tbuckley/cabot-search huggingface dataset:
Limitations of Impedance Plethysmography in the Diagnosis of Clinically Suspected Deep-Vein Thrombosis
Authors: David R. Anderson
Journal: Annals of Internal Medicine (1993)

Objective: To reevaluate the accuracy of impedance plethysmography (IPG) for the detection of proximal deep-vein thrombosis (DVT). Patients: A total of 384 of 390 consecutive outpatients referred with their first episode of clinically suspected DVT. Setting: University-based tertiary care medical center associated with a cancer clinic. Design: A retrospective analysis of a cohort of patients whose data were recorded and stored prospectively on a computerized data base over a 22-month period. Measurements: Patients were evaluated by a physician and underwent IPG testing. Patients with abnormal IPG tests and those with normal IPG results in whom there was a high clinical suspicion of DVT or in whom follow-up IPG testing was not feasible were referred for venography. Venography and IPG results were interpreted by a panel of independent observers. Two models of the IPG instrument were used (Codman 200 and Electrodiagnostic Instruments 800). Results: Venography (or compression ultrasound) was done in 57 patients with an abnormal IPG test and in 85 patients with normal IPG results. Impedance plethysmography was abnormal in only 37 of 56 patients with confirmed proximal-vein thrombosis (sensitivity, 66%; 95% CI, 52% to 78%). Of the 57 patients with an abnormal IPG result, 37 had DVT (positive predictive value, 65%). The sensitivity for the detection of proximal DVT did not differ between the IPG 200 and 800 instruments (sensitivity, 63% and 71%, respectively; P > 0.2). Of the 19 proximal-vein thrombi not detected by IPG, 12 (63%) were occlusive and 11 (58%) involved at least the popliteal and superficial femoral veins. Conclusions: At our center, IPG has a far lower sensitivity for proximal-vein thrombosis than has been previously reported for symptomatic outpatients. The reason for this low sensitivity is unclear. Our findings indicate that centers using IPG as the initial diagnostic test for suspected DVT should be aware of this potential problem and should consider reevaluating the sensitivity of their IPG machines by performing venography in a cohort of their patients with normal test results.
Applying research evidence to individual patients
Authors: F. Godlee
Journal: BMJ (1998)

Clinical review p 1660 

At the heart of clinical medicine is an unresolved conflict—between the essentially case based nature of clinical practice and the mainly population based nature of the research evidence. While clinicians are exhorted to use up to date research evidence to give patients the best possible care, actually doing so in individual patients is difficult. The reasons are well known.1 The research literature is poorly organised,2 largely of poor quality and irrelevant to clinical practice,3 often conflicting, and often not there at all.4 The most valid and, at first sight, relevant information may be based on highly selected groups of patients bearing little resemblance to the patient in front of you. And statistical probabilities may mean little to you or your …
The effect of reserpine and guanethidine on carbohydrate metabolism in ischaemic rat myocardium
Authors: V. METZ, W. BERNAUER
Journal: Cardiovascular Research (1989)

We have investigated the role of endogenous catecholamines in myocardial carbohydrate metabolism in isolated, perfused rat hearts after left coronary artery occlusion for 30 min. A significant decrease in ATP and glycogen, and an increase in glucose-6-phosphate (G-6-P) content in the ischaemic myocardium was obtained. After depletion of the cardiac noradrenaline stores by reserpine or guanethidine pretreatment the increase in the G-6-P levels was very markedly enhanced, and the myocardial glycogen content of non-ischaemic control hearts was significantly increased by reserpine. However, the amount of glycogen broken down during the ischaemia in pretreated animals was similar to that in the ischaemic myocardium from control animals, and the decrease in the myocardial ATP was not altered by reserpine or guanethidine. Thus the well known release of noradrenaline during myocardial ischeamia is not an essential prerequisite for the activation of the ischaemic breakdown of glycogen. Rather, it is of importance for later steps in anaerobic carbohydrate metabolism, probably for the activation of phosphofructokinase, as suggested by the large ischaemic accumulation of G-6-P in noradrenaline depleted hearts.
Pulmonary metastases from basal-cell carcinoma of skin.
Authors: A Sakula
Journal: Thorax (1977)

Although rodent ulcers are a relatively common malignant condition of the skin, pulmonary metastases arising from them are extremely rare. There have so far been only 29 authenticated reports of this condition. A further case is described of a man who, at the age of 35, developed a rodent ulcer (typical basal-cell carcinoma) on the forehead. Despite local excisions, skin grafting, and radiotherapy, the ulcer continued to recur, although there was no spread to regional lymph nodes. When he was aged 52, he developed widespread bilateral pulmonary lesions and a right pleural effusion. Thoracotomy provided a lung biopsy which showed the typical histological appearance of basal-cell carcinoma. He died aged 54, 19 years after the onset of the rodent ulcer, and necropsy confirmed that the pulmonary lesions were bloodborne metastases of basal-cell carcinoma.
A Six-Gene Signature Predicts Survival of Patients with Localized Pancreatic Ductal Adenocarcinoma
Authors: Jeran K. Stratford, David J. Bentrem, Judy M. Anderson, Cheng Fan, Keith A. Volmar, J. S. Marron, Elizabeth D. Routh, Laura S. Caskey, Jonathan C. Samuel, Channing J. Der, Leigh B. Thorne, Benjamin F. Calvo, Hong Jin Kim, Mark S. Talamonti, Christine A. Iacobuzio-Donahue, Michael A. Hollingsworth, Charles M. Perou, Jen Jen Yeh
Journal: PLoS Medicine (2010)

Background Pancreatic ductal adenocarcinoma (PDAC) remains a lethal disease. For patients with localized PDAC, surgery is the best option, but with a median survival of less than 2 years and a difficult and prolonged postoperative course for most, there is an urgent need to better identify patients who have the most aggressive disease. Methods and Findings We analyzed the gene expression profiles of primary tumors from patients with localized compared to metastatic disease and identified a six-gene signature associated with metastatic disease. We evaluated the prognostic potential of this signature in a training set of 34 patients with localized and resected PDAC and selected a cut-point associated with outcome using X-tile. We then applied this cut-point to an independent test set of 67 patients with localized and resected PDAC and found that our signature was independently predictive of survival and superior to established clinical prognostic factors such as grade, tumor size, and nodal status, with a hazard ratio of 4.1 (95% confidence interval [CI] 1.7–10.0). Patients defined to be high-risk patients by the six-gene signature had a 1-year survival rate of 55% compared to 91% in the low-risk group. Conclusions Our six-gene signature may be used to better stage PDAC patients and assist in the difficult treatment decisions of surgery and to select patients whose tumor biology may benefit most from neoadjuvant therapy. The use of this six-gene signature should be investigated in prospective patient cohorts, and if confirmed, in future PDAC clinical trials, its potential as a biomarker should be investigated. Genes in this signature, or the pathways that they fall into, may represent new therapeutic targets. Please see later in the article for the Editors' Summary
Molecular and cellular basis of deficiency of the b subunit for factor XIII secondary to a Cys430-Phe mutation in the seventh Sushi domain.
Authors: T Hashiguchi, A Ichinose
Journal: Journal of Clinical Investigation (1995)

We studied the defect responsible for deficiency of the b subunit for factor XIII in the first known case of this condition. The patient is a compound heterozygote of two genetic defects: deletion of A-4161 at the acceptor splice junction of intron A, resulting in a loss of the obligatory AG splicing sequence; and, replacement of G-11499 by T in exon VIII, resulting in an amino acid substitution of Cys430 by Phe. To determine how the latter mutation impaired b subunit synthesis, recombinant b subunit bearing the mutation was expressed in BHK cells. The mutant as well as wild-type b subunit was synthesized by the cells. However, the apparent molecular weight of the mutant was slightly higher than those of the wild-type and plasma b subunits under nonreducing conditions, probably because of destruction of a disulfide bond. The mutant b subunit was secreted from the cells much less effectively than the wild type and remained susceptible to endoglycosidase H, indicating that it was not transported from the endoplasmic reticulum to the Golgi apparatus where the processing of oligosaccharides occurs. Immunofluorescence study suggested that the mutant protein was retained in the endoplasmic reticulum. These studies demonstrate that a Cys430-Phe mutation does not prevent the de novo synthesis of the b subunit, but alters the conformation of the mutant protein sufficiently to impair its intracellular transport, resulting in its deficiency in this patient.
A decision analysis of allogeneic hematopoietic stem cell transplantation in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia in first remission who have an HLA-matched sibling donor
Authors: S Kako, S Morita, H Sakamaki, H Ogawa, T Fukuda, S Takahashi, H Kanamori, M Onizuka, K Iwato, R Suzuki, Y Atsuta, T Kyo, T Sakura, I Jinnai, J Takeuchi, Y Miyazaki, S Miyawaki, K Ohnishi, T Naoe, Y Kanda
Journal: Leukemia (2010)
SUGGESTION OF SPIROCHAETA NEOTROPICALIS AS NAME FOR SPIROCHETE OF RELAPSING FEVER FOUND IN PANAMA
Authors: Lewis B. Bates
Journal: JAMA (1922)

<h3>To the Editor:</h3> —Work recently done has proved that the spirochete of relapsing fever in Panama is transmitted by the human tick<i>Ornithodoros talaje</i>, and that this spirochete is of a distinct species, variety or strain from the commonly recognized relapsing fever spirochetes,<i>S. obermeieri, S. novyi, S. kochi, S. duttoni</i>and<i>S. carteri</i>. Thus far we have called the organism referred to above the spirochete of Panama, but now feel that the time has come to give it a specific name.<i>S. novyi</i>is generally recognized as the relapsing fever spirochete of North America. Agglutination and immunologic tests demonstrate that the spirochete found in Panama differs as markedly from<i>S. novyi</i>as<i>S. novyi</i>does from the Old World strains. The surface of the earth is divided by zoologists into six regions, namely, the Palearctic, the Oriental, the Australasian, the Ethiopian, the Nearctic and the Neotropical regions. The boundaries
Let them eat asparagus
Authors: W A Macrae, H T O Davies
Journal: BMJ (1997)

Editor—Through the letterboxes of residents of East Fife recently dropped a booklet entitled Eating for Health published by the Health Education Board for Scotland.1 Tucked into the booklet was a letter from Lord James Douglas-Hamilton, minister of state at the Scottish Office, exhorting us all to read and digest the contents. The booklet gives advice about healthy eating—we should all eat more bread, cereals, fruit, and …
Neuroblastoma: mlBG in its Diagnosis and Management
Authors: James M. Mountz, Donald M. Wieland, Brahm Shapiro, Barry L. Shulkin
Journal: Clinical Nuclear Medicine (1990)

MOUNTZ, JAMES M. M.D. PH.D.; WIELAND, DONALD M. PH.D.; SHAPIRO, BRAHM M.B., CH.B., PH.D.; SHULKIN, BARRY L. M.D. Author Information
Ki-Lymphoma and Interleukin-6
Authors: Razelle Kurzrock
Journal: Annals of Internal Medicine (1998)

Letters15 March 1998Ki-Lymphoma and Interleukin-6Razelle Kurzrock, MDRazelle Kurzrock, MDUniversity of Texas M.D. Anderson Cancer Center; Houston, TX 77030Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-6-199803150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Kubonishi and colleagues describe high serum levels of interleukin-6 in two patients with aggressive Ki-1 lymphoma. They further demonstrate that expression of interleukin-6 RNA and protein is absent in cell lines derived from these two patients, whereas expression of RNA for the interleukin-6 receptor is present. In addition, interleukin-6 could stimulate proliferation of the patients' lymphoma cells in vitro, suggesting a paracrine growth mechanism.These results are of interest. We have shown that high serum interleukin-6 levels are present and that they correlate with poor prognosis in both Hodgkin and non-Hodgkin lymphoma [1-3]. Indeed, in diffuse large-cell ...References1. Seymour JF, Talpaz M, Hagemeister FB, Cabanillas F, Kurzrock R. Clinical correlates of elevated serum levels of interleukin-6 in patients with untreated Hodgkin's disease. Am J Med. 1997; 102:21-8. Google Scholar2. Seymour JF, Talpaz M, Cabanillas F, Wetzler M, Kurzrock R. Serum interleukin-6 levels correlate with prognosis in diffuse large-cell lymphoma. J Clin Oncol. 1995; 13:575-82. Google Scholar3. Preti HA, Cabanillas F, Talpaz M, Tucker SL, Seymour JF, Kurzrock R. Prognostic value of serum interleukin-6 in diffuse large-cell lymphoma. Ann Intern Med. 1997; 127:186-94. Google Scholar4. Voorzanger N, Touitou R, Garcia E, Delecluse HJ, Rousset F, Joab I, et al. Interleukin (IL)-10 and IL-6 are produced in vivo by non-Hodgkin's lymphoma cells and act as cooperative growth factors. Cancer Res. 1996; 56:5499-505. Google Scholar5. Yee C, Biondl A, Wang XH, Iscove NN, de Sousa J, Aarden LA, et al. A possible autocrine role for interleukin-6 in two lymphoma cell lines. Blood. 1989; 74:798-804. Google Scholar Author, Article, and Disclosure InformationAuthors: Razelle Kurzrock, MDAffiliations: University of Texas M.D. Anderson Cancer Center; Houston, TX 77030 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1998Volume 128, Issue 6Page: 506-507KeywordsCell proliferationDiffuse large B-cell lymphomaForecastingHodgkin lymphomaLymphomaLymphoproliferative disorderMultivariate analysisProteinsRNA ePublished: 15 August 2000 Issue Published: 15 March 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Impact of Specific Toy Warning Labels
Authors: Jean A. Langlois, Beth A. R. Wallen, Stephen P. Teret, Linda A. Bailey, J. Henry Hershey, Mark O. Peeler
Journal: JAMA (1991)

According to the 1980 Consumer Product Safety Commission's small parts standard, toys with small parts that pose a choking hazard cannot be marketed for children under the age of 3 years. To comply with the standard, toy manufacturers place age labels on packaging to indicate the ages for which toys with small parts are recommended. We conducted a survey of 199 toy buyers to determine the degree to which they understood such labels as warnings and whether more explicit warning labels would affect toy buyers' willingness to purchase toys with small parts for children between 2 and 3 years of age. Forty-four percent of respondents said they would buy for a child between 2 and 3 years of age a toy with the label "Recommended for 3 and up"; only 5% said they would buy for a young child a toy with the label "Not recommended for below 3--small parts." These findings indicate that a change in the small parts standard to require more specific labeling might substantially reduce potentially hazardous toy purchases.
Normalization of blood glucose in diabetic rats with phlorizin treatment reverses insulin-resistant glucose transport in adipose cells without restoring glucose transporter gene expression.
Authors: B B Kahn, G I Shulman, R A DeFronzo, S W Cushman, L Rossetti
Journal: Journal of Clinical Investigation (1991)

Evidence is emerging for a direct role of glucose, independent of changes in insulin, in the regulation of cellular glucose transport and glucose utilization in vivo. In this study we investigate potential cellular and molecular mechanisms for this regulatory effect of glucose by determining how normalization of glycemia without insulin therapy in diabetic rats influences 3-O-methylglucose transport and the expression and translocation of two genetically distinct species of glucose transporters (GTs) in adipose cells. These results are compared with alterations in glucose disposal in vivo measured by euglycemic clamp. In rats rendered diabetic by 90% pancreatectomy, insulin-stimulated glucose transport in adipose cells is decreased 50% in parallel with reduced insulin-mediated glucose disposal in vivo. Levels of adipose/muscle GTs measured by immunoblotting are decreased in adipose cell subcellular membrane fractions, as are the corresponding mRNA levels assessed by Northern blotting of total adipose cell RNA. Normalization of blood glucose in diabetic rats with phlorizin, which impairs renal tubular glucose reabsorption and thus enhances glucose excretion, restores insulin-stimulated glucose transport in adipose cells and insulin-mediated glucose disposal in vivo. Importantly, levels of the adipose/muscle GT protein remain 43% reduced in the low-density microsomes in the basal state and 46% reduced in the plasma membranes in the insulin-stimulated state. Adipose/muscle GT mRNA levels remain approximately 50% depressed. Levels of the HepG2/brain GT protein and mRNA are unaltered by diabetes or phlorizin treatment. Thus, changes in ambient glucose independent of changes in ambient insulin can regulate the glucose transport response to insulin in isolated adipose cells and changes in responsiveness parallel alterations in glucose uptake in vivo. Since this effect can occur without alteration in the expression of the two species of glucose transporters present in adipose cells or in their translocation to the plasma membrane in response to insulin, it may result from changes in GT functional activity.
[759] ADIPONECTIN PROTECTS AGAINST FATTY ACIDS-INDUCED IMPAIRMENT OF ENDOTHELIAL FUNCTION IN VITRO. IMPLICATIONS FOR VASCULAR DYSFUNCTION IN NON-ALCOHOLIC FATTY LIVER DISEASE
Authors: G. Soardo, C. Pagano, D. Donnini, C. Milocco, L. Hasan, L. Domenis, D. De Silvestri, D. Cappello, R. Vettor, L.A. Sechi
Journal: Journal of Hepatology (2007)
Selective Potentiation of Peripheral Chemoreflex Sensitivity in Obstructive Sleep Apnea
Authors: Krzysztof Narkiewicz, Philippe J. H. van de Borne, Catherine A. Pesek, Mark E. Dyken, Nicola Montano, Virend K. Somers
Journal: Circulation (1999)

Background —The chemoreflexes are an important mechanism for regulation of both breathing and autonomic cardiovascular function. Abnormalities in chemoreflex mechanisms may be implicated in increased cardiovascular stress in patients with obstructive sleep apnea (OSA). We tested the hypothesis that chemoreflex function is altered in patients with OSA. Methods and Results —We compared ventilatory, sympathetic, heart rate, and blood pressure responses to hypoxia, hypercapnia, and the cold pressor test in 16 untreated normotensive patients with OSA and 12 normal control subjects matched for age and body mass index. Baseline muscle sympathetic nerve activity (MSNA) was higher in the patients with OSA than in the control subjects (43±4 versus 21±3 bursts per minute; P &lt;0.001). During hypoxia, patients with OSA had greater increases in minute ventilation (5.8±0.8 versus 3.2±0.7 L/min; P =0.02), heart rate (10±1 versus 7±1 bpm; P =0.03), and mean arterial pressure (7±2 versus 0±2 mm Hg; P =0.001) than control subjects. Despite higher ventilation and blood pressure (both of which inhibit sympathetic activity) in OSA patients, the MSNA increase during hypoxia was similar in OSA patients and control subjects. When the sympathetic-inhibitory influence of breathing was eliminated by apnea during hypoxia, the increase in MSNA in OSA patients (106±20%) was greater than in control subjects (52±23%; P =0.04). Prolongation of R-R interval with apnea during hypoxia was also greater in OSA patients (24±6%) than in control subjects (7±5%) ( P =0.04). Autonomic, ventilatory, and blood pressure responses to hypercapnia and the cold pressor test in OSA patients were not different from those observed in control subjects. Conclusions —OSA is associated with a selective potentiation of autonomic, hemodynamic, and ventilatory responses to peripheral chemoreceptor activation by hypoxia.
Doctors question India's polio strategy after surge in number of cases
Authors: Ganapati Mudur
Journal: BMJ (2006)

A surge in the number of cases of polio this year in India, has prompted the Indian Medical Association to question India's eradication strategies.

India has already recorded a total of 258 cases of polio this year, against only 66 in 2005. Eight states have confirmed polio cases, but most have been clustered around the district of Moradabad in the northern state of Uttar Pradesh. Health officials are worried that the outbreak is increasing the risk of further domestic and international spread of the wild polio virus.

Federal health officers have attributed the outbreak to poor delivery of vaccines by state health staff. “Vaccine coverage had dropped in this …
The Evolution of Small Insertions and Deletions in the Coding Genes of Drosophila melanogaster
Authors: Zechen Chong, Weiwei Zhai, Chunyan Li, Min Gao, Qiang Gong, Jue Ruan, Juan Li, Lan Jiang, Xuemei Lv, Eric Hungate, Chung-I Wu
Journal: Molecular Biology and Evolution (2013)

Studies of protein evolution have focused on amino acid substitutions with much less systematic analysis on insertion and deletions (indels) in protein coding genes. We hence surveyed 7,500 genes between Drosophila melanogaster and D. simulans, using D. yakuba as an outgroup for this purpose. The evolutionary rate of coding indels is indeed low, at only 3% of that of nonsynonymous substitutions. As coding indels follow a geometric distribution in size and tend to fall in low-complexity regions of proteins, it is unclear whether selection or mutation underlies this low rate. To resolve the issue, we collected genomic sequences from an isogenic African line of D. melanogaster (ZS30) at a high coverage of 70× and analyzed indel polymorphism between ZS30 and the reference genome. In comparing polymorphism and divergence, we found that the divergence to polymorphism ratio (i.e., fixation index) for smaller indels (size ≤10 bp) is very similar to that for synonymous changes, suggesting that most of the within-species polymorphism and between-species divergence for indels are selectively neutral. Interestingly, deletions of larger sizes (size ≥11 bp and ≤30 bp) have a much higher fixation index than synonymous mutations and 44.4% of fixed middle-sized deletions are estimated to be adaptive. To our surprise, this pattern is not found for insertions. Protein indel evolution appear to be in a dynamic flux of neutrally driven expansion (insertions) together with adaptive-driven contraction (deletions), and these observations provide important insights for understanding the fitness of new mutations as well as the evolutionary driving forces for genomic evolution in Drosophila species.
Neuroendocrine differentiation in breast carcinoma with osteoclast-like giant cells. Report of a case and review of the literature
Authors: Immmacolata Cozzolino, Giuseppe Ciancia, Gennaro Limite, Rosa Di Micco, Valeria Varone, Antonio Cortese, Alessandro Vatrella, Vincenzo Di Crescenzo, Pio Zeppa
Journal: International Journal of Surgery (2014)