tbuckley/cabot-search huggingface dataset:
Rheumatology Examination and Injection Techniques
Authors: David H. Neustadt
Journal: Annals of Internal Medicine (1999)

Medical Writings: Book Notes3 August 1999Rheumatology Examination and Injection TechniquesDavid H. Neustadt, MDDavid H. Neustadt, MDUniversity of Louisville School of Medicine, Louisville, Kentucky. (Neustadt)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-3-199908030-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Second edition. 164 pages. Doherty M, Hazleman BL, Hutton CW, Maddison PJ, Perry JD; eds. Philadelphia: WB Saunders; 1998. $75.00. ISBN0702023876. Order phone 800-545-2522.Field of medicine: Rheumatology and medical orthopedics.Format: Hardcover book.Audience: General internists, family physicians, physiatrists, house staff in rheumatology and orthopedics, nurses, and occupational and physical therapists.Purpose: To improve clinical skills in the diagnosis and assessment of arthritis and rheumatic diseases, with an emphasis on examination of the musculoskeletal system. Some instruction on the principles and techniques of arthrocentesis and joint injections is included.Content: The first section includes a basic introduction with a ... Author, Article, and Disclosure InformationAffiliations: University of Louisville School of Medicine, Louisville, Kentucky. (Neustadt) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 August 1999Volume 131, Issue 3Page: 235KeywordsArthritisCorticosteroid therapyKneesMusculoskeletal systemOrthopedicsRheumatologySoft tissuesSpineSynovial fluidWalking ePublished: 15 August 2000 Issue Published: 3 August 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Pharmacological Enhancement of α-Glucosidase by the Allosteric Chaperone N-acetylcysteine
Authors: Caterina Porto, Maria C Ferrara, Massimiliano Meli, Emma Acampora, Valeria Avolio, Margherita Rosa, Beatrice Cobucci-Ponzano, Giorgio Colombo, Marco Moracci, Generoso Andria, Giancarlo Parenti
Journal: Molecular Therapy (2012)

Pompe disease (PD) is a metabolic myopathy due to the deficiency of the lysosomal enzyme α-glucosidase (GAA). The only approved treatment for this disorder, enzyme replacement with recombinant human GAA (rhGAA), has shown limited therapeutic efficacy in some PD patients. Pharmacological chaperone therapy (PCT), either alone or in combination with enzyme replacement, has been proposed as an alternative therapeutic strategy. However, the chaperones identified so far also are active site-directed molecules and potential inhibitors of target enzymes. We demonstrated that N-acetylcysteine (NAC) is a novel allosteric chaperone for GAA. NAC improved the stability of rhGAA as a function of pH and temperature without disrupting its catalytic activity. A computational analysis of NAC–GAA interactions confirmed that NAC does not interact with GAA catalytic domain. NAC enhanced the residual activity of mutated GAA in cultured PD fibroblasts and in COS7 cells overexpressing mutated GAA. NAC also enhanced rhGAA efficacy in PD fibroblasts. In cells incubated with NAC and rhGAA, GAA activities were 3.7–8.7-fold higher than those obtained in cells treated with rhGAA alone. In a PD mouse model the combination of NAC and rhGAA resulted in better correction of enzyme activity in liver, heart, diaphragm and gastrocnemia, compared to rhGAA alone. Pompe disease (PD) is a metabolic myopathy due to the deficiency of the lysosomal enzyme α-glucosidase (GAA). The only approved treatment for this disorder, enzyme replacement with recombinant human GAA (rhGAA), has shown limited therapeutic efficacy in some PD patients. Pharmacological chaperone therapy (PCT), either alone or in combination with enzyme replacement, has been proposed as an alternative therapeutic strategy. However, the chaperones identified so far also are active site-directed molecules and potential inhibitors of target enzymes. We demonstrated that N-acetylcysteine (NAC) is a novel allosteric chaperone for GAA. NAC improved the stability of rhGAA as a function of pH and temperature without disrupting its catalytic activity. A computational analysis of NAC–GAA interactions confirmed that NAC does not interact with GAA catalytic domain. NAC enhanced the residual activity of mutated GAA in cultured PD fibroblasts and in COS7 cells overexpressing mutated GAA. NAC also enhanced rhGAA efficacy in PD fibroblasts. In cells incubated with NAC and rhGAA, GAA activities were 3.7–8.7-fold higher than those obtained in cells treated with rhGAA alone. In a PD mouse model the combination of NAC and rhGAA resulted in better correction of enzyme activity in liver, heart, diaphragm and gastrocnemia, compared to rhGAA alone.
Endoscopic removal of over-the-scope clips using a novel cutting device: a retrospective case series
Authors: Arthur Schmidt, Bettina Riecken, Michael Damm, Oscar Cahyadi, Markus Bauder, Karel Caca
Journal: Endoscopy (2014)

<b>Background and study aims:</b> Over-the-scope clips (OTSCs; Ovesco Endoscopy, Tübingen, Germany) are extensively used for treatment of gastrointestinal perforations, leakages, fistulas, and bleeding. In this report, a new method of removing OTSCs using a prototype bipolar cutting device is described. <b>Patients and methods:</b> A total of 11 patients underwent endoscopic removal of an OTSC. The OTSC was cut at two opposing sites by a prototype device (DC ClipCutter; Ovesco Endoscopy). The remaining clip fragments were extracted using a standard forceps. <b>Results:</b> Mean procedure time was 47 minutes (range 35 – 75 minutes). Cutting of the OTSC at two opposing sites was successful in all cases (100 %). Complete retrieval of all clip fragments was possible in 10 patients (91 %). The overall success rate for cutting and complete removal of the clip was 91 %. No major complications were observed. <b>Conclusions:</b> Removal of OTSCs with the prototype device was feasible and effective. The device may be valuable for OTSC removal in emergency as well as elective indications.
Weight gain between dialyses in diabetics.
Authors: J Burn, G V Gill, C T Flear
Journal: BMJ (1980)

alterations in sleep and behaviour, alopecia, and platelet dysfunction; but surely one must pay attention to acute hepatic failure3 or Reye's syndrome4 when over a dozen deaths from liver damage had been recorded at the last published count a year ago,4 and several are on the register of the Committee on Safety of Medicines.By all means let us improve emergency services to prevent damage from first or subse- quent febrile convulsions, but let us avoid the long-term use of toxic drugs of unproved benefit.
CD55 expression patterns on intestinal neuronal tissue are divergent from the brain
Authors: K A Gelderman
Journal: Gut (2004)

and objectives: In this study, we investigated how enteric plexuses protect themselves from complement mediated attack. For this purpose, the expression patterns of membrane bound complement regulatory proteins (mCRP) and their association with C3 deposition was determined. In addition, mCRP expression patterns of enteric plexuses were compared with those in the central nervous system (CNS).Immunohistochemical stainings were performed to discriminate neuronal cells from glial cells and to detect the presence of CD46, CD55, CD59, and C3d. RNA in situ hybridisation (RISH) was used to determine the cell types that produce CD55 mRNA.Enteric plexuses minimally expressed CD46 whereas CD55 and CD59 were highly expressed. CD55 expression was also observed in a ring around Auerbach's plexuses which was not observed for CD46 and CD59. C3d was deposited around the plexuses but plexus cells themselves did not stain for C3d. In contrast with CNS neurones, enteric neurones were shown to express CD55 whereas enteric glial cells did not. This was confirmed with CD55 RISH. Phospholipase C mediated cleavage of CD55 demonstrated that CD55 was most likely attached to elastic fibres surrounding the plexus. Attached CD55 might protect CD55 negative glial cells from complement mediated injury during inflammatory reactions. CD55 on elastic fibres surrounding the plexuses most likely originated from enteric neuronal cells.In contrast with the CNS, enteric neurones express CD55 and enteric glial cells lack CD55 expression. CD55, produced by neuronal cells, attached to elastic fibres surrounding the plexuses is proposed to protect the CD55 negative glial cells within plexuses.
"Locked-in" patient asks for ruling on mercy killing
Authors: C. Dyer
Journal: BMJ (2010)

A man with locked-in syndrome after a catastrophic stroke is taking legal action against the director of public prosecutions to clarify the law on mercy killing.

Tony Nicklinson is not physically capable of committing suicide even with assistance, but he wants the director of public prosecutions of England and Wales, Keir Starmer, to say whether it is always in the public interest to prosecute someone who kills another person at the victim’s request.

He is calling on Mr Starmer to issue guidelines on when he would prosecute in a case of voluntary euthanasia, as he was forced to do on assisted …
On the Treatment of Rheumatic Paralysis by Electro-Magnetism
Authors: W. Davies
Journal: BMJ (1848)

The sooner the premonitory diarrhoea is stopped, and the earlier our resources can be brought to bear, the less everywhere becomes the mortality.We believe the fact to be indubitable, not only from Indian, but from European statistics; and the more men's minds are enlightened as to the necessity of sanitary measures, and the removal of nuisances, the better chance we have in arresting the progressof the formidable epidemic.
Ventricular Tachycardia During Intravenous Urography
Authors: Robert Stadalnik
Journal: JAMA (1974)

THE incidence of reactions to intravenously given contrast agents approximates 1 in 2,000,<sup>1</sup>and mortality from the use of these agents is considerably lower, 8.6 per million to 19 per million. Death, which is usually sudden, occurs more often in older patients, frequently in association with cardiac arrest.<sup>1</sup>Electrocardiographic changes comprising ectopic atrial, junctional, or ventricular beats, bundle-branch block, and ischemic ST-T segmental changes are not uncommon.<sup>2</sup>However, the onset of ventricular tachycardia (VT) has not been reported previously, to our knowledge. During electrocardiographic monitoring in more than 100 patients undergoing intravenous urography at the Sacramento Medical Center, 2 of the more than 80 patients receiving iothalamate sodium 66.8% (Conray 400) showed an abrupt onset of VT, one, without premonitory ectopic ventricular beats. Both patients reverted to sinus rhythm after an intravenous injection of 100 mg of lidocaine (Xylocaine) was given to each. <h3>Report of Cases</h3><h3>Case</h3>
Preintervention Arterial Remodeling as an Independent Predictor of Target-Lesion Revascularization After Nonstent Coronary Intervention
Authors: George Dangas, Gary S. Mintz, Roxana Mehran, Alexandra J. Lansky, Ran Kornowski, Augusto D. Pichard, Lowell F. Satler, Kenneth M. Kent, Gregg W. Stone, Martin B. Leon
Journal: Circulation (1999)

Background —Pathological and intravascular ultrasound (IVUS) studies have documented arterial remodeling during atherogenesis. However, the impact of this remodeling process on the long-term outcome after percutaneous intervention is unknown. Methods and Results —We used preintervention IVUS to define positive and negative/intermediate remodeling in a total of 777 lesions in 715 patients treated with nonstent techniques. Positive remodeling (lesion external elastic membrane area greater than average reference) was present in 313 lesions; intermediate/negative remodeling (lesion external elastic membrane area less than or equal to reference) was present in the other 464. Baseline clinical and angiographic characteristics were similar, except for a slightly higher percentage of insulin-dependent diabetic patients (10.2% versus 6.1%; P =0.054) in the negative/intermediate-remodeling group. Angiographic success and in-hospital and short-term complications were comparable in the 2 groups. There was no significant correlation between remodeling (as a continuous variable) and final lumen area ( r =0.06) or final lesion plaque burden ( r =0.17). At 18±13 months of clinical follow-up, both groups had similar rates of death and Q-wave myocardial infarction: 3.4% and 2.5% for the negative/intermediate-remodeling group versus 2.7% and 2.7% for the positive-remodeling group. However, the target-lesion revascularization (TLR) rate was 20.2% for the negative/intermediate-remodeling group versus 31.2% for the positive-remodeling group ( P =0.007), and remodeling, as a continuous variable, was strongly correlated with probability of TLR ( P =0.0001). By multivariable logistic regression analysis, diabetes (OR=2.3), left anterior descending artery location (OR=1.8), and remodeling (OR=5.9) were independent predictors of TLR. Conclusions —Positive lesion-site remodeling is associated with a higher long-term TLR after a nonstent interventional procedure. Thus, long-term clinical outcome appears to be determined in part by preintervention lesion characteristics.
Quantitative buffy coat analysis. A new laboratory tool functioning as a screening complete blood cell count
Authors: S. C. Wardlaw
Journal: JAMA (1983)

We have developed a system for the quantitative analysis of the buffy coat in centrifuged whole blood samples. This analysis, performed in a modified microhematocrit tube, provides a hematocrit value, total WBC count, platelet count, and a separation of the leukocyte population into granulocytes and nongranulocytes. All results are available within 15 minutes and correlate well with existing methods. The system is expected to provide a rapid means of performing a complete blood cell count in a physician's office. (<i>JAMA</i>1983;249:617-620)
Rationale for the Use of Hypnotic Agents in a General Hospital
Authors: SAMUEL W. PERRY
Journal: Annals of Internal Medicine (1984)

A survey at a teaching hospital found that 46% of medical patients had prescriptions written specifically for sleep and 31% received a hypnotic agent at least once during hospitalization. Physicians for 96% of surgical patients ordered hypnotic agents and 88% received such a drug. The rationale for prescribing hypnotic agents was not well documented. Administration did not correlate with requests by patients, with previous use of hypnotic agents, or with recorded indications of sleep disturbance; however, the chance of receiving a hypnotic agent was greater if the patient was on a private instead of a ward service and if nurses were more inclined to fill as-needed prescriptions. Patients who received a hypnotic agent did not rate the quality of their sleep as being any better than those who did not, and they complained of as many awakenings during the night. Further studies are necessary to ascertain the indications and efficacy of hypnotic agents for hospitalized patients.
Randomized Comparison of Systemic Anti-inflammatory Therapy Versus Fluocinolone Acetonide Implant for Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment Trial
Authors: John H. Kempen, Michael M. Altaweel, Janet T. Holbrook, Douglas A. Jabs, Thomas A. Louis, Elizabeth A. Sugar, Jennifer E. Thorne
Journal: Ophthalmology (2011)
Abstract 3744: Measurement of Myocardial Free Radical Production in Patients with Congestive Heart Failure Using EPR Spectroscopy
Authors: Jay H Traverse, Yuri E Nesmelov, William Katsiyiannis, Daniel Melby, Chuen Tang, Adrian Almquist, Charles Gornick, David D Thomas, Robert J Bache
Journal: Circulation (2006)

Increased myocardial free radical (ROS) production may contribute to the pathogenesis of congestive heart failure (CHF). In humans, indirect measurements of oxidative stress are increased in blood ...
Turmoil at New South Wales Cancer Council
Authors: S. Chapman
Journal: BMJ (1997)

The past 12 months have been the bleakest in the history of the New South Wales Cancer Council. On 15 May its director for 12 years, Elaine Henry, left her office carrying a “please explain” letter from her politically appointed board. Seven of 17 questions put to Ms Henry arose out of the board's embarrassment after it failed to condemn swiftly enough the state health minister's weak response to a report on passive smoking. Two weeks later Ms Henry was sacked after an inquisition from the board and is now pursuing a remedy through the courts.

The Cancer Council is the state's largest and most loved health charity, …
Effectiveness of Primary Care–Based Vestibular Rehabilitation for Chronic Dizziness
Authors: Lucy Yardley, Margaret Donovan-Hall, Helen E. Smith, Bronagh M. Walsh, Mark Mullee, Adolfo M. Bronstein
Journal: Annals of Internal Medicine (2004)

Background: Dizziness is a very common symptom and is usually managed in primary care. Vestibular rehabilitation for dizziness is a simple treatment that may be suitable for primary care delivery, but its effectiveness has not yet been determined. Objective: To evaluate the effectiveness of nurse-delivered vestibular rehabilitation in primary care for patients with chronic dizziness. Design: Single-blind randomized, controlled trial. Setting: 20 general practices in southern England. Patients: 170 adult patients with chronic dizziness who were randomly assigned to vestibular rehabilitation (n = 83) or usual medical care (n = 87). Intervention: Each patient received one 30- to 40-minute appointment with a primary care nurse. The nurse taught the patient exercises to be carried out daily at home, with the support of a treatment booklet. Measurements: Primary outcome measures were baseline, 3-month, and 6-month assessment of self-reported spontaneous and provoked symptoms of dizziness, dizziness-related quality of life, and objective measurement of postural stability with eyes open and eyes closed. Results: At 3 months, improvement on all primary outcome measures in the vestibular rehabilitation group was significantly greater than in the usual medical care group; this improvement was maintained at 6 months. Of 83 treated patients, 56 (67%) reported clinically significant improvement compared with 33 of 87 (38%) usual care patients (relative risk, 1.78 [95% CI, 1.31 to 2.42]). Limitations: Psychological elements of the therapy may have contributed to outcomes, and the treatment may be effective only for well-motivated patients. Conclusions: Vestibular rehabilitation delivered by nurses in general practice improves symptoms, postural stability, and dizziness-related handicap in patients with chronic dizziness.
Genetic anomalies in mammalian germ cells and their significance for human reproductive and developmental risk.
Authors: V L Dellarco
Journal: Environmental Health Perspectives (1993)

The induction of heritable mutations in germ cells represents a potential health concern. This paper highlights data from mouse germ-cell mutagenesis studies that have implications in the assessment of reproductive and developmental risks. The paper discusses the developmental and reproductive consequences of induced chromosomal damage (structural rearrangements and numerical anomalies) and describes environmental agents that have been shown to produce such anomalies. Additionally, factors that influence the yield of genetic damage are addressed. Studies showing that the various germ-cell stages vary in their susceptibility to the induction of genetic damage are summarized. Of the chemicals evaluated in the male mouse, most appear to have their predominant or strongest effect on post-stem-cell stages. The differences between males and females in the susceptibility to mutagens is examined. Recent studies have shown that the female may be uniquely sensitive to certain mutagens. Finally, an important aspect of mutagenic risk is not only effects induced in developing germ cells but also the effects of environmental agents during the period from fertilization through the zygote and the two-cell embryo. Recent work in the mouse has demonstrated that exposure during these early developmental stages leads to high frequencies of external and visceral fetal malformations, as well as mid-to-late gestational death.
Antibody and T-Cell Receptors
Authors: Susumu Tonegawa
Journal: JAMA (1988)

A VERTEBRATE is an attractive culture medium for viruses, bacteria, fungi, and metazoan parasites. It is therefore understandable that vertebrates have had to develop a body defense mechanism directed toward these pathogens for their emergence and survival. This defense mechanism is the See also pp 1834 and 1837. immune system. The crucial event in mounting an immune response is the recognition of chemical markers that are present on infectious organisms and foreign bodies. The molecules entrusted to this task are the B-cell-synthesized antibodies and the antigen-specific T-cell receptors (TCRs). Antigens are numerous and structurally diverse. The fact that the body can produce antibodies against many artificially made chemicals and can discriminate among them attests to the vastness of the antigenic world. The antigen-binding specificity of an antibody or a TCR is determined by the amino acid sequence of the polypeptide chains that compose these proteins. The enormous diversity of antigens,
Management of traumatic intracranial haematoma.
Authors: G Teasdale, S Galbraith, L Murray, P Ward, D Gentleman, M McKean
Journal: BMJ (1982)

Deciding which head-injured patients should be transferred to a neurosurgical unit can be difficult. Traditional criteria emphasise the development of deteriorating responsiveness but lead to delayed diagnosis and to avoidable mortality and morbidity. To discover if a more liberal admission policy improved results a study was conducted analysing data collected prospectively from 683 patients who had a traumatic intracranial haematoma evacuated in the Glasgow neurosurgical unit between 1974 and 1980. In the first four years, before the change in policy, mortality was 38% but decreased to 29% afterwards. This reflected a reduction in the proportion of patients who talked after injury but who deteriorated into coma before operation--that is, 31% before the change in policy, 16% afterwards. If the potential benefits of CT scanning in the management of head injuries are to be realised patients must be scanned sooner than in the past. This will usually mean that more patients should go to a neurosurgical unit and that simple criteria for transfer should be established.
Chronic Viral Infections of the Central Nervous System
Authors: Luiz Horta-Barbosa
Journal: JAMA (1971)

Several subacute and chronic conditions of the central nervous system (CNS) of man and animals have been found to be of possible viral etiology. In man, these include subacute sclerosing panencephalitis, Creutzfeldt-Jakob disease, and kuru. In animals, scrapie, visna, and lymphocytic choriomeningitis have been transmitted by cell-free filtrates. The techniques of tissue culture, immunofluorescence, and electron microscopy have greatly contributed to a better understanding of the latent and masked viruses which cause these chronic infections of the CNS. The exceptionally long latent or incubation period of these neurological diseases results from an unusual virus-cell interaction.