allele of <i>Fgfr2</i> which broadly phenocopies the null mutant. While signaling mutations in either receptor, even when combined, failed to recapitulate the null mutant phenotypes, they revealed discrete roles for various pathways in regulating specific aspects of craniofacial development. We furthermore found that these signaling mutations together abrogate multiple established FGF-induced signal transduction pathways, while other FGF functions such as cell-matrix and cell-cell adhesion remain unaffected. Our studies establish combinatorial roles of both <i>Fgfr1</i> and <i>Fgfr2</i> in development and identify novel kinase-dependent cell adhesion properties for FGF receptors, beyond their well-established roles in intracellular signaling.
Ventricular tachycardia in a young population without overt heart disease.
Authors: B J Deal, S M Miller, D Scagliotti, D Prechel, J L Gallastegui, R J Hariman
Journal: Circulation (1986)

Since 1974, 24 young patients presenting with ventricular tachycardia and without clinical evidence of heart disease were evaluated and followed. Sixteen patients (67%) were symptomatic. Clinical episodes of ventricular tachycardia were sustained in 18, incessant in four, and nonsustained in two patients. The rate of tachycardia ranged from 130 to 300 beats/min (mean = 200 beats/min). Subtle abnormalities of cardiac size or function were present at cardiac catheterization in 16 of 23 patients (70%). During electrophysiologic studies, spontaneous ventricular tachycardia was present in six patients. The clinical ventricular tachycardia was inducible by programmed stimulation in 13 of 18 patients. The site of origin of tachycardia based on endocardial mapping in 17 patients was the right ventricle in 14, the ventricular septum in one, and indeterminate in two patients. Seventeen patients were treated based on results of short-term drug testing. During a mean follow-up period of 7.5 years, three patients died suddenly; none of these patients were receiving antiarrhythmic medication at the time of death. We conclude that in a young population without clinical evidence of heart disease, ventricular tachycardia may be the first manifestation of cardiomyopathy, since at least two-thirds of these patients have abnormalities at cardiac catheterization. Without treatment mortality in this population may be as high as 13% over an 8 year period. Presently we recommend treatment of ventricular tachycardia in any symptomatic patient, with therapy guided by electrophysiologic and treadmill testing. In addition, we recommend treatment for any asymptomatic patient with exercise-related tachycardia, since this group appears to be at increased risk for sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)
Haemophilus aphrophilus Endocarditis
Authors: R. M. Pine, H. S. Ballard
Journal: BMJ (1970)

MEBRITJSHIn view of the prognostic and therapeutic implications, the possibility of a malabsorption syndrome should always be firmly excluded in patients presenting with renal tubular defects and osteomalacia before the diagnosis of an irrevers- ible renal disorder is accepted.
The Appropriateness of Use of Coronary Artery Bypass Graft Surgery in New York State
Authors: Lucian L. Leape
Journal: JAMA (1993)

<h3>Objective.</h3> —To determine the appropriateness of use of coronary artery bypass graft surgery in New York State. <h3>Design.</h3> —Retrospective randomized medical record review. <h3>Setting.</h3> —Fifteen randomly selected hospitals in New York State that provide coronary artery bypass graft surgery. <h3>Patients.</h3> —Random sample of 1338 patients undergoing isolated coronary artery bypass graft surgery in New York State in 1990. <h3>Main Outcome Measures.</h3> —Percentage of patients who had bypass surgery for appropriate, inappropriate, or uncertain indications; operative (30-day) mortality; and complications. <h3>Results.</h3> —Nearly 91% of the bypass operations were rated appropriate; 7%, uncertain; and 2.4%, inappropriate. This low inappropriate rate differs substantially from the 14% rate found in a previous study of patients operated on in 1979,1980, and 1982. The difference in rates was not due to more lenient criteria but to changes in practice, the most important being that the fraction of patients receiving coronary artery bypass grafts for one- and two-vessel disease fell from 51% to 24%. Individual hospital rates of inappropriateness (0% to 5%) did not vary significantly. Rates of appropriateness also did not vary by hospital location, volume, or teaching status. Operative mortality was 2.0%; 17% of patients suffered a complication. Complication rates varied significantly among hospitals (<i>P</i>&lt;.01) and were higher in downstate hospitals. <h3>Conclusions.</h3> —The rates of inappropriate and uncertain use of coronary artery bypass graft surgery in New York State were very low. Rates of inappropriate use did not vary significantly among hospitals, or according to region, volume of bypass operations performed, or teaching status. (<i>JAMA</i>. 1993;269:753-760)
Clinical Use of New Video-Endoscopes (EVIS 100 and 200)
Authors: H. Niwa, A. Kawaguchi, T. Miyahara, H. Koyama
Journal: Endoscopy (1992)

The authors report on their clinical experience with two new videoendoscopes developed in cooperation with Olympus Co. One of them is an instantaneous image method videoendoscope (EVIS 100), the other produces sequential images (EVIS 200). EVIS 100 is as compact as a fiberscope; EVIS 200 has the special advantages of electronic magification, the use of infrared rays and image display of hemoglobin concentration in the tissue. In clinical application in 245 patients examined with EVIS 100 and 30 cases with EVIS 200, both instruments were found to be satisfactory in terms of daily use; EVIS 200 could be applied in further endoscopic research. In our opinion videoendoscopes will replace conventional fiberscopes in the future.
The effect of alendronate on progression of spinal osteophytes and disc-space narrowing
Authors: T Neogi, M C Nevitt, K E Ensrud, D Bauer, D T Felson
Journal: Annals of the Rheumatic Diseases (2008)

Bisphosphonates may have chondroprotective effects that could be of relevance in osteoarthritis. Using data from a large fracture prevention trial, we evaluated the effect of alendronate on the progression of radiographic spinal osteophytes (OST) and disc-space narrowing (DSN).The Fracture Intervention Trial (FIT) evaluated the effectiveness of alendronate at 5 mg/day (first 2 years) followed by 10 mg/day (third year) vs placebo over 3-4 years in preventing osteoporotic fractures. In 200 randomly selected subjects from FIT, we read baseline and follow-up lateral x rays for anterior OST and DSN (both scored 0-3 at each vertebral level) in the thoracic and lumbar spine. We calculated the mean difference in change in the sum of OST and DSN scores at T4 to L5 from baseline to follow-up, respectively, in each treatment arm using linear regression.The participants' baseline characteristics were similar in the alendronate and placebo arms. The adjusted mean change in summary OST score was less in the alendronate group compared to placebo (3.2 vs 4.7, p = 0.04), indicating that OST progression was less in the alendronate group. The adjusted mean change in summary DSN score was less in the alendronate group vs placebo for the whole spine (0.4 vs 0.7, p = 0.2), particularly when limited to the lumbar spine (0.3 vs 0.6, p = 0.04).In this secondary analysis of data from a randomised controlled trial, alendronate was associated with less spinal OST and DSN progression than placebo. This suggests a role for bisphosphonates in altering the pathological processes seen in osteoarthritis.
Anti-KCNQ1 K+ channel autoantibodies increase IKs current and are associated with QT interval shortening in dilated cardiomyopathy
Authors: Jin Li, Claudia Seyler, Felix Wiedmann, Constanze Schmidt, Patrick A. Schweizer, Rüdiger Becker, Hugo A. Katus, Dierk Thomas
Journal: Cardiovascular Research (2013)

Autoimmune-associated proarrhythmia in dilated cardiomyopathy (DCM) is poorly understood. Given the significance of KCNQ1 potassium channels in heart rhythm disorders, we hypothesized that circulating anti-KCNQ1 autoantibodies directly modulate cardiac electrophysiology in DCM patients. The purpose of this pilot study was to characterize ion channel autoantibodies in DCM targeting the cardiac repolarizing K(+) current, IKs, and the underlying KCNQ1 potassium channel.One hundred and fifty DCM patients were screened for anti-KCNQ1 autoantibodies using an enzyme-linked immunosorbent assay. Autoantibodies targeting the extracellular pore domain of the KCNQ1 channel were detected in 6% of study patients. Seropositive individuals exhibited significantly shorter corrected QT intervals when compared with seronegative patients (371 ± 39.9 ms vs. 408 ± 47.9 ms; P = 0.036). There was no difference in clinical severity of heart failure between groups. The functional significance of anti-KCNQ1 antibodies was determined in human embryonic kidney 293 cells expressing KCNQ1/KCNE1 using the whole-cell patch clamp technique. IKs recordings demonstrated a 2.7-fold increase in mean current density on exposure to patients' sera containing anti-KCNQ1 antibodies in contrast to seronegative controls (8.74 ± 1.44 pA/pF vs. 3.26 ± 0.36 pA/pF; P = 0.003). IKs enhancement was not associated with increased KCNQ1 protein levels or altered cell surface expression of the channel.Anti-KCNQ1 autoantibodies found in a subgroup of DCM patients are associated with QT interval shortening and increased IKs current.